[Comorbidity of mental disorders among the stuttering children referred to speech therapy department of Akhavan hospital in Kashan]

Stuttering is a developmental disorder which may adversely affect the individual on many emotional levels and cause many impairments [e.g. lack of self- confidence, depression, poor communication and finally the avoidance of social situation. This study was carried out to evaluate the comorbidity of mental disorders among the stuttering children in Kashan during 2007-8. In this cross-sectional study, 50 children [age range, 3-12 years] referred to speech therapy department of Akhavan hospital were selected using the census sampling. The diagnosis of mental disorders was made by psychiatrists through a clinical interview based on the DSM-IV-TR checklist. In addition, the IQ of cases was measured using the Wechsler test. Data were analyzed using the Chi-square test. Thirty-three children [70%] had the comorbid mental disorders. The most common comorbid disorders were attention deficit hyperactivity and anxiety disorders [51.4% and 25.7%, respectively]. A significant difference was found between the comorbid mental disorder and the age and also the educational level of children [P=0.005 and P=0.003, respectively]. According to the results, the majority of children had comorbid mental disorders. Considering the high rates of comorbidity among the children and also their outcomes, more careful attention should be paid to offer the effective therapeutic plans

[Effect of cognitive-behavioral group therapy on anxiety and depression hemodialysis patients in Kashan, Iran]

Hemodialysis as a treatment manner in chronic renal failure is a stressful process and has several various psycho-cognitive and social complications. The present study evaluated effect of cognitive-behavioral group therapy on anxiety and depression in hemodialysis patients. This research was a clinical trial study. Samples were young adults who were 18-45 years old. The Participants were divided into two groups [case and control]. The Beck depression and anxiety inventories were used as a measure of psychological symptoms at pretest and posttest and Cognitive-behavioral group therapy as intervention was done at week12. Data Were analyzed with SPSS-16 and t-test, chi square. A p<0.05 was considered significant. In this study, there was not a significant difference in the demographic characteristics between the two groups. Before of intervention, mean Anxiety score of the experimental group was 25.72 +/- 5.87, and in the case group it was 25.22 +/- 7.56 as well as mean Depression score in the two groups was 35.44 +/- 14.97, 33.11 +/- 9.2 respectively. The difference of the two groups in anxiety and depression scores was not significant. After the intervention, the mean anxiety score of experimental group was 15.94 +/- 6.23, and in the case group it was 28.05 +/- 10.04 [p<0.05]. Mean of depression score in the experimental group was 22.27 +/- 13.32, and in the case group it was 33.94 +/- 9.46 [p<0.01]. This research showed that group therapy [cognitive-behavioral] decreased depression and anxiety remarkably in dialysis patients. Therefore, it is suggested that in addition to the prescription of medication, psychological interventions be done for such patients

Epidemiology of attempted suicide in Kashan during 2003-8

Background: Suicide is a major public health problem in developing countries which depending on geographical area, several factors have been associated with its prevalence and incidence. This study was conducted to evaluate the prevalence of attempted suicide and its related factors in Kashan during 2003-8

Materials and Methods: This cross-sectional study was performed on all suicide attempters referred to Kashan health centers during 2003-8. Patient's demographic information, manner, outcome and a previous history of suicide attempts were recorded on a questionnaire by interviewing patients or their families

Results: There were 2867 suicide cases during the study period. Most of them were in age range of 25-35 years. Fifty-nine percent of patients were female and 56% married. Drug abuse was the most common method of suicide [79%]. So, an overall attempted suicide rate was 119 per 100000 people in Kashan during 2003-8 and there were only 29 cases [1.1%] of successful suicide

Conclusion: Although the rate of attempted suicide are high in this city, the rate for successful suicide is very low. Therefore, this problem and its related factors need to be considered by health managers

[ frequency of osteoporosis in hip fracture following minor trauma and the resulting mortality rate and direct treatment costs in patients over 45 years old in Kashan Naghavi Hospital During 2005-2007]

