[Prevalence of depression before, after, and during anti-viral therapy among patients with chronic hepatitis B and C]

Depression is a possible side effect associated with antiviral therapy for chronic hepatitis B [CHB] and chronic hepatitis C [CHC]. The objective of this study was to evaluate the prevalence of depression in patients receiving different anti-viral medications before, during and after treatment. This descriptive cross-sectional study was undertaken on 248 CHB or CHC patients referred to two clinics of Mazandaran University of Medical Sciences between March 2011 and April 2012. Those who received alpha interferon, another antivirus medication or combination of them were evaluated by Hospital Anxiety and Depression Scale [HADS] and clinical psychiatric interview before initiation of the medications, 12 and 24 weeks after the initiation of the treatment and 6 weeks after termination of antiviral therapy. The prevalence of depression in patients with either hepatitis B or C was higher than general population, but similar to each other. During the 12 and 24 week of the antiviral therapy, the prevalence of depression was increased especially in whom were receiving alpha-interferon. Six weeks after the termination of medical therapy, the prevalence of depression in whom received alpha interferon was decreased statistically. However, this event did not happen in the group that did not use interferon. It is suggested that patients receiving alpha-interferon should be psychologically assessed in the course of treatment. Displaying the symptoms of depression, doctors should apply the prophylactic and therapeutic measures as soon as possible

Quality of life in patients with gastroesophageal reflux disease in an Iranian population

The study was designed to evaluate quality of life [QOL] for Iranian patients with gastroesophageal reflux disease [GERD]. GERD is a common and chronic world-wide disease. Impact of GERD on QOL has been studied in many countries, but it has not been studied in Iranian population. Fifty five patients suffering from GERD and fifty five age and sex matched controls were enrolled. Patient inclusion criteria were based on clinical and endoscopic findings. All other major diseases having an impact on QOL had been excluded. All the subjects were asked to fill the validated translation of SF-36 and GHQ-28 questionnaires. Results of the SF-36 questionnaire was analyzed directly and after correction for the results obtained from the GHQ-28 tool. GERD patients had lower QOL scores than controls. Correction of the results based the findings of GHQ-28 questionnaire did not change the results. QOL in GERD patients is impaired and should be considered in clinical practice and implementing research studies upon GERD patients

[Study on the simultaneity of the substance abuse with psychiatric disorder in referred outpatients to psychiatry clinic of zare hospital for period of one year]

One of the important problems in diagnosis and treatment of psychiatric disorders is its accompaniment with substance abuse. In addition to substance abuse symptoms which are present in all addicts, in psychiatric patients it cause special problems in main diagnosis, slow reaction to therapy and even non effectiveness of the therapy and also poor prognosis. Considering its different prevalence in studies and also considering the point that a similar work has never been done in Iran, this study is designed to find out the abundancy of disorders and pattern and type of substances used by the referred patients to psychiatric clinic of zare hospital. In this descriptive research study, 782 referrals to psychiatric clinic of zare hospital in a period of one year were evaluated D.S.M. IV interview. The self made Questionnaire which is filed by a psychologist and then referred to a psychiatric for the diagnosis of the disease, includes the time of Commencement, amount and type of substance used. The results obtained, showed that 79.1% were men, 20.9% were women, 54.4% were urban and 45.5% were from rural areas. 4.8% were referred for substance - withdrawal and 95.2% for psychiatry problems. And also the 28% were smokers, 68.4% never smoked and 3.8% were smokers in the past. 12.7% were substance abuse at persent 3.3% had a history if substance abuse in the past and 84% had no history of substance abuse ever. Substance dependency and nondependency were 8.6% and 91.4% respectively. The percentages for the first consumed substance were as follow: 60.8 opium, 6.4 alcohal, 26.4 hashish, 4 heroin and 2.4 other substances. From psychiatry diagnostic point of view 28.7% suffered from schizophrenia, 41% had mood disorders, 14% had personality disorders and 4% suffered from anxiety. There has been a statistically significant relationship between the variables such as sex, residential areas, occupation, education, marital status, history of cigarette smoking and age of commence ment of smoking with substance dependency [p<0.05]. Considering the high prevalence of Substance usage by the patients referred to psychiatric clinics, the Concurrency of substance usage and psychiatry problems are important in history taking and treatment of the patients. On the other hand to have a high success Coefficient, a simultaneous psychiatric diagnosis for the patients referred for withdrawal, should be kept in mind

