Trends in change of mental health status in the population of tehran between 1998 and 2007

According to a WHO report, the world will face great changes in the epidemiology of diseases in next three decades. Infectious and communicable diseases will be replaced by mental disorders at an alarming rate [9], making psychiatric disorders the most common cause of disability and premature death. This study compares trends and changes in the mental health of the residents of Tehran [> 15 years old] in 1998 and 2007. This study was an overview of two cross-sectional, descriptive researches that were performed in 1998 and 2007. The study populations in these two studies were residents of Tehran. Samples were recruited by regular randomized cluster sampling. In both studies, the General Health Questionnaire [GHQ-28] was used to assess mental health. Trained physicians and health experts completed questionnaires, and data were analyzed by SPSS software [Version 18]. The results showed that 21.5% of participants in the 1998 survey suffered from mental disorders, of which 27.7% were women and 14.9% were men. In 2007, this figure increased to 34.2% [37.9% in woman and 28.6% in men]. The prevalence of mental disorders increased from 1998 until 2007 by about 1.6 fold [1.4 fold for women and 1.9 fold for men]. In both studies, the risk of mental disorders increased with increasing age. Anxiety symptoms were more prevalent in both studies compared to somatization, depression, and social dysfunction scales. The result shows a dramatic increase of mental disorder prevalence in Tehran from 1998 until 2007. We believe there is a lack of sufficient and qualified facilities for mental health provisions in Tehran. Based on these facts, policymakers and officials have to place greater importance in controlling stressful situations that predispose people to mental disorders, with the intent to improve the mental health of Tehran residents

[Evaluation of mental health program integration into the primary health care system of Iran]

The aim of the current study was to evaluate the integration of mental health program into primary health care system. In a cross-sectional, quantitative and qualitative study, the knowledge, attitude and performance of 1209 individuals of general population, 146 behvarzes, 35 health technicians and 51 general practitioners from rural health centers of Gilan, Tehran, Meshad, Iran, Kerman and Kermanshah universities of medical sciences who were undercoverage and out of coverage of mental health program in the rural areas of selected centers, were selected by randomized cluster sampling. The data was gathered using knowledge, attitude and performance questionnaires of behvarzes, general population and general practitioners toward mental health, behvarzes' performance on training, following up and referral of mentally patients based on primary health care [PHC] program, knowledge and attitude of general population toward mental illnesses, epilepsy, mental retardation, their causes and treatments, general physicians awareness about treatment, referral and integration of mental health program into PHC, general practitioners's performance of health centers and a semi-structured questionnaire for focus group discussion sessions [FGD]. Thirty trained mental health experts from neighborhood of selected provinces, completed questionnaires and analyzed. Descriptive statistics and independent t-test were executed. There was significant difference between behvarzes in areas under coverage and out of coverage in knowledge [p

Mental health status of individuals fifteen years and older in Tehran-Iran [2009]

This survey was implemented as a part of the Urban Health Equity Assessment and Response Tool [Urban HEART Project] in Tehran, Iran. Since an accurate programming in order to provide mental health services in the province of Tehran requires basic and essential information, the present study was carried out to determine the mental health status of a population sample aged 15 years and over in the mentioned city. The present research was a descriptive cross-sectional study. The statistical population comprised all individuals residing in the 22 areas of Tehran Municipality. Regular random cluster sampling was used in order to choose the subjects from among the households in the mentioned areas. In total, 19370 subjects [7705 male and 11665 female] completed the 28-item version of the General Health Questionnaire for the assessment of mental health. Data were collected and analyzed by trained personnel of Tehran municipality health centers. The results of this survey indicated that 34.2% of the population in the age group 15 years and above suffer from mental disorders [37.9% of women and 28.6% of men]. Women's relative risk of developing mental disorders was 1.3 times higher than that of men. The risk of mental disorders increased with age; and divorced or widowed people were 1.5 times more likely to develop mental disorders compared with single and married individuals. Housewives and unemployed men had the highest risk of developing mental disorders. The highest rates of positive responses to questions on the GHQ-28 were related to malaise and being bad-tempered, anxiety and apprehension, inability to allocate time to tasks, insomnia and hopelessness. Anxiety and somatization were more common than social dysfunction and depression. It is estimated that about 2 million individuals in Tehran require mental health care. Also, insufficient number of psychiatrists and psychiatric beds, indicates that there is a need to provide appropriate staff and facilities to make mental health care available in large cities such as Tehran. The provision of life skills workshops for general population is also suggested, in order to enable individuals to cope with stressful situations in urban areas

