[Quality of studies on the prevalence of psychiatric disorders in Iran]

The aim of this research was to investigate the quality of studies on the prevalence of psychiatric disorders in Iran. All studies on the prevalence of psychiatric disorders among Iraniangeneral population as well as school children over 15 were identified through searching several databases including PubMed, ISI WOS, PsychINFO, CINAHL, Irandoc, EMBASE, IranPsych, IranMedex, and Scientific Information Database as well as reference lists of the accessed documents, unpublished reports, conference proceedings and dissertations. The original studies, which contained an estimation of the prevalence of "any psychiatric disorder" [overall prevalence] among a sample of general population or high school students in the country were selected. A quality assessment checklist was developed based on the following criteria: accurate description of research questions, random sampling, representativeness of the study sample for a defined target population, using the same method of data collection for the entire sample, using valid and reliable tools, and proper analysis of the results. The assessment was performed on those studies on the prevalence of any psychiatric disorder in the country that had used random sampling [43 studies]. It showed that in only about 40% of the studies the sample was representative of the target population. In more than 25% of the studies, validity and reliability of the Persian translation of the instruments were not assessed or were not reported. In total, nearly a third of studies had acceptable quality [random sampling, application of valid and reliable tools, and sample representing the target population]. Although this research - as part of a systematic review-was based only on a group of prevalence studies in psychiatric disorders, its findings indicated that a significant proportion of these studies are non-compliant with key quality measures. Instead of mere emphasis on increasing the number and quantity of studies, policy makers should employ strategies to improve research quality

Emotional intelligence in a group of patients with first-episode psychosis in Iran

This study was aimed to evaluate the Emotional Intelligence [EI] of a group of patients with first episode psychosis in Iran as compared with a healthy control group. A case-control design was used. EI was assessed using Persian version of Bar-On Emotional Quotient inventory [EQ-i] administered on 25 patients with history of a single psychotic episode in the last two years, as well as 64 healthy participants. The mean [+/- SD] of EI scores of patients' and healthy controls' group was 319.8 [+/- 40.9] and 328.8 [+/- 33.3], respectively. Two-independent sample t-test revealed no significant difference in the EI scores of two groups [P=0.29]. In contrast with chronic schizophrenia, the patients with first-episode psychosis were not different from the healthy subjects in terms of emotional intelligence score. It might be implied that the low emotional intelligence of the patients with chronic psychotic disorders is an accumulative result of the underlying disease over time

Anger in adolescent boy athletes: a comparison among judo, karate, swimming and non athletes

Karate and judo are originally Japanese martial arts which may have different influences on adolescents' behavior. This study was conducted to examine the total anger rate and its subscale-reactive anger, instrumental anger, and anger control-rates in young karateka and judoka. A cross-sectional study was carried out in 11 to 19-year old boys. Adolescents included in the study were judoka [n=70], karateka [n=66], swimmers [n=59], and non athletes [n=96]. One stage cluster sampling method was used to select judoka, karateka, and swimmers from sport clubs in Tehran. Students of governmental schools at the same area were chosen as the non-athletes group. The "Adolescent Anger Rating Scale" questionnaire was utilized to assess the anger rate. The mean age of participants was 12.90[ +/- 2.06] years. The total anger rates were 45.40 [ +/- 5.61] in judoka, 41.53[ +/- 5.63] in karateka, 41.19[ +/- 5.33] in swimmers, and 45.44 [ +/- 8.58] in non athletes. In total anger scale karateka and swimmers had a significantly lower score compared to judoka and non athletes. In instrumental anger subscale the difference was significant just between karateka and non athletes. In reactive anger subscale judoka showed higher scores than swimmers. In anger control subscale the difference was significant between judoka and swimmers and also judoka and karateka. The difference of anger control between karateka and non athletes was significant. The findings of this study propose a difference in the anger rate between judoka and karateka. In contrary to the results of previous studies, judo training may have no influence on anger control, while karate training could be beneficial

