Lifetime and current waterpipe use among adolescents in Tehran, Islamic Republic of Iran

Waterpipe use among Iranian adolescents has become a matter for concern. A descriptive, crosssectional community-based survey was performed in 2010 to determine the prevalence of waterpipe use and associated factors among Iranian adolescents in Tehran, Islamic Republic of Iran. After multi-stage, random cluster sampling 1201 adolescents aged 15–18 years old responded to a questionnaire based on the Youth Risk Behavior Surveillance. The prevalence of current waterpipe smoking [at least once in the previous 30 days] was 28.0%, significantly higher among males [34.8%] than females [21.4%]. A total of 45.1% of adolescents reported lifetime use [ever use] of waterpipes and 34.2% had ever shared a waterpipe. In multivariate logistic regression analysis the significant correlates of current waterpipe use for both males and females were having smokers among friends and family members, while for males, older age and educational failure were also risk factors.

Psychometric properties of the Persian version of the youth risk behavior survey questionnaire

Adolescents may get involved in high-risk behaviors. Surveys are the primary, and sometimes the sole source of data collection for many high-risk health behaviours. We examined the reliability and validity of the psychometric properties of the self-administered Persian version of the 2009 Youth Risk Behavior Surveillance System [YRBSS] questionnaire. In a methodological study in summer 2010, 100 Iranian adolescents aged 15-18 years were recruited through convenience sampling. The face and content validity were used for the questionnaire validity. In order to evaluate the questionnaire's reliability, the Intraclass Correlation Coefficient [ICC] and Cronbach's alpha were calculated for domains and 89 items. Among 89 items, the ICC values were below 0.4 [weak reliability] for 2 items [2.25%], 0.4-0.6 [moderate reliability] for 10 items [11.24%], 0.6-0.8 [good reliability] for 32 items [35.96%] and 0.8-1 [excellent reliability] for 45 items [50.56%]. The prevalence of most high-risk behaviors was constant in the first and second survey. The value of Cronbach's alpha was 0.73 for intentional and unintentional injuries, 0.77 for tobacco use, 0.86 for alcohol and other drug use, and 0.79 for unsafe sexual behaviors. No domain had a mean ICC of below 0.6. Furthermore, 97.75% of the items had moderate to excellent reliability. Thus, the Persian YRBSS questionnaire had an acceptable reliability. Over the 2-week period, sexual behaviors were reported with less consistency compared to other behaviors. In any case, researchers must be aware of the limitation of the data collected through this questionnaire, particularly in comparison to the domain of sexual behaviors. Overall, 97.75% of the items had moderate to excellent reliability. Thus, the Persian YRBSS questionnaire had an acceptable reliability

[Effectiveness of grouped spiritual psychotherapy on patients with opium using disorder]

Introduction: Some scientists believe that the definition of Bio-psychosocial is not a comprehensive definition for humankind. They are willing to add the spirituality as a part of human being

Methods: This study aimed to assess the effectiveness of a spiritual group therapy among patients with opium using disorders in Tehran. This study was a clinical trial in which 61 opium users were selected using simple sampling from patient referred to the Iranian national center for addiction studies and two other private centers. Patients were divided into two equal intervention and control groups. The intervention group was treated by spiritual group therapy presented at Yale University, modified according to the Iranian/Islamic culture of the participants within eight sessions in eight weeks. Urine morphine test was done for each participant every week. The Beck depression test, Beck anxiety test and quality of life test [the short form Health survey SF36] were completed before, during and after the intervention

Results: The mean scores of the depression test [p>0.002], anxiety test [p>0.001], and the short form health survey SF 36 test [p>0.001] were improved in the intervention group after the intervention. Although urine morphine test showed a negative trend, the decline was not statistically significant [p<0.75]

Conclusion: This package showed to be effective in many dimensions of psycho-somatic, social and spiritual health of opium users. Subsequent interventions with more modified packages may be more influential

Amantadine versus methylphenidate in children and adolescents with attention deficit/hyperactivity disorder: a randomized, double-blind trial