[Effectiveness of psycho-social support intervention in Qazvin earthquake survivors]

Psycho-social consequences and effects of natural disasters are important issues, but it has been paid little attention in our country. This research aims to study the effectiveness of psycho-social support intervention in Qazvin earthquake survivors in 2003. In this research, about 389 of participated in meetings such as children and adults were assessed in order to determine the effectiveness of psycho-social support services for the injured before intervention and a year after providing services by 10 clinical psychologists. The control group was selected from unaffected areas in Qazvin province. The research was done by using different questionnaires such as 28 questions of public health; Rutter behavioral disorder; and questionnaire of stress disorder symptoms of Watson and Yule after disaster. After receiving services, psycho-pathological disorders among people at age 15 or over were 33/5% [45% before intervention] in the experimental group and it was 23/1% [34/1% before intervention] in children [under the age of 15]. Psychological support services could relieve significantly stress disorder symptoms after disasters in two groups. Psycho-social support services to the injured can greatly minimize stress disorder symptoms after stressful disasters and psycho-pathological mental disorders among survivors and also prevent the prevalence of social problems in them

Prevalence of mood disorders in Iran

To study the prevalence and demographic characteristics of mood disorders among Iranian adults. In this cross-sectional population-based epidemiological study [age 18] in Iran, 25180 individuals were selected through a randomized cluster sampling method for a diagnosis using the Schedule for Affective Disorders and Schizophrenia [SADS]. They were then interviewed at home by 250 trained clinical psychologists. The estimated lifetime prevalence of Major Depressive Disorder [MOD] and Minor Depressive Disorder [mDD] were 3.1% and 0.3% respectively. Also, the estimated lifetime prevalence of Bipolar Mood disorder [BMD] type I and type II were 0.1% and 0.7% respectively. The current prevalence of MDD, mDD, BMD-I and BMD-II were 1.8%. 0.2%, 0.04%, and 0.3% respectively. Mood disorders were associated with female gender, lower education, being married, being middle-aged, living in cities, and not being a homemaker. The prevalence of mood disorders was lower among Iranian adults than reported in Western studies, and a number of demographic associations differed from those reported in Western studies: Important cultural differences in the nature or manifestation of depression are implied by these results

Qualitative analysis of mental hospitals problems from view point of thier managers

This study revealed mental hospitals problems based on view point of their managers and analyzed atiologyand its consequences. Delphi method, which is a mean of systematicall data collecting and refining information provided by a group of selected experts, was conducted. The majority of the problems in the mental hospitals were due to self-management procedure, lack or enough budget and irrational fees. In one hand mental patients and their families don't have sufficient income to pay the expenses of these hospitals and on the other hand facilities for improvement of patients social, occupational and rehabilitation capabilities are inadequate. Coverage of insurance for mental patients is incomplete and lack of proper socio-economic supports due to negative attitudes toward them are a many other problems. There are no administrative structures for standardization of mental hospitals and most of the mental hospitals are dilapiodated and without enough space for patients. Based on complicated problems of mental hospitals and increasing needs of mental patients to health care and treatment services, it is the time to change the structure and budgetary of psychiatric centers in Iran

Prevalence of intestinal parasitic infections in the Islamic Republic of Iran

A national survey of the prevalence of intestinal parasitic infections in the Islamic Republic of Iran was made on a r and om sample of families covered by local health centres affiliated to the medical universities. Out of 53,995 people aged 2+ years, from 12,495 families [0.1% of all families in 1999], 45,128 stool samples were analysed by formalin-ether precipitation. Intestinal parasitic infections were found in 19.3% of the study population [19.7% male, 19.1% female]. Giardia lamblia [10.9%], Ascaris lumbricoides [1.5%], Entamoeba histolytica [1.0%] and Enterobius vermicularis [0.5%] were the most common infections. The infection rate was highest in the 2-14 years age group [25.5%] and in rural residents [23.7%]

[ epidemiology of psychiatric disorders in Kerman province [year 2001]