Psychiatric problems in general outpatient clinics: prevalence and reasons for help seeking

The aims of the present study are to examine the prevalence of psychiatric problems and the reasons for seeking care in urban health centers in district 17 of Tehran [capital of Iran], and to study the sensitivity and predictive value of the presence of psychiatric symptoms as chief complaint and self-report of a psychiatric history for correct recognition of a psychiatric problem. The present research was a cross-sectional and descriptive study. Two urban health centers located in district 17 in Tehran were randomly selected from a total of 7 health centers. Patients referring to outpatient clinics of the centers were consecutively asked to fill in General Health Questionnaire-28 and a pathways-to-care questionnaire. In total, 126 subjects [54% female] were included. Forty-two patients [33.3%] had psychiatric problem based on GHQ. Only 11 [8.7%] had psychiatric symptoms as chief complaints [reasons for referral] and 60 [47.6%] considered themselves having a psychiatric illnesses. Of all GHQ cases, 27 [64.2%] had never consulted for a psychiatric illness. The sensitivity of self-report of psychiatric complaint or illness was less than 70% with positive predictive values of less than 55%. In line with previous research, psychiatric disorders were commonly observed in outpatient clinics in Tehran. However, most of those with a problem had not sought care. In addition, sole reliance on patients' self-report of psychiatric complaint or illness might not lead to proper recognition of patients in primary care

pattern of brain perfusion SPECT in non-medicated schizophrenic patients

Studies with single photon emission computed tomography [SPECT] have revealed inconsistent changes of regional cerebral blood flow [rCBF] in schizophrenia. Some studies investigated the rCBF and its relationship with psychopathology, positive and negative symptoms in treated patients. However, there is a little information about the pattern of rCBF in recently untreated or never treated schizophrenic patients. The aim of this study was to evaluate the pattern of rCBF of the drug-na‹ve or drug free schizophrenic patients. Thirty-three patients with schizophrenia participated in the study. For each subject, the regional brain perfusion was evaluated with SPECT and the clinical state was assessed according to PANSS and CGI in a medication-free state. Also a group of 12 cases without any history of neurological or psychological disorder was enrolled as a control group for comparing of the SPECT data. Regional perfusion indices [RPI] were defined as mean count per pixel in each of 25 brain regions normalized to the mean count per pixel of the whole brain. The RPI patterns were compared in control and patient subjects. In comparison with control subjects, the RPI of the anterior cingulate and inferior parts of the prefrontal and temporal cortices of the schizophrenic patients are significantly higher while the RPI of the occipital and parietal regions are unilaterally lower. Different schizophrenic patients showed hyperperfusion as well as normal or hypoperfusion in different regions of the brain cortex. However, hyperperfusion rather than hypoperfusion mainly is seen in the inferior prefrontal and temporal regions, while hypoperfusion patterns are more prominent in the cerebellar, occipital, parietal and dorsolateral prefrontal cortices. Different patterns of brain perfusion are seen in drug-free or drug-naive patients with schizophrenia. Hyperperfusion in the frontal and temporal regions and hypoperfusion in the cerebellar, parietal and dorsolateral prefrontal cortices are the most predominant abnormal patterns in these cases

Roozbeh home care program for severe mental disorders: a preliminary report

To describe a home care service developed in Roozbeh Hospital for patients with bipolar disorder and schizophrenia and report baseline and 6-month follow-up data. Roozbeh Home Care Program consists of home visits by multidisciplinary home care teams, including general practitioners, nurses, and social workers who are supervised by psychiatrists. Home visits are scheduled as biweekly for the first three months following discharge and then on a monthly basis and the care includes biopsychosocial assessments and interventions. Baseline and 6-month data were extracted using a chart review. After 10 months of the Program development. 53 patients were enrolled and a total of 349 home visits were made. Of these, 29 were followed for at least 6 months. More than 86% of the patients remained in the community throughout the follow-up period, most in full remission and a small minority [4 patients] with a mild to moderate relapse that was overcome with interventions made by the home care teams. A home care service is a feasible mode of community-based aftercare for patients discharged from the hospital. Its effectiveness should be assessed by a randomized controlled trial