Background: The aim of the present study was to further evaluate, under double blind and controlled conditions, the efficacy of amantadine for attention-deficit/hyperactivity disorder [ADHD] in children and adolescents as compared to methylphenidate. Materials and methods: this was a 6-week randomized clinical trial. Forty patients [28 boys and 12 girls] with a DSM-IV-TR diagnosis of ADHD were the study population of this trial. All study subjects were randomly assigned to receive the treatment using capsule of amantadine at a dose of 100- 150 mg/day depending on weight [100 mg/day for <30 kg and 150 mg/day for >30 kg] or methylphenidate at a dose of 20-30 mg/day for a 6- week double blind, randomized clinical trial. The principal measure of outcome was the Teacher and Parent Attention Deficit/Hyperactivity Disorder Rating Scale-IV. Results: No significant differences were observed between the two groups on the Parent and Teacher Rating Scale scores [df=1; F=0.02; p=0.86 and df=1; F=0.01; p=0.89, respectively]. Side effects of decreased appetite and restlessness were observed more frequently in the methylphenidate group. Conclusion: The results of this study indicate that amantadine significantly improved symptoms of ADHD and was well tolerated and it may be beneficial in the treatment of children with ADHD. Nevertheless, the present results do not constitute proof of efficacy

Comparision of barry and barry-taguchi ureterovesical reimplantation techniques in kidney transplantations: a randomized clinical trial

Renal transplantation is the treatment of choice for chronic renal failure. Using a suitable uretero- vesical anastomosis technique can prevent most of risks for kidney graft. Extravesical ureteroneocystos- tomy is becoming popular in renal transplantation because of the low complication rate and technical ease. The decreased complication rate is due to limited bladder dissection and the need for a shorter ureteral segment from the donor. In this study we assessed the effectiveness and complications of a new technique, Barry-Taguchi technique and compared it with Barry technique. We recorded all urological complications developed in the recipient's kidney between September 2004 and March 2007 [mean follow-up 12 months] after performing extravesical Barry-Taguchi [new tech- nique] and Barry ureteroneocystostomy. The urological complications studied included complicated hema- turia, urinary fistula, and ureteral stenosis. A total 100 patients who underwent Barry-Taguchi technique and 98 patients who underwent Barry technique were studied. The incidence of urological complications in Barry-Taguchi and Barry re-implan- tation technique was 4% [n=4] and 5% [n=5%], respectively. These complications included 1 urinary leak- age and 3 ureteral obstructions for Barry-Taguchi technique, and 4 obstructions and 1 leakage from Barry group. In both trial groups, no complicated hematuria has occurred. In addition, the recorded time taken for ureteral anastomosis ranged from 4 to 16 [mean 8.3] min for Barry-Taguchi technique and 5 to 20 [mean 9.9] min in Barry technique. The Barry-Taguchi extravesical ureteroneocystostomy technique is a rapid and rather simple tech- nique. Without increasing the incidence of urological complication rate, it is a reliable method for perform- ing ureteroneocystostomy

Farsi version of the strength and difficulties questionnaire self-report form: the normative data and scale properties

This study was performed to evaluate the normative data and psychometric properties and the internal consistency of the Farsi [Persian] version of the Strength and Difficulties Questionnaire [SDQ] self-report form, as a screening tool in a community-based sample of 12 to 17 year-old adolescents of urban Tehran. In this investigation, 1105 adolescents [12 to 17 years old], selected from 250 clusters from all the 22 municipality areas of Tehran, responded to 25 questions of the Farsi version SDQ self-report form. The frequency of each symptom domains according to Goodman's cutoff points and 90th percentile and the mean score in each subscale were determined. The 90th percentile cutoff points were somewhat different from those of the previous reports. Using Goodman's cutoff points, the prevalence of symptom domains was relatively high. For example, 13.7 percent of the adolescents studied had total scores equal to 20 or more. There were significant correlations between different subscales and their constituting questions. Self-report form of SDQ is a valuable tool in the screening of adolescent psychopathologies. Frequency of majority of the symptom domains seems to be higher in the adolescents in Tehran urban areas

