Razi Journal of Medical Sciences

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1.Introduction

The Covid-19 pandemic has had serious negative effects on the physical and mental health of people around the world (1). Such effects are related to internalizing (anxiety symptoms, depression, social withdrawal and physical complaints) and externalizing (conflict, aggression and violence/delinquency) psychological behaviors (2).

Having high levels of mental health is considered to be a necessity for effective confrontation with numerous stressors during life, especially in critical situations (4). Regarding the psychological consequences, Covid-19 interpreted as a collective traumatic event can cause symptoms related to post-traumatic stress disorder. Stressful reactions to future events suggest that Covid-19 is also a traumatic stressor that can lead to PTSD symptoms (5).

Among the important variables in passing through unfamiliar stressful situations are defense mechanisms. Mental health is related not only to the application of mature defense strategies, but also, most importantly, to the appropriate use of a variety of defenses based on circumstances. In support of this, previous research has shown a negative association between adaptive defense mechanisms and perceived distress, depression, and PTSD symptoms during the COVID-19 pandemic (15).

Therefore, investigating the role of defense mechanisms as a reducing or additional effect on the effect of personality characteristics on the experience of traumatic events during the Covid-19 era, can enrich the clinical conceptualization of maladjustment problems and disorders caused by Covid-19 and provide more effective psychological treatments. follow Therefore, the researcher is trying to answer the question, what is the role of defense mechanisms in the relationship between personality traits and the experience of traumatic events during the pandemic in the employees of technology centers referring to psychiatric hospitals?
2.Methods
In terms of purpose, this study is applied, and in terms of data collection method (research design), it is considered a descriptive-correlational research. The statistical population of this study includes the employees of technology centers working in Tehran who had referred to psychiatric hospitals in Tehran to evaluate and measure public health, and 150 of them were selected as a sample. Then, the short 10-item questionnaires of the Personality Traits Questionnaire (TIPI) by Gusiling et al. (2003), the Defense Mechanisms Questionnaire (DSQ-40) and the Revised Event Impact Questionnaire by Weiss and Marmar (1997) (IES-R) between They were distributed and collected.

3.Results

The results showed that extraversion has a significant and negative effect on the experience of traumatic events (path c in Figure 1); In addition, extraversion trait on developed defenses (path a3 in Figure 1; β = 0.421) and neurotic defenses (path a2 in Figure 1; β = -0.558) and underdeveloped defenses (path a1 in Figure 1; 0.4318 β =-) had a significant effect. By simultaneously entering the three defense styles into the model, developed and underdeveloped defenses played a statistically significant role in the relationship between extraversion and the experience of traumatic events, also, the direct effect was significant after controlling for mediators (path c ' in Figure 1; 0.233β =-)).

The results showed that conscientiousness has a significant and negative effect on the experience of traumatic events (path c in Figure 2); In addition, conscientiousness trait on developed defense (path a3 in Figure 2; β = 0.4187) and neurotic defenses (path a2 in Figure 2; β = - 0.3846) and underdeveloped defense (path a1 in Figure 2; 0.2909 β =-) had a significant effect. By simultaneously entering the three defense styles into the model, developed and underdeveloped defenses played a statistically significant role in the relationship between conscientiousness and the experience of traumatic events, also, the direct effect was significant after controlling for mediators (path c ' in Figure 2; 02330β =-)).
The results showed that agreeableness has a significant and negative effect on the experience of traumatic events (path c in Figure 3); In addition, trait agreeableness on developed defenses (path a3 in Figure 3; β = 0.383) and neurotic defenses (path a2 in Figure 3; β = -0.333) and underdeveloped defenses (path a1 in Figure 3; 0.438 β =-) had a significant effect. By simultaneously entering the three defense styles into the model, developed and underdeveloped defenses played a statistically significant role in the relationship between agreeableness and the experience of traumatic events, also, the direct effect was significant after controlling for mediators (path c ' in Figure 2; 0251β =-)).

