[Validity of the Iranian version of the structured clinical interview for DSM-IV [SCID-I] in the diagnosis of psychiatric disorders]

To assess the validity of diagnoses obtained with the Iranian version of the Structured Clinical Interview for DSM-IV [SCID-I]. This study was undertaken in two stages: [a] translation of SCID-I into Persian [Iranian language], [b] assessing the validity of the Persian version in a sample of Iranian patients. We recruited 299 psychiatric patients- including inpatients and ambulatory cases- from 3 teaching hospitals. A trained SCID interviewer administered the SCID and then two psychiatrists developed a consensus diagnosis, using data from multiple sources. The degree of agreement between SCID interviews and psychiatrists' diagnosis ranged from "moderate" for obsessive-compulsive and major depressive disorders to "good" for bipolar disorder and schizophrenia. With the psychiatrists' diagnosis used as the gold standard, the SCID-based diagnosis showed high specificity and moderate to high sensitivity for most psychiatric diseases. The results of this study indicate that the Iranian version of the SCID is a valid instrument for diagnosis in clinical settings

[Reboxetine versus methylphenidate in the treatment of children and adolescents with attention deficit hyperactivity disorder]

Attention Deficit Hyperactivity Disorder [ADHD] is a prevalent disorder among children and stimulant remedies are the drugs of choice for its treatment. A substantial minority of stimulant-treated patient do not respond adequately or cannot tolerate the associate adverse effects and these difficulties highlight the need for alternative effective medications. This study was conducted to evaluate the efficacy and tolerability of reboxetine compared to that of methylphenidate in treatment of children and adolescents with ADHD. Thirty three children [7-16 years of age] diagnosed with ADHD, participated in a 6-week double-blind clinical trial with reboxetine [4-6mg/d] and methylphenidate [25-50mg/d]. The principal measure of the outcome was the Teacher and Parent ADHD Rating Scale. Patients were assessed by a child psychiatrist at baseline of treatment and 2, 4 and 6 weeks of medication, respectively. No significant differences were observed between two protocols of the parent and teacher ADHD rating scale scores and in terms of the dropouts and both groups showed a significant improvement in ADHD symptoms over the 6 weeks of treatment. The most common adverse effects seen with reboxetine were sedation/drowsiness and mild to sever decrease in appetite. Our finding must be considered preliminary, however, they do suggest that reboxetine may be beneficial in the treatment of ADHD. Further research is needed to clarify the potential benefit for comorbid depression and anxiety with ADHD and profile of side effects

[Validity of a Farsi translation of the composite international diagnostic interview [CIDI] to diagnose schizophrenia and bipolar disorder]

The Composite International Diagnostic Interview [CIDI] is a comprehensive, standardized diagnostic interview for the assessment of psychiatric disorders. There have been few studies on the validity of the CIDI. The objective of present study was to assess the validity of a Farsi translation of the complete CIDI and its psychosis/mania module in five referral clinical psychiatric settings. Two hundred and three as well as 104 consecutive admissions were interviewed using the complete and the psychosis/mania module, respectively. Within two days of the CIDI interview, two last year residents of psychiatry or psychiatrist who were blind to the CIDI diagnosis completed the Clinical diagnostic checklists [based on DSM-IV and ICD-10 criteria] simultaneously and reached the consensus diagnosis. Data analysis was performed using SPSS 11 to determine the validity of CIDI. The sensitivity and specificity for the diagnosis of schizophrenia was 0.12 and 0.96 using DSM-IV criteria. According to ICD-10 criteria, the results were the same with 0.19% sensitivity and 0.96% specificity. The sensitivity for the diagnosis of bipolar I disorder was low [0.21 using DSM-IV criteria and 0.17% using ICD-10] and specificity, high [0.90 compared to DSM-IV and 0.89 compared to ICD-10 criteria]. The results were rather similar for the psychosis/mania module of CIDI. This study suggests that the Farsi translation of both the complete CIDI and the psychosis/mania module of CIDI have good specificity, but poor sensitivity for the diagnosis of schizophrenia and of bipolar I disorder