Frequency of and barriers to utilization of mental health services in an Iranian population

This study in 2005 compared the need for mental health services, actual use of services and barriers to use by 3 groups in Shiraz city in the Islamic Republic of Iran: a sample of the general population, parents of children with mental illness and primary-school teachers. Among the general population, 76.0% reported that they had wanted help in the previous 6 months and, of these, 50.0% actually sought it. The rates for parents of children with mental problems were 81.3% and 55.4% and for teachers were 60.0% and 35.0% respectively. The most common barriers to service use were logistic, especially the cost of and inconvenient access to services. Barriers related to perceptions of mental health services were also important, such as lack of trust and perceptions of friends/family

Analysis of mental health research in the Islamic Republic of Iran over 3 decades: a scientometric study

This study described the characteristics of mental health research from the Islamic Republic of Iran published from 1973-2002. Research articles in psychiatry, psychology and neuroscience published in local or international journals were drawn from IranPsych, a national database of research in mental health and related disciplines. Of 3113 articles, 21.8% appeared in international journals, but there was international collaboration among the authors in only 2.3%. There was a marked increase in the number of publications over time, especially in the last 5 years. Analysis of research areas showed a proportionate rise in neuroscience research and a decline in mental health service research. Our study provides an empirical basis for policy-making and strategy planning in the nation's mental health research

[Comparative study of adverse effects of Olanzapine and Risperidone on blood sugar, lipid and other side effects in psychotic disorders]

Chronic mental disorders are among the problems in psychiatrics. Atypical anti psychotic drugs are new effective medications to treat these disorders. Unfortunately these drugs lead to side effects such as increase in blood glocuse, weight gain and edema. This study aims to investigate adverse effects of Olanzapine and Rispridone on lipid level and blood glocuse and other complications in patients with psychotic disorders. This clinical trial-double blinded study, patients with psychotic disorders were randomly categorized into two groups. Group one treated with Olanzapine and other with Rispridone. All the subjects were initially assessed for blood sugar and lipids, and in the case of normal, they were randomly assigned to two groups in a double- blinded method to be treated with Olanzapine or Risperidone. Blood sugar and lipids tests were performed for all subjects at the 1st week and 3 months after initiation of therapy. Other complications were assessed too, then the data were analyzed using SPSS software. The results of the study indicated that the levels of cholesterol, triglycerides and blood sugar rose significantly at the 1st week and third month after beginning the treatment. Increase of cholesterol and triglyceride in the Olanzapine and Risperidone groups was significant, while blood sugar level showed no significant difference in these two groups. Other side effects including restlessness, impotence, weight again, edema and drowsiness were significantly different between the two groups. Based on the findings of this study and the emphasis of other related studies on the metabolic changes of the body resulting from atypical antipsychotic drugs, it is suggested that these drugs should be prescribed for high risk patients with great care and cautions

effect of supportive and cognitive- behavioral group therapy on bam earthquake survivors with post- traumatic stress disorder

Psychological debriefing is a way for prevention and reduction of post- traumatic stress disorder [PTSD] symptoms. Many studies have shown the efficacy of cognitive- behavioral therapy in treatment of post- traumatic stress disorder. Only some evidence is available about using these techniques in large scale disasters. This study was done to evaluate the efficacy of psychological debriefing and cognitive- behavioral group therapy combination on Bam earthquake related PTSD symptoms. In a before-after trial, we evaluated the effect of single session psychological debriefing and three sessions of group cognitive-behavioral therapy on PTSD symptoms of Bam earthquake survivors. Individuals with severe PTSD or other psychiatric disorders needing pharmacological interventions were excluded. Before, immediately and 3 months after interventions, we evaluated PTSD symptoms by clinically- administered PTSD scale for DSM-IV and analyzed them. 95 persons were included in the study; 11 and 25 people were excluded during the first month of interventions and the 3 month follow- up period, respectively, because of migration. The frequency of PTSD symptoms and the frequency, intensity and severity of avoidance symptoms reduced during 3 month period of study which was statistically significant [p<0.05]. No effect was obsereved regarding the frequency, intensity and severity of hyper- arousal, re-experience and the intensity and severity of total PTSD symptoms. Psychological debriefing and group cognitive- behavioral therapy may be effective on avoidance and the frequency of total PTSD symptoms