The results showed that neuroticism has a significant and positive effect on the experience of traumatic events (path c in Figure 4); In addition, trait neuroticism on developed defenses (path a3 in Figure 4; β = -0.5148) and neurotic defenses (path a2 in Figure 4; β = 0.4311) and underdeveloped defenses (path a1 in Figure 4; 0.4181 β =) had a significant effect. By simultaneously entering the three defense styles into the model, developed and underdeveloped defenses played a statistically significant role in the relationship between neuroticism and the experience of traumatic events, also, the direct effect was significant after controlling for mediators (path c ' in Figure 2; 03317β =)).

The results showed that empiricism has a significant and negative effect on the experience of traumatic events (path c in Figure 3); In addition, the empiricism trait on developed defenses (path a3 in Figure 3; β = 03556) and noetic defenses (path a2 in Figure 3; β = -0.4294) and underdeveloped defenses (path a1 in Figure 3; 0.4379β =-) had a significant effect. By simultaneously entering the three defense styles into the model, developed and underdeveloped defenses played a statistically significant role in the relationship between empiricism and the experience of traumatic events, also, the direct effect was significant after controlling for mediators (path c ' in Figure 2; 02445β =-)).

4.Discussion

The results showed that the personality trait of neuroticism has a positive and significant effect on the experience of traumatic events, both directly and indirectly. Similarly, other research has shown that individuals high in neuroticism tend to react to disappointment or loss with strong negative emotional reactions, report worse mental health after stressful events, and are more prone to The risk of post-traumatic symptoms is (12, 20).

The results also showed five protective pathways, which included agreeableness, conscientiousness, extraversion, empiricism, and neuroticism, which interacted directly with defense mechanisms and only indirectly with event impact. Specifically, all five personality traits were associated with underdeveloped defense styles, which represent a risk factor for mental health (22). In addition, conscientiousness, agreeableness, extroversion, empiricism were positively related to developed defense. All five indirect pathways moderated the experience of traumatic events, consistent with evidence in the scientific literature regarding the positive association of neuroticism and conscientiousness with psychological well-being (23).

Extroversion, empiricism showed a significant relationship with the experience of traumatic events. These results can be an expression of the special situation related to Covid-19. Previous research has shown the association of extroversion and empiricism with higher levels of positive emotions and psychological well-being (23, 24).

 

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Introduction: depression is one of the most common psychiatric disorders that its treatment imposes large amount of costs on the individual and consequently the family and society.
Depression is one of the most common psychiatric disorders, which destroys a person's innate capacity to grow and flourish, causing a disorder in a person's mental health [1] and as one of the major health problems, it is predicted that by 2030, it will be the only become the main cause of disease all over the world [2]. This serious mood disorder is accompanied by severe symptoms that affect a person's feelings, thoughts and daily life [3]. The prevalence rate of depression is higher than other mental disorders and is around 17%. In the Iranian population, the prevalence rate of depression varies between 5.69% and 73%, and among women it is reported to be 1.7 times more than men [4]. Depressed patients are part of the group of patients who do not receive adequate treatment and only half of them recover. It seems that the effective management of depression in patients requires more attention to their preferences, treatment needs, and finally the use of more comprehensive treatment packages to maximize patient participation and adequate use of the treatment method[5].
Objective: the study aimed to evaluate effectiveness acceptance and commitment therapy for cognitive flexibility, resilience and perceived stress among depressed women of Andimeshk.
Method: statistical population included all the women referring to psychiatric clinics of Andimeshk from March 2021 to March 2022. According to the inclusion criteria, 30 patients who were willing to participate in the research were randomly assigned into two groups (experiment group and control group, 15 people each). to Morrow’s questionnaire was used; for cognitive flexibility, Dennis and Vander Wal’s questionnaire and for resilience, Connor-Davidson Scale and for perceived stress, Cohen, Kamarck & Mermelstein were applied. To diagnose depression the clinical interview SCID5 was applied. The data were analyzed using analysis of covariance and evaluation of its assumptions.
Findings: the results indicated that acceptance and commitment therapy affected the depressed patients’ cognitive flexibility and perceived stress. Inferential findings showed that the treatment based on acceptance and commitment to reflection, cognitive flexibility, resilience and perceived stress of depressed patients had a significant effect. In order to align the obtained results with the research background, it can be said that the treatment based on acceptance and commitment, relying on its therapeutic principles, including the principle of acceptance, as the most basic principle of treatment, by increasing the patient's psychological acceptance of his thoughts and feelings, has been able to reduce ineffective control actions such as perceived stress are effective. Because during the above treatment method, a person learns to accept them without any internal or external reactions in order to eliminate the above reactions, then the above acceptance by the patient makes him able to act independently of such negative experiences. This has been able to lead to a reduction in and a more logical evaluation of stressful situations by the person, and this is how the perceived stress of patients has decreased. Also, by increasing the psychological and mental acceptance of the person, the above treatment has increased the patient's cognitive flexibility by actively and effectively confronting his thoughts and feelings and avoiding any avoidance.
Conclusion: the results emphasized the efficiency of this therapy for depressed patients and that it can be used as an effective interventional procedure. Treatment based on acceptance and commitment in depressed patients has resulted in their ability to use effective coping strategies. This ability causes people to have a more logical approach to the conditions of different life situations and when problems arise, they deal with them by solving the appropriate problem, and in this way, their resilience has increased. Treatment based on acceptance and commitment instead of changing cognitions increases the psychological connection of a person with his thoughts and feelings. It also increases the capacity to accept psychological experiences and commitment, meaningful, flexible, adaptive activities without considering the content of obvious experiences [60]. By clarifying values and paying them and determining the important goals of life, instead of dealing with symptoms and everyday issues, people including depressed patients learn to deal with values and what is more important in life instead of physical and mental responses. It causes a decrease in the attention and excessive sensitivity of the person to the complications of the disease.
 

