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

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

[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