Osteoporosis is the most common metabolic bone disease .In the recent decades due to the increase of population age, the prevalence of osteoporosis has been increased. The most important complication of osteoporosis is bone fracture, especially in the hip. The aim of this study was to evaluate the prevalence of osteoporosis, its mortality rate and direct treatment costs in patients over 45 years old referred to Kashan Naghavi hospital following hip fracture during 2005-2007. This cross-sectional study was done on 119 patients with hip fracture following minor trauma admitted during one year to Naghavi hospital in Kashan Iran. Demographic findings, types of fracture, costs of hospitalization, treatment and prosthesis were recorded in a questionnaire. BMD of lumbar spine and neck of femur was done with Osteocore II instrument by DXA method. Data analysis was done by SPSS 14. Mean age of patients was 71/6 +/- 9/35 years. From all, 72/3% were female and 27/7% was male and 67/8% had fracture of neck of femur and 23/2% had intertrocanter fracture. In whole, 65% had osteoporosis. In 51.3%, it was in lumbar and in 23.5% it was in femur. Mean hospitalization period was 7.92 +/- 3.66 days. Mortality rate was 17/2%. Mean cost of hospitalization and treatment was 277 $ and mean cost of prosthesis for each person was 1670$. Osteoporosis is a predisposing factor for hip fracture in old patients after minor trauma. Since Hip fracture places a high cost burden on the healthcare system, wise programming for prevention of hip fracture seems to be highly necessary

[Prevalence of burnout in senior medical students of Kashan university of medical sciences in 2008]

Burnout is caused by high-stress jobs and could induce somatic, psychological disorders and negative attitude to professional actives so that this condition causes poor relationship with the patient. This study aimed at investigating burnout in senior medical students of Kashan University of Medical Sciences. This research was a cross sectional study carried out on all senior medical students [N=56] in 2008. Data were obtained by two questionnaires including demographic questionnaire and Maslach burnout Inventory. They were then analyzed using SPSS software and Chi square Test. The findings showed that the majority of medical students [91.1%] had burnout and only 8.9% of them had not burnout. Severe burnout was in 16% of students. There was not any significant relationship between burnout and sex, age, smoking, duration of education, interest in medical course and marital status P<0.05. The results of the study showed that burnout is common problem in senior medical students and need special consideration. Therefore medical students should be encouraged to seek help and adequate facilities by holding workshops of life-skill training and coping with stress. However, burnout should be paid special attention in medical students by counseling centers of University for prevention of consequences

[Prevalence of insomnia among 18 years old people and over in Kashan city, Iran in 2008]

Background: Insomnia is a distressing and disabling condition affecting not only many people's quality of life and work but also their psychosocial conditions. Therefore, this research has done to survey insomnia prevalence among 18 years old people and over in Kashan city in 2008

Materials and Methods: This cross-sectional research has performed done in Kashan using randomized sampling [N=1155]. The research tools contain demographic characteristics questionnaire and insomnia questionnaire based on DSM-IV criteria including difficult falling asleep, staying asleep and daytime sleepiness. Its validity was confirmed by five psychiatrists; the reliability of this questionnaire with test-retest method was 99%. The data were analyzed via Chi square, Fisher exact test and OR, CI

Results: Of 1155 persons, 684 [59.2] had insomnia problem. Insomnia problem is extremely prevalent among those who were between 41 to 65 years old [266 of persons 67.9] and women [387 of persons 56.5]. This study showed that there was a significant relationship between insomnia problem and mental disorder history [P<0/0001, OR=2.24], sleep disorder in family history [P<0/0001, OR=4.67] and drinking caffeine before sleep [P<0/001, OR=1.64]

Conclusion: According to this study, most people studied suffer from insomnia problem, particularly women and middle aged people. Since insomnia can be a risk factor for onset of depression and anxiety disorders, and increases direct and indirect medical costs among other consequences it is necessary to prepare an exact schedule for resolving this problem and improving sleep quality

[Survey of effect of methadone on depression symptoms in prisoner Iv drug abusers]

Background and Aim: Substance abuse is associated with high prevalence of psychiatric disorders including mood disorders [especially depression], personality disorders and psychosis. The purpose of this study was to investigate the effect of methadone and its result on substance induced depression-symptoms among IV drug abusers of Kashan prison in 1384

Method and Materials: This is a semi-experimental study. A two part questionnaire including demographic data and Beck Depression Inventory [BDI] were administered to participants by the prison clinical psychologist. After insuring privacy, performing the questionnaire, and interviewing with each participant done by three psychologists, oral methadone was prescribed to non-excluded participants. After three months of taking methadone, they were re-evaluated by BDI and re- interviewed by psychologists for making diagnoses based on DSM-IV. Data were analyzed by paired T-test

Findings: Based on clinical interview, from the 35 participants, 26[74.2%] were diagnosed as having Major Depressive Disorder, 2 of whom were excluded from the study and referred for further follow up because of suicidal thinking .The rest 9 participants [25.7%] were not depressed. After the intervention, of all 24, 19 ones[79.16%] showed relative improvement and 5[20.83%] remained unchanged. A significant reduction was found in the mean BDI score after the intervention[p < 0.001]. Diagnostic value[positive predictive value] for BDI was found to be 47.28% in this study

Conclusion: This study showed that methadone can reduce depression severity in IV drug abusers