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Abstract
Introduction
Addiction is a physical, mental, and social disease (1) in which multiple factors such as genetics, beliefs, unconscious processes, and mood are involved as well as developmental, social, economic, and political factors (2). Addictive and substance-related disorders have become a public concern worldwide. In fact, according to the statistics of the United Nations Office on Drugs and Crime, between 4 and 7 million people in Iran were infected with illegal addictive substances in 2003 (3).
Mental disorder is a type of illness with psychological and behavioral manifestations accompanied by disturbance in functioning caused by a biological, social, psychological, genetic or chemical disorder (7). In general, addiction and substance-related disorders are defined as a state in which a person continues to consume a substance that causes mood or behavioral changes, or suffers from neurological disorders, despite the symptoms and adverse consequences of drug use. It is derived from those behaviors (7).
Comorbidities (multiple disorders) of psychiatric disorders and drug use is a very tangible and widespread problem (8). In particular, substance use disorder in individuals with schizophrenia shows a high degree of comorbidity (9), as does substance use disorder (SUD) in populations suffering from mood disorders (10), showing a prevalence of more than 50%. For people with bipolar disorder (BD) there is substance use (11).
Substance use in both schizophrenia and bipolar disorder is associated with a more severe course and outcome. Stimulant substance use is associated with crime, violence, and homelessness in severe mental disorders, and high levels of cannabis use are associated with increased psychopathology in schizophrenia and bipolar disorder. Alcohol consumption is associated with depression in bipolar disorder. The use of multiple substances (simultaneous use) in substance use disorder is associated with schizophrenia (17). Little is known about substance use patterns and rates of use in severe mental disorders. Increasing knowledge about substance use problems for these two disorders could improve phenotypic characterization and thereby clarify the nature of the conditions. A complete description of the patient along with a detailed description of substance use can also reveal new aspects of the condition necessary to improve the treatment of these complex clinical conditions. In these patients, it seems necessary. Therefore, researchers are trying to answer the question of whether there is a difference between substance problems in schizophrenic and bipolar patients admitted to Ibn Sina Hospital in Mashhad.
Method
This study is descriptive and analytical cross-sectional. The research population included patients suffering from schizophrenia or bipolar disorder with substance use disorder admitted to Ibn Sina Hospital in Mashhad in 1400, in the number of 40 male patients, provided they met the criteria for entering the research. Since this was done for the first time, it was planned to be a pilot study and 20 patients in each group. The participants were selected based on available sampling and were examined by a psychiatrist, and the diagnosis of schizophrenia or bipolar disorder was made for the patients, and after a full explanation of the plan, they entered the plan with informed consent. In this study, PASUPP questionnaire was used to evaluate the study population. In the data analysis, the normality of the data was first checked using the one-sample Klomogrov-Smirnoff test. Chi-square test was used in the analysis of nominal scale data. Also, Pearson's correlation test was used to check the linear relationship between quantitative variables due to the normal distribution of data, and Spearman's correlation test was used to check the linear relationship between quantitative and rank variables.
Results
The results showed that there is no statistically significant difference in the score of problems related to substance dependence in two groups of patients. (P-Value>0.05). Another finding showed that there is no statistically significant difference in the score of problems related to substance dependence in two groups of patients according to age. (P-Value>0.05). It was also found that there is no significant linear relationship between age and the score of problems related to substance dependence in bipolar patients (P-Value>0.05), but in the group of schizophrenic patients, there is a relationship between age and the score of problems related to substance dependence in schizophrenia patients. There is a direct significant line with medium intensity (P-Value < 0.05) so that in these patients, as the age increases, problems related to substance dependence also increase. Also, the results showed that there is no statistically significant difference in the score of problems related to substance dependence in two groups of patients according to education. (P-Value>0.05). Finally, it was found that there is no significant linear relationship between the level of education and the score of problems related to substance dependence in both groups of bipolar and schizophrenia patients (P-Value>0.05).
Discussion
According to the data obtained from this study, in terms of gender distribution in the studied subjects, all subjects in both groups of patients were male. In the group of schizophrenic patients, there is a direct significant linear relationship between age and the score of problems related to substance dependence in schizophrenia patients with moderate severity, so that with increasing age, problems related to substance dependence also increase in these patients. Also, there is no statistically significant difference in the score of problems related to substance dependence in two groups of patients. Also, there is no statistically significant difference in the score of problems related to substance dependence in two groups of patients according to age. In the following, we will examine similar studies and examine their results.
Suicide attempt, poor compliance, longer hospitalization, shorter recovery and criminal activity were also observed more in the group of patients with bipolar disorder and SUD. The presence of a substance use disorder seems to have more statistical weight than the main diagnosis (schizophrenia vs. bipolar disorder) in predicting worse social adjustment (22).
 

