[ efficacy of an integrated treatment in comparison with treatment as usual in a group of children and adolescents with first-episode psychosis during a two -year follow-up]

This study aimed to compare the efficacy of an integrated treatment [IT] versus treatment as usual [TAU] in a group of inpatient children and adolescents with first episode psychosis [FEP] during a two year follow up. In a randomized controlled trial, 40 children and adolescents with FEP based on DSM-IV criteria were recruited from referrals to Robe Hospital [Tehran, Iran]. They were divided into a TAU group [N=20], and an IT group [N=20] who received a low dose of atypical antipsychotic medications and family psycho-education program, and were followed up by telephone contacts. All participants were evaluated at admission and discharge as well as in 6, 12, 18 and 24 month intervals using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Persian Version [K-SADS-PLPV], Positive and Negative Syndrome Scale [PANSS], Young Mania Rating Scale [YMRS], Children's Depression Inventory [CDI], Hamilton Depression Rating Scale [HAM-D], Global Assessment of Functioning Scale [GAF], and Children Global Assessment Scale [CGAS]. Statistical methods consisted of analysis of independent t and x[2] for qualitative variables, and random effect regression model for quantitative variables. The two groups showed significant improvement in all outcome measures at different time-points. The rate and duration of recurrences were lower in the IT group compared to the TAU group. All of the other outcome measures were comparable in the two groups and there was no difference between them in different follow-up periods. Integrated treatment may decrease the rate and duration of recurrences in children and adolescents with FEP

[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EMBASE, IranPsych, IranMedex, and Scientific Information Database as well as reference lists of the accessed documents, unpublished reports, conference proceedings and dissertations.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

[Cultural adaptation, validity and reliability of Persian version of experience of caregiving inventory in families of patients with severe mental disorders]

This study aims to evaluate the cultural adaptation, validity and reliability of the Persian version of Experience of Caregiving Inventory [ECI] in families of patients with severe mental disorders. After the translation and cultural adaptation of ECI, 225 family members of patients with severe mental disorders completed the ECI, the General Health Questionnaire [GHQ-28] and a demographic questionnaire. The Split half test was used to assess reliability. To determine internal consistency, Cronbach's alpha test and the concurrent validity was calculated by Pearson's correlation between the GHQ-28 and the ECI total negative score. Reliability of the Inventory as assessed by the Spearman-Brown correlation coefficient was 0.80. The range of the Cronbach's alpha for each subscale, total negative score and total positive score was 0.51 to 0.90. Pearson's correlation between the GHQ-28 score and the total negative score was 0.37 [p<0.01]. The Persian version of the ECI has good reliability and validity for family members of patients with severe mental disorders

Training health professionals to conduct family education for families of patients with first-episode psychosis: adherence to protocol

The implementation of family psychoeducation at the service delivery level is not without difficulty. Few mental health professionals receive special training to work with families especially in Iran. The aim of the present study was to evaluate the effectiveness of training health professionals in terms of their adherence to protocol. Eight professionals [general practitioners, nurses and social workers] participated in a training program for health professionals as part of the Roozbeh First-Episode Psychosis Program [RooF] to conduct family psychoeducation. Training included a 3-day- workshop and 12 supervision sessions during the course of the implementation of the psychoeducation program. The family psychoeducation sessions [multiple-family group or single-family home-based] were tape-recorded. Transcripts of the audiotaped sessions were analyzed based on the content of the manual and were scored accordingly. Twenty-four recorded sessions were analyzed in terms of the adherence to protocol, the number of questions and the time for each session. The overall rating showed a 72% adherence to the protocol. Multiple-family group sessions had a higher rate compared to the singlefamily home-based family psychoeducation sessions [79% to 69%] as well as the time spent and questions asked. The rate of adherence to the protocol of conducting the family psychoeducation sessions had not changed over time. Considering the amount of time taken for training and supervision, the level of adherence to the protocol was satisfactory. Tape recording sessions and regular supervision would be beneficial following specialized training. Further research is needed to tailor the amount of training and supervision required for professionals to conduct family psychoeducation programs in different settings

Association of premorbid adjustment with symptom profile and quality of life in first episode psychosis in a tertiary hospital in Tehran, Iran

Poor premorbid adjustment has been reported to be a predictor of more severe psychotic symptoms and poor quality of life in such psychotic disorders as schizophrenia. However, most studies were performed on chronic schizophrenic patients, and proposed the likelihood of recall biases and the effect of chronicity. The aim of this study was to investigate these factors in a sample of first episode psychotic patients, as a part of Roozbeh first episode psychosis project [RooF]. Premorbid adjustment was assessed using Premorbid Adjustment Scale [PAS] in 48 patients with the first psychotic episode who were admitted to Roozbeh Psychiatric Hospital. The severity of symptoms was measured using Positive and Negative Scale [PANSS] in three subgroups of positive, negative and general subscales. Quality of life was measured using WHO QOL, and Global Assessment of Functioning [GAF] was also measured. The mean age was 24 years. Poor Premorbid adjustment in late adolescence was significantly associated with more severe symptoms according to PANSS negative symptoms [p=0.019, r=0.44]. Furthermore, sociability and peer relationship domains had a positive correlation with PANSS negative subscale scores [r=0.531, p=0.002 and r=0.385, p=0.03, respectively]. There were no significant differences between males and females in premorbid adjustment. Furthermore, this study failed to show any differences between affective and non-affective psychosis in premorbid functioning. Our study confirms poor premorbid adjustment association with more severe negative symptoms and poor quality of life in a sample of Iranian first episode psychotic patients