Assessment research performance and educational research needs of Iran's Dental schools-2004

Compared to the information about educational responsibilities, there is not much information about the research skills and activities of the academics in dental schools. The aim of this study was to evaluate the research performance of the academic staff of the dental schools and their educational needs to promote their research skills. This cross-sectional study was done by mailing a questionnaire to all of the members of Iran dental faculties. The questionnaires contained personal information like age, sex, place of employment, educational records, and additional questions like the workshops previously attended, and interests to attend certain workshops. To evaluate the research performance of the academic staff, the number of accomplished researches, the articles published in known national and international journals, their skills in using internet, and the number of attended workshops about research methodology were included in the questionnaire. The completed questionnaires were gathered and evaluated by descriptive statistics. From the questionnaires gathered, 436 were eligible to be included in the study, which formed 58% of the academic staff of dental schools. The results showed that 7.4% of the staff had more than 10 researches conducted, 15% had 5-10, 49.9% had less than 5, and 27.7 had no researches done. Considering the articles published in known national journals, 28.2% had no papers, 51.8% had 1-5 papers, and 20% had more than 5 papers. Regarding the number of articles published in known international journals, 77.5% had no papers, and 20.2% had 1-3, and 2.3% and more than 3 papers. The "preliminary research methods" workshop had the highest percent of participation [71.6%], and "Stata acquaintance" workshop had the least [0.7%]. The participants were mainly interested to participate in three workshops, "English scientific writing" [26.3%], "principles of scientific writing" [17.5%], and preparing research proposals" [16.2%], respectively. We concluded that the research skills and performance of the academic staff, though improved in the recent years, is still unsatisfying. In order to promote it, it is recommended to organize workshops about "research methodology", "scientific writing" and "preparing of proposals"

[ effect of psychosocial supportive interventions on PTSD symptoms after Bam earthquake]

Many studies have shown the efficacy of cognitive' behavioral therapy and psychological debriefing in treatment of post traumatic stress disorder [PTSD] and a few evidences are available for using these techniques in large scale disasters. This study aimed to asses the effect of some psychological interventions in reducing PTSD symptoms after Bam earthquake in different age groups. In a before-after quasi experimental clinical trial, we compared the efficacy of one session of psychological debriefing and three sessions of group cognitive-behavioral therapy in bam earthquake PTSD symptoms in different age groups. We evaluated PTSD symptoms before and immediately and three months after interventions by CASP scaling system and analyzed data. one hundred and thirty persons entered in the study and 51 persons excluded during interventions because of migration. Interventions were showed to be effective only in short term period. The means of PTSD symptoms frequency and severity of avoidance symptoms were reduced during three months period of study which were statistically significant P<0.05. Interventions showed no efficacy for recall symptoms in long term and hyper arousal symptoms in short term and long term periods. There was no statistically significant difference among age groups. Psychosocial supportive interventions may be effective on some of the PTSD symptoms but there is no difference in different age groups

[Impact of computer game and computer assisted type instruction on inattention and impulsivity of children suffering from attention deficit hyperactivity disorder]

Treatment of inattention and impulsivity in attention deficit hyperactivity disorder [ADHD] is challenging. The aim of this study was to compare the effect of computer games versus computer assisted type instruction on inattention and impulsivity of primary school children with ADHD. In this single blind clinical trial, 37 primary school children with attention deficit hyperactivity disorder were divided into two groups. Group I [n=17] and group II [n=20] underwent one month intervention by computer game and computer assisted type instruction, respectively. Intervention was consisted of eight one-hour sessions. The two groups were matched for age, sex, school grade, drug, school performance, parents and teacher Conners' scale, having computer at home and history of work with computer. Inattention [commissions] and impulsivity [omission] was tested with continuous performance test, pre- and post-intervention. In the group I commission errors did not change significantly by the intervention. Commission errors decreased significantly in the group II [11.64 +/- 20.44 versus 14.10 +/- 10.18] [p<0.05]. Omission errors and reaction time showed no significant changes in both groups. With respect to the life time complications of ADHD children, and decrease in impulsivity by the computerized type learning in this study, we hope that with future studies, computer assisted instruction can play a role in the treatment of ADHD