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 The negative symptoms of schizophrenia still cause one of the major problems in therapeutic work with schizophrenics. Although there has been great progress in the field of pharmacology for identifying effective drugs to alleviate the negative symptoms. We are still far away from having satisfactory and successful results. The purpose of the present project is to study the effects of a type of Dopamine Agonist such as Bromocriptine on the negative symptoms of schizophrenia.

  A double-blind cross-over controlled design was applied for this study. The participants, who were chosen on the basis of their diagnosis to prevent the effects of confounding factors, caution was made to choose those patients who showed severe negative symptoms, but who did not have any of the following: depression, active psychosis, substance abuse, physical diseases drug side-effects, and did not use drugs or have disorders which contraindicated the use of Bromocriptine. Out of 60 patients under treatment for schizophrenia, 14 met the above criteria, two of which refused to participate, (n=12).

  The 12 participants were randomly assigned to the experimental and the control groups, and were observed for 13 weeks. For 6 weeks the patients in the experimental group recived 15 mg of Bromocriptine, and those in the control group receive placebo. For one week, Both groups received placebo (washing period). And for the find 6 weeks the two groups were crossed over, the former experimental group receiving placebo, and the former control group receiving 15 my of bromocriptine. For measuring the effects of the drug on the positive and negative symptoms, the PANSS which is a standardized instrument for this purpose was applied.

  The data was analyzed by wileoxon, using the SPSS computer program, in two different ways. The results of the analysis showed that adding a Dopamine Agonist such as Bromocriptine to the drug regimen, can have significant effects on the negative symptoms of patients with schizophrenia. Bromocriptine can, not only reduce the negative symptoms of schizophrenia if can also prevent the risk of psychosis.