Nowadays the burden of psychiatric disorders has been identified in developed countries by screening questionnaires and standard clinical interviews at a high level, but there has been conducted few investigation to study the epidemiology of psychiatric disorders in our country, comprehensively. The aim of this study was to estimate the prevalence of psychiatric disorders in the individuals of 18 years and over in urban and rural areas of Kerman province.This study was a cross-sectional survey in year 2001. This was a part of national epidemiological study of psychiatric disorders. In this survey 876 individuals were selected through randomized systematic and clustered sampling methods from the existing families in Kerman and the Schedule for Affective Disorders and Schizophrenia [SADS] questionnaire were completed by the clinical psychologist. The diagnosis of the disorders was based on DSM-1V classification criteria. The results of the study showed that the prevalence of psychiatric disorders in Kerman province was 19.62% which was 25.48% in the women and 13.50% in men. The anxiety and mood disorders respectively with 8.33% and 7.19% had the higher prevalence in the province. The prevalence of psychotic disorders in this study was 0.46%, neurocognitive disorders 1.93% and dissociative disorders 1.71%. In the group of mood disorders, major depression with 5.59% and in the group of anxiety disorders, obsessive compulsive disorder with 2.85% had the higher prevalence. This study showed that 13.93% of individuals that were studied suffered at least from one of the psychiatric disorders. The prevalence of psychiatric disorders among the women in this province was 17.67%, age group of 66 years and above 29.82%, widows 33.33%, residents of villages 16.09%, illiterate individuals 17.57% and among the retired individuals was 29.03% and were more than the individuals in other groups.Being aware of this matter reveals the responsibility of the health policy makers and programmers, prevention, treatment and medical education more than before in relation to preparing application and executive plans in Kerman province for mental health

[ epidemiological study of psychological disorders in chaharmohal and bakhtiari province, 2001]

The objective of this survey was to carry out the epidemiological study of the psychiatric disorders among over 18 years old individuals in the urban and rural areas of Chaharmohal and Bakhtiari province. The sample consisted of 305 persons selected by randomized clustered and systematic sampling methods from the families of Chaharmohal and Bakhtiari province. For each person the Schedule for Affective Disorders and Schizophrenia [SADS] questionnaire was completed by a clinical psychologist. The diagnosis of the disorders was based on DSM-IV classification criteria. The overall prevalence of psychiatric disorders in the province was 16.42%. It was 20% among women and 13.14% among men. The anxiety and neuro-cognitive disorders with 9.52% and 3.28% respectively were the most prevalent in the province. The prevalence of psychotic disorders in this study was 0.33%, mood disorders 2.63% and dissociative disorders 0.66%. In the group of mood disorders, major depression with 2.30% and in the group of anxiety disorders, phobic disorder with 2.62% had the highest prevalence. We found that 10.49% of the individuals suffered from at least one psychiatric disorder. The prevalence of psychiatric disorders in the province among the age group of 56-65 with 30%, individuals whose spouses had passed away with 25%, urban residents with 15.53%, illiterates with 12.66% and unemployed persons with 21.74% were more than other groups. These findings emphasize the responsibility of the health policy makers for prevention, treatment and medical education for mental health

epidemiological study of psychiatric disorders in Qazvin province [2001]

Planning for providing essential mental health services to the people requires a comprehensive understanding of the present status of psychiatric disorders in the society. To carry out the epidemiological study of the psychiatric disorders among the individuals within the age group of 18 years and above in urban and rural areas of Qazvin. This study was a cross-sectional survey in the year 2001. 354 individuals were selected through randomized systematic and clustered sampling methods from among the existing families of Qazvin province. The Schedule for Affective Disorders and Schizophrenia [SADS] questionnaires were completed by a clinical psychologist. The diagnosis of the disorders was based on DSM-IV classification criteria. The results of the study showed that the prevalence of psychiatric disorders in the province is 31.61% with a value of 42.23% for women and 20.66% for men. The anxiety and mood disorders with 20.89 and 4.80% respectively, showed a higher prevalence in the province. The prevalence of psychotic disorders in this study was 1.12%, neuro-cognitive disorders 2.54% and dissociative disorders 2.26%. In the group of mood disorders, major depression with 2.82% and in the group of anxiety disorders, phobia with 8.19% showed a higher prevalence. The findings make the responsibility of the health policy makers and programmers, in the fields of prevention, treatment and medical education more than before in relation to preparing both executive and practical plans in Qazvin province for mental health

Mental health in the Islamic Republic of Iran: achievements and areas of need

The development of mental health in the Islamic Republic of Iran is described with particular reference to the integration mental health into the primary health care system. The achievements made so far are outlined and the areas of need discussed