[ survey of death anxiety among personnel of hospital in Sari]

Death anxiety is defined as anxiety caused by conscious and unconscious fear of death that has relations with several variables. The aim for this study is to estimate the prevalence of death anxiety among a hospital staff in Sari. This is a descriptive study and data was collected through a questionnaire. The number of cases was 576. The questionnaire [Templer's Death Anxiety Scale] includes 15 True-False questions. After data collection processing was done through spss.16 and analyzing performed through T-test and Chi-square test. The age range was 20-53. 42.2% of cases had low death anxiety and 57.8% had high death anxiety. The mean of scores achieved by cases through questionnaire was 7.70 +/- 3.133 by women and 6.19 +/- 2.552 by men. The degree of death anxiety has had significant correlation with variable of sex while has had no relation with age, marriage condition, having or lack of child, level of graduation and career condition. The results of this study shows that the most cases have had high degrees of death anxiety that can be because of the special condition of working or the combination of cases's sex and age. With caution to results, it is recommended to Mental Health interventions to the same population to improve the mental health Quality additionally perform more comprehensive studies in more generally populations

Comparative study of clozapine, electroconvulsive therapy [ECT], and the combination of ECT with clozapine in treatment-resistant schizophrenic patients

Despite the discovery of new antipsychotic drugs, a number of schizophrenic patients show no response to such drugs and are considered treatment-resistant. In such cases, clozapine and occasionally ECT or a combination of drugs are used, though they are not very effective. In recent years, the combination of clozapine and ECT for treatment-resistant schizophrenic patients has been suggested; the results of preliminary studies have been hopeful. The aim of this study was to compare the results of treatment with clozapine alone, ECT alone, and the combination of clozapine with ECT in treatment-resistant schizophrenia. Eighteen treatment-resistant schizophrenic patients were assigned to three equal groups: one group was given clozapine; one group was treated with ECT; and one group was treated with the combination of clozapine and ECT. The treatment response was evaluated using the PANSS criteria, and the data were analyzed with ANOVA. Combination therapy was superior to single modality therapy. The reduction of PANSS scores was 46% in the clozapine group, 40% in the ECT groups, and 71% in the combination group; the difference between the combination group and the other groups was statistically significant [p<0.05]. Patients had a quick response to combination treatment, which resulted in a higher cure rate of positive and negative symptoms and improved the patients' general performance. There were no significant adverse effects with combination treatment. Combination treatment with clozapine and ECT was safe and effective in treatment-resistant schizophrenic patients. It should be considered for the treatment of treatment-resistant schizophrenic patients

Association between hirsutism and mental health

To ascertain the prevalence of psychiatric disturbances in a sample of hirsute women. This case-control study was carried out on 100 hirsute women referred to a dermatology clinic in Sari, Mazandaran, Iran from 2004 to 2005. One hundred non-hirsute healthy control subjects were case-matched for demographic variables and completed the symptom checklist revised [SCL-90-R] instrument. Data were analyzed using SPSS software [version 11]. Forty-three percent of the women reported psychological distress, with the most common subscales being interpersonal sensitivity, paranoid, depression, and obsessive compulsive. In the control group, 42% were suspicious for mental disorders. There was no significant difference between the 2 groups. No significant difference concerning mental health was reported between the hirsute and non-hirsute women. This maybe due to patients having adapted to their disorder due to the presence of high social stress conditions in Iran