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This study was a comparative evaluation conducted to assess the effectiveness of cognitive-behavioral religious-cultural therapy in addition to medication treatment versus medication treatment alone and cognitive-behavioral therapy in addition to medication treatment in improvement of anxiety disorder (obsessive-compulsive). 15 obsessive-compulsive patients (5 males & 10 females) with religious background were randomly assigned into three groups: 1) Cognitive-behavioral religious-cultural therapy in addition to medication treatment (CBRCT, add. M), 2) Medication treatment alone (clomipramine or Fluoxetine), 3) Cognitive-behavioral therapy in addition to medication treatment (CBT, add. M). The subjects’ religious affiliation was determined by religious attitude questionnaire. All patients were evaluated before the commencement of treatment and, once again, eight weeks after the treatment by Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Yale-Brown Obsessive-Compulsive Scales, a checklist of obsessive behaviors, religious beliefs questionnaire and dysfunctional attitude questionnaire. The results were analyzed and further interpreted by chi-squared test(X2) and one-way analysis of variance (ANOVA). The results showed that both cognitive-behavioral religious-cultural therapy in addition to medication treatment and cognitive-behavioral therapy in addition to medication treatment were effective in reducing the severity of anxiety symptoms, depression, obsession, and dysfunctional beliefs and attitudes. Medication treatment alone was only effective in reducing symptoms of depression and obsession, while it was not effective in reducing anxiety or dysfunctional beliefs and attitudes. Cognitive-behavioral religious-cultural therapy in addition to medication treatment was more effective than medication treatment alone, but in comparison with cognitive-behavioral therapy in addition to medication treatment was less effective. Based on the statistical analysis of findings, the addition of religious cultural components to cognitive-behavioral therapy was not necessarily effective in improvement of religious patients with symptoms of obsessive- compulsive disorder however, the raw scores of improvement indices were higher in subjects receiving cognitive–behavioral religious-cultural therapy in addition to medication treatment than the other groups.

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    Background & Aim: Following the increasing rate of suicide and its outcomes in recent decades, WHO introduced its attempt to decrease suicide rate as one of its aims in world health program by 2000. As a part of multinational project of World Health Organization, this study was undertaken to determine demographic characteristics of suicide attempters attending emergency ward of Karaj Hospitals in 2003-2004. Patients & Methods: Statistical population of this study was all suicide attempters attending emergency department of Karaj hospitals, out of whom 632 attendants ready to participate in the study were selected. Demographic variables, method of suicide, time and place of doing suicide, frequency of attempts and use of health services were all collected by hospital records, as well as interview with accompanies and patients. This cross-sectional study was conducted as a part of multinational projects of WHO between 2003-2004. T-test and chi-square test were used for data analysis. Results: Most of suicide attempters were female(62.5%), single(53.6%), with high school education(52.8%). The mean age was 24.5(±9) years. Suicide attempters were unemployed(29.8%) and housewife(67.5%) in male and female group respectively. There was a positive history of suicide in relatives in 15.4% of attempters(97 subjects). 28% of subjects had previous attempt and 23.7% of them reported a poor physical health in the past 3 months before attempt. Conclusion: Unemployed, female, single individuals, married females, and housewives are at risk of suicide more than others.

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    Background & Aim: Almost any medical illness that causes significant pain or discomfort may negatively affect the quality of sleep. Illnesses affecting cardiovascular, respiratory, gastrointestinal, and nervous systems and injuries disrupt the quality of sleep. The objective of this study is to investigate the parameters of sleep and the factors affecting the quality of sleep in medically ill patients. Patients and Method: In a descriptive cross-sectional study, a total of 300 medical patients with various somatic complaints who attended internal, ENT, orthopedic, neurology, urology and surgery clinics were selected. The assessment instrument was Pittsburgh Sleep Quality Index(PSQI) which measures the quality of sleep in 7 major domains. A score of >5 is considered as a significant sleep disturbance. The data were analyzed using descriptive statistics and one-way ANOVA. Results: The mean PSQI score of the patients from all six selected clinics was higher than anchor point(M=8.02). Significant differences were found in sleep duration, sleep disturbances and daytime dysfunction among the clinics. Pain and worry were the major causes of sleep disturbances. Conclusion: Based on the findings of this study, the majority of medical conditions can cause sleep disturbances per se. Because pain and worry may adversely affect the quality of sleep, they should be considered in the assessment and treatment of various medical conditions.

