Self stigma among people with bipolar-I disorder in Iran

Psychiatric stigma refers to systemic and internalized stereotypical negative attitudes against individual with mental illness. This article describes the level of self stigma, stereotype endorsement and perceived discrimination experienced by patients with Bipolar- I disorder in Tehran. Data were collected from a total of 126 patients with Bipolar- I disorder who responded to acute phase treatment using the Internalized Stigma of Mental Illness scale. The ISMI scale has five. Alienation, Stereotype Endorsement, Perceived Discrimination, Social Withdrawal and Stigma Resistance. In this study 26.7% of participants reported moderate to high levels of self stigma, 57.49% moderate to high levels of stigma resistance and 18.3% moderate to high levels of Perceived discrimination. The results suggest that, self stigma appears in over one fifth of individuals with Bipolar-I disorder in Iran. The symptoms of Bipolar- I disorder have profound impacts on the quality of life of affected patients. Psychosocial functioning and self-esteem is impaired in people with Bipolar-I disorder. Interventions are required to reduce the negative effects of internalized stigma in this group

[Comparative evaluation of educational-medical and just medical psychiatric wards in terms of diagnosis and treatment process in schizophrenic patients at Razi psychiatric hospital]

Schizophrenia is one of the most important psychiatric disorders and the majority of the mental hospital beds occupied by these patients. In this study, patients suffering from schizophrenia treated in educational-medical ward or just medical wards were compared in terms of diagnostic and treatment processes. This cross-sectional study was conducted on schizophrenic patients admitted to the Tehran Razi psychiatry hospital between 2011 and 2012. A total of 300 medical records were randomly selected from both educational-medical [n=150] and just medical ward [n=150]. The selected medical records were compared regarding to diagnosis, treatment, duration of hospitalization, use of electroconvulsive therapy, history of previous hospitalization and patients efficiency. First-generation antipsychotics were the most used drugs in medical ward [56.7%] and second-generations antipsychotics [54.7%] were more used in educational-medical ward [p<0.05]. The use of psychosocial treatments was considerably higher in educational-medical ward [34% vs. 13.3%]. Electroconvulsive therapy was used more than three times in medical ward compared to educational-medical ward [p<0.05]. Mean [+/- SD] duration of hospitalization was 39 +/- 35 days and 58 +/- 39 days in medical ward and educational-medical ward, respectively [P<0.05]. It seems that comparing to medical wards, educational-medical wards were more consistent with new guidelines in the world regarding to excellence of second-generations, use of psychosocial treatments, use of electroconvulsive therapy and hospital stay

How to run psychiatry OSCE in three days

Objectivity, reliability and validity of examinations in psychiatry have always been one of the major concerns of experts in this discipline. Recently, objective structured clinical examination [OSCE] for its unique approach and by providing the requirements of psychiatric examinations has been a topic of interest. In Iran, an OSCE has been replaced the individual patient assessment [IPA] for examination of the National Board of Psychiatry. Although it is better to provide psychiatry OSCE in an extended time frame, in some cases this examination should be executed in a short period of time. For executing OSCE in psychiatry, especially if it should be performed in a short time, it requires addressing various points. In this article, based upon the previous experiences, we offer a standard format for establishing a practical, reliable and measurable OSCE in psychiatry in three days

Rehabilitation of schizophrenia: at the end or in the beginning?

The Majority of the long stay psychiatric patients who are in need of rehabilitation suffer from schizophrenia. Most of them enter the old age with this illness, and besides the consequences of schizophrenia, they are facing the deprivation and misery due to the old age. In contrast to the previous decades in which there was no effective treatment for schizophrenia, today with the immediate diagnosis of schizophrenia and its treatment with effective medications, we can prevent chronicity and resistance to the treatment. By these means, we can improve the prognosis and the quality of life of patients and their care givers. Since last decade, the unfair discrimination of schizophrenic patients to chronic and non-chronic has lost its validity. It is widely recommended that instead of constructing the special and isolated hospitals for the mentally ill, psychiatric wards in the general hospitals be established. By all these efforts, the schizophrenics can have a better treatment and rehabilitation, and can be saved from the social and psychological consequences of staying in the isolated mental hospitals

Sensation seeking behavior among schizophrenics

To compare sensation seeking between schizophrenic patients [and clinical subtypes of schizophrenia] according to criteria of DSM-IV-TR; and a healthy control group. Two hypotheses were assumed: 1. Sensation seeking in the control group is higher than schizophrenic patients. 2. The levels of sensation seeking are different among clinical subtypes of schizophrenia. The sample comprised a study group of 69 schizophrenic inpatients at Raazy Psychiatric Center, Tehran, Iran in 2005 [10 males and 10 females for each of paranoid, undifferentiated and residual subtypes, and 9 males from disorganized subtype], and 50 randomly selected healthy people, the control group. To measure sensation seeking, the Zuckermann Sensation Seeking Scale, a 41-item questionnaire form, was used after evaluating its validity and reliability. After obtaining a weak or negative correlation, we omitted 9 questions, so that finally a 32-item questionnaire with highest reliability [Crunbach's alpha = 0.64], remained and was utilized. We used descriptive statistical methods and calculation of statistical indices, and Student t-test for independent groups to evaluate the research hypotheses. The first hypothesis was confirmed at a 99% significance level. The second hypothesis was rejected at a 95% significance level. We found a definite correlation between schizophrenia and a low level of sensation seeking. Accordingly, and since sensation seeking [as a part of temperament] has a strong genetic component, a low level of sensation seeking is probably an existing feature of schizophrenia. Assessing sensation seeking in high-risk populations [children or the siblings of schizophrenics] could be a practical attempt at prevention or immediate treatment of schizophrenia

[Alzheimer's disease: yesterday, today, tomorrow]

Alzheimer's disease is the most common and well - known cause of dementia, as a progressive, irreversible brain disorder that affects cognitive function, personality, thought, perception and behaviour. Alzheimer's disease is the fourth leading cause of death in western countries. Interesting to know that this disease was unknown in medical community till 100 years ago and had no name. Dr. Alois Alzheimer, a German psychiatrist was the person who suspected the presence of this new illness and by succinct clinical, neuroanatomic, and neuropathologic examination of some cases, including the first known case of this disease - a woman named Auguste Deter - documented it. In further Emil Kraepelin by knowing about the cases that Dr. Alzheimer reported, and another reports of this disease that were published in the first decade of the twentieth century, set the name of Alzheimer on this new disease. Descriptions of Dr. Alzheimer and Kraepelin are the same as the present day descriptions of this disease. Electron microscopy, quantitative morphology and modern biochemistry emerging in the second half of the twentieth century opened a new era in dementia research with description of the ultra structure and biochemistry of senile plaques and neuronfibrillary tangles, the major disease markers of Alzheimer's disease. Basic research gave insight into the molecular genetics and pathophysiology of Alzheimer's disease and based on the biochemical findings, new pharmacological treatment options were opened. The future attempts will probably be concentrated on the prevention of this disease. Oxidative stress, excessive transition metal ions, and misfolded / aggregated proteins and inflammation are among the probable causes of Alzheimer's disease and the future research will focus on their better understanding and prevention of their occurrence. As the last word, stem cells grafts that in animals have led to remarkable improvement of brain function, may also be a promising course in the cure of Alzheimer's disease in the future