Prevalence of mood disorders in Iran

To study the prevalence and demographic characteristics of mood disorders among Iranian adults. In this cross-sectional population-based epidemiological study [age 18] in Iran, 25180 individuals were selected through a randomized cluster sampling method for a diagnosis using the Schedule for Affective Disorders and Schizophrenia [SADS]. They were then interviewed at home by 250 trained clinical psychologists. The estimated lifetime prevalence of Major Depressive Disorder [MOD] and Minor Depressive Disorder [mDD] were 3.1% and 0.3% respectively. Also, the estimated lifetime prevalence of Bipolar Mood disorder [BMD] type I and type II were 0.1% and 0.7% respectively. The current prevalence of MDD, mDD, BMD-I and BMD-II were 1.8%. 0.2%, 0.04%, and 0.3% respectively. Mood disorders were associated with female gender, lower education, being married, being middle-aged, living in cities, and not being a homemaker. The prevalence of mood disorders was lower among Iranian adults than reported in Western studies, and a number of demographic associations differed from those reported in Western studies: Important cultural differences in the nature or manifestation of depression are implied by these results

[Reliability of the Persian translation of the composite international diagnostic interview [CIDI] for diagnosing schizophrenia and bipolar disorder]

This study aimed to assess the reliability of the Persian version of the Composite International Diagnostic Interview [CIDI] for a lifetime diagnosis of schizophrenia and bipolar disorder according to DSM-IV and lCD-10. This project was conducted at three stages of translation of the instrument, reliability assessment and validation, and feasibility and diagnostic reliability assessments for bipolar disorder and schizophrenia using a test-retest methodology. Trained interviewers administered the instrument twice [at 3-7 days' interval] to 100 clients at four university centers [complete CIDI on 65 persons and psychosis/mania module on 35 persons]. Test-retest reliability of CIDI for bipolar disorder was moderate in DSM-IV diagnostic system and poor in ICD-10. Test-retest reliability of CIDI for schizophrenia was poor in both diagnostic systems. The results showed that the diagnostic reliability was good only for bipolar disorder in DSM-IV, otherwise it was not acceptable. However, since the samples were selected from the clinical population, the results cannot be generalized to the normal population. According to the results, adaptation of the key questions to the Persian culture must be considered

[Reliability and feasibility of the Persian version of the structured diagnostic interview for DSM-IV [SCID]]

In this study the Structured Diagnostic Interview for DSM-IV axis I disorders [SCIDI] was translated into Persian using a cross-cultural methodology, and its reliability and feasibility was tested in a multi-center study. The study had two phases: a] translation of the instrument and assessing the cross-cultural equivalence, including forward and backward translation, and face validity of the translated version in regard with cross-cultural characteristics; b] reliability and feasibility assessment of the Persian translation on an Iranian clinical population. This is part of a larger study on validation of the SCID on 299 subjects admitted to outpatient and inpatient services of thee psychiatric centers [Roozbeh Hospital, Imam Hossein Hospital and Iran Hospital] in Tehran, Iran. For test-retest reliability assessment, two SCID interviews [3 to 7 days apart] were administered to 104 subjects and the level of diagnostic agreement was assessd. Feasibility for interviewees [n=299] and interviewers was tested by questionnaires considering the length of interview, its being boring/tiring, comprehensibility and acceptance of the questions, and difficulty of administration. Diagnostic agreement of SCID test and retest were fair to good for most diagnostic categories [kappas over 0.6]. Overall weighted kappa equaled 0.52 for current diagnoses and 0.55 for lifetime diagnoses. Most interviewees and interviewers reported the administration of the Persian SCID as feasible. Acceptable reliability of diagnoses made by the Persian translation of SCID, and its feasibility suggest it as a useful diagnostic instrument in clinical, research, and educational settings