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  Background: The stigma associated with mental illness adds to the public health burden of mental illness itself. In general terms stigma is the status loss and discrimination triggered by negative stereotypes. To our knowledge, this is not any large scale study of knowledge of and attitudes towards mental illness in Iran. Therefore, the aim of this study was to determine the knowledge and attitude of a community sample towards mental illness in city of Tehran.

  Methods: This cross-sectional study was conducted in city of Tehran between April and December 2009. By a multistage random sampling of household respondents, 800 subjects were recruited in the study. A modified version of the questionnaire developed for the "World Psychiatric Association Program to Reduce Stigma and Discrimination" was used. The method of collecting data was interview by trained interviewers. We used SPSS V.13 software for describing and analyzing data. Chi-square was used for subgroup analyses.

  Results: The mean age of sample was 37.5 years (14.7 yrs) with 53.3% being males. Most of them (70%) mentioned that mental illness is treatable out of hospital and 74% of them believed patients with mental illness could have ordinary jobs. About 68% had a positive attitude towards friendly relationship with mental illness patients. About 52.5% of the subjects believed that people with mental illness are dangerous because of their violent behaviors. Only 17% of subjects were afraid of having conversation with a mentally ill person. Generally, socio-demographic variables were not associated with knowledge and attitudes of peoples towards mental illness strongly.

  Conclusion: There is not extensive stigmatization of mental illness in our sample. Compared to other similar studies, the views and attitudes of our sample towards mental illness were partially good and acceptable.

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  Background : Our purpose in this research was to evaluate the correlation between skill in chess (international chess rating scale) and severity of depression and anxiety and ten cognitive errors in members of Iranian Chess Federation that have international chess rating scale as well as to study the prevalence of depression and anxiety in the sample.

  Methods: 96 persons that had an international chess rating scale were sampled with convenient method and took part in this cross sectional study. All samples completed the second version of Beck Depression Inventory, Beck Anxiety Inventory and Cognitive Error Test. Data were analyzed with SPSS software.

  Results: There was a significant reverse correlation between chess rating scale and four cognitive errors including over generalization, magnification, jumping to conclusion and must statement. The depression severity decreased by increasing the numbers of hours of game playing in the day. Also there was a reverse significant correlation between chess skill and depression severity, but chess skill had no significant correlation with severity of anxiety. The prevalence of mild moderate depression was 16.7%. There was no case with severe depression. The prevalence of mild and moderate anxiety was 27.1% and severe anxiety was 5.2%.

  Conclusion: We conclude that this significant reverse correlation between chess rating scales and depression severity is mediated by decrease of cognitive errors and the number of the hours of game playing in the day, which is in accordance with Beck's Cognitive Theory and Behavioral Activation Theory.

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Background: The aim of this study is to evaluate the prevalence of sexual dysfunctions and their related factors in women referring to health clinics in Tehran.

 

Method: The study was performed as a descriptive analytic study. For this purpose, 405 married women were selected from 4 clinics of four geographic areas (north, south, west and east) in Tehran city (30 people from each center) through randomized and multistage sampling. The assessment was done by using demographic questionnaire and Sexual Function Questionnaire (SFQ). The research data were analyzed by independent t-test and one-way ANOVA and correlation test.

 

Results: The results of data analysis showed general prevalence of sexual dysfunction in women were 31%, so that the prevalence of hypoactive sexual desire was 33%, the prevalence of sexual arousal disorder was 16.5%. The prevalence of orgasmic disorder was 25% and the prevalence of painful sexual disorder (dyspareunia) was 45.5%.

 

Conclusion: The assessment of related factors showed that age of women, duration of marriage, positive history of psychiatric disorders and using psychotropic medication and also history of sexual abuse had significant correlation with sexual dysfunction.

 

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Background: Obesity is a complex physical disorder caused by different biological, psychological, and social factors. Identification of the psychological factors and consequences of obesity is one of the main elements of its control and treatment. The present study was carried out to compare depression and quality of life in the obese women with different body mass indices (BMIs) with the normal women.

 

Methods: for each three groups of obesity 40 and in total 120 women were selected of all the visitors of the Minimally Invasive Surgery Research Center of Tehran University of Medical Sciences using convenience sampling method and based on the BMI table in a causal-comparative design. Forty women were the normal women sample. Instruments of the study were composed of a questionnaire of personal information, Beck Depression Inventory (second version), and Health-Related Quality of Life Questionnaire (SF-36). The data were analyzed using Multi-Variable Analysis of Variance (MANOVA), One Way Analysis of Variance (ANOVA), Bonferroni Post hoc test, and Pearson’s correlation coefficient as well as the SPSS software.

 

Results: the results suggested a significant difference between the obese women in different levels of BMI and the normal ones concerning depression and quality of life at p<0.001. In addition, it was revealed that there is a significant negative difference among the obese women in different levels of BMI concerning depression and quality of life at p<0.001.

Conclusion: Regarding the different psychological variables such as depression in obesity, psychological interventions can be useful in the prevention, control, and treatment of obesity as well as promotion of the patients’ quality of life.
  

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Background: Psychiatric disorders and behavioral disturbance are prevalent in epileptic patients and in previous studies the reported rates of personality disorders range from 4% to 38%. Comorbidity of personality disorders in epileptic patients could cause dysfunction, poor compliance, maladjustment and other psychological distresses which are important in the treatment of epilepsy, therefore the diagnosis and treatment of personality disorders could be helpful in management of epilepsy. The aim of this study was assessment of personality disorders in epileptic patients.

 

Methods: The samples were recruited from epilepsy clinic of Rasoul Akram Hospital. Characteristics of epilepsy were collected by reviewing the files and assessments such as EEG and interviewing with patients. Personality disorders were assessed by MCMI III.

 

Results: the most prevalent personality disorder was depressive personality and 36% of the patients had at least one personality disorder. The socio-economic status in patients with personality disorder was poorer, but characteristics of epilepsy had no significant relationship with comorbidity of personality disorders.

Conclusion: Personality disorders in epileptic patients are prevalent and require attention

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Background: Children with attention deficit/hyperactivity disorder (ADHD) often experience academic difficulties. Stimulants have limited effect on cognitive abilities important to academic progress and that academic interventions are indicated in children with ADHD. Poor academic programs and other aspects of ADHD may cause conflict with parents and there is little information on the efficacy of multimodal parental management training that includes academic assistance and (Parental management training) PMT combined with methylphenidate. The current study evaluates the adjunctive efficacy multimodal parental management training in children with ADHD treated with methylphenidate.

Methods: Participants were 62 parents of children with a principal diagnosis of ADHD, being treated by child and adolescent psychiatrist .The children were aged between 6 to 12 years. Parents were randomly divided into 2 groups: the intervention group (who participated in 6 sessions for 2 hours multimodal PMT (N=31) and a control group (N=31). Individuals were included only if their children were taking Ritalin for at least 3 months and they should not be absent more than 1 session in a program. Participants in two groups filled demographic data questionnaires and were given a pretest that was Conners' Parent Rating Scale-Revised (CPRS-R) plus academic questions. Posttest was given after 6 educational sessions in sample group and after 1 and 3 months in both groups. Finally, the mean pretest and posttest scores were analyzed with SPSS v.16 software.

Results: There were no significant differences in pre intervention measures between the two groups. After intervention, the mean scores of CPRS-R between the two groups was significantly different in the two groups for academic achievement (p&le0.001), hyperactivity (p&le0.004), inattention (p&le0.008), impulsivity (p&le0.001) and oppositional behaviors (p&le0.001).

Conclusion: Multimodal PMT combined with methylphenidate can be recommended for parents of children with ADHD to enhance the academic achievement and reduce problem behaviors of school aged children (hyperactivity, inattention, impulsivity, oppositional). 

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Background: Drug abuse create for individuals according to the type substance undesirable  effects. The aim of current study was to compare the executive functions among heroin dependence and normal Individuals.

Methods: The method of current research was causative-comparative that done on two groups of heroin dependence and  normal Individuals. Consumer substance group include 30 patients of  heroin dependence that were selected among those referred to addiction treatment centers of Gonabad city according to available sampling. The comparison group consisted of 30 normal individuals  that were matched in terms of age, gender and education groups with group of heroin dependence. To collect data was used Wisconsin Card Sorting Test. Data analyzed with SPSS-16 software and Multivariate Analysis.

Results:The results of multivariate analyze showed a significant difference between heroin dependence and normal individuals in executive function. Group of Heroin dependence were lower performance on the Wisconsin card sorting test compared with the normal group.

Conclusion: Considering the results, it can be inferred that heroin dependence has damaging effects on the brain executive functions.

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Background: Many problems of students with attention deficit / hyperactivity disorder is related to disorder in executive functions that neurofeedback training are effective to improve them. This study aimed to investigate the effect of neurofeedback training on executive function (sustain attention, planning and working memory) in elementary girl students with attention deficit / hyperactivity disorder.

Methods: This study was a quasi-experimental with a pre-test and post-test design. The statistical population included all elementary girl students with attention deficit / hyperactivity disorder that referred to counseling centers of Gharchak city in 2015 year. Totally 30 students were selected through available sampling method and randomly assigned to two groups. The experimental group educated 12 sessions of 60 minutes by neurofeedback method. To assess sustain attention, planning and working memory respectively were used from CPT, T-London and N-back computerized tests. Data analyzed with the SPSS-19 software and by multivariate analysis of covariance method.

Results: The results showed there was a significant difference in three variable of sustains attention, planning and working memory. On the other hand the neurofeedback training method significantly lead to increase sustains attention, planning and working memory in elementary girl students with attention deficit / hyperactivity disorder (P<0/01).

Conclusion: Regarded the results of this research suggest that therapist and clinical psychologist use from neurofeedback training for increase sustains attention, planning and working memory in students with attention deficit / hyperactivity disorder.

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Background: Obsessive-compulsive disorder is one of the psychological disorders that, theoretically, is connected with migraine. This study aimed to compare components of obsessive-compulsive disorder in migraine sufferers with healthy individuals.
Methods: This study is causal-comparative and its population includes all patients admitted to Khatam Hospital in Zahedan during 2015. 105 people with migraine selected by using Gpower, recognition of neurologists and Ahvaz Migraine Questionnaire. They were compared with 105 normal individuals. The tools were Ahvaz Migraine Questionnaire (AMQ) and obsessive-compulsive disorder (OCI-R) questionnaire. Data were analyzed by using descriptive statistics and Manova.
Results: Results showed there is a significant difference between the groups with and without migraine in component scores of obsessive-compulsive disorder. So that migraine sufferers in washing, ordering, checking, neutralization and intellectual obsession acquired better scores (p<0.05). Between the two groups, no significant differences was observed in the accumulation component (p>0.05).
Conclusion: The results, in terms of more attention to obsessive-compulsive disorder, is important in reducing migraine attacks.
 

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Background: The aim of this study was to determine the relationship between decisiveness and trait-state anxiety in students at Kurdistan University of Medical Sciences during 2017-18.
Methods: In this cross-sectional study, 385 students (173 males & 212 females) were recruited using a stratified random multi-stage sampling methods. Data were collected using a "Trait Spilberger Anxiety", and "Assertion Inventory" (AI) of Gambrill & Richey. In order to investigate the relationship between two questionnaires, linear regression analysis was used. The significance level in this study was considered to be below 0.05.
Results: The results of study showed that with increasing trait anxiety in students, the mean score of the decisiveness questionnaire was increased, which indicates a reduction of decisiveness in students. In this study, age has a significant positive correlation with the degree of determination in students (p= 0.0001).
Conclusion: Considering the relationship between decisiveness and anxiety and their impact on mental health, academic performance and occupation of students, the special attention of educators and planners towards determining the inhibitors and facilitators of incisive behavior; increasing the efficiency of counseling systems to increase decisiveness and anxiety reduction is essential.