[Correlation among neuropsychological tests and questionnaires in attention deficit hyperactivity disorder]

Current study aimed to assess the possibility of prediction of continuous performance test in primary school children with attention deficit hyperactivity disorder, with parents and teacher reports of inattention, hyperactivity and oppositional behavior.Fifteen school aged children with Attention Deficit Hyperactivity Disorder without co-morbid psychiatric disorders were selected from Roozbeh child and adolescent psychiatry clinic. Teachers and parent Conner's questionnaires. Continuous Performance Test and 4 class dictation scores were registered from each subject.Commission errors were correlated with hyperactivity scale in the parent report [r=-0.50, p<0.05], and with ADHD score [r=-0.49, p<0.05]. Omission error was correlated with inattention [r=0.66, p<0.05] and ADHD score [r=0.51, p<0.05] on teachers report. Reaction time was correlated with oppositional [r=0.51, p<0.05] subscale in parents Conner's questionnaire. Dictation scores were correlated with inattention on parents report[r-0.52, p<0.05] and omission on Continuous Performance Test [r=-0.79, p<0.05].Current study reported a significant correlation between neuropsychological tests and questionnaires, in ADHD

[ 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

[Psychosocial group interventions on Bam earthquake related PTSD symptoms in adolescents]

Psychological debriefing is a way for prevention and reducing post- traumatic stress disorder [PTSD] symptoms. Many studies have shown the efficacy of cognitive-behavioral therapy in treatment of PTSD. Few evidence is available for using of these techniques in large scale disasters. This study was carried out to evaluate the efficacy of psychological debriefing and cognitive behavioral group therapy combination on Bam earthquake-related PTSD symptoms in adolescents. In a before-after trial, we evaluated the efficacy of one session psychological debriefing and three sessions of group cognitive-behavioral therapy in Bam earthquake adolescents survivors with PTSD symptoms. The mean age of participants was 16.4 years and no one had severe PTSD or other psychiatric disorder that needed pharmacological intervention. Before, immediately and 3 months after interventions we evaluated PTSD symptoms using Clinical Administrated PTSD Scale for DSM-IV and analyzed them. 30 persons were included in the study, 8 of whom were excluded during interventions because of migration. The mean frequency of PTSD symptoms reduced immediately after interventions which was statistically significant [P<0.05]. There was no efficacy for intensity and severity. Psychological debriefing and group cognitive behavioral therapy may be effective in reducing the frequency of avoidance symptoms

[ bibliometric study of scientific mental health journals of Iran]

The aim of this project was to appraise the scientific mental health journals published in Iran and also to present a general profile of their characteristics. The journals evaluated in the study were published from 1990 to 2003. The scientific journals in the domain of mental health published in Iran and circulated until the implementation of this study were identified by library references, data banks, internet sites, and the editorial offices of the publications. The variables in the study were divided into three main groups: publication characteristics of the journals, distinctiveness of journals' license holders and personnel, and finally specificities of journals' contents. 23 out of 800 evaluated journals met the inclusionary criteria for this project. Less than 1/3 of the journals possess the official academic ranking of Publication Commission granted by Ministry of Science, Research, and Technology or Ministry of Health, Treatment, and Medical Education. None of these periodicals are indexed in any of the credible information banks. Nine journals did not have International Standard Serial Number [ISSN] and five journals had no English abstracts. Eleven journals were published by universities; five were published by governmental organizations and seven were funded by private organizations or scientific societies. During the study period, 1008 research articles were published in the journals. The average number of articles binded in each issue was 2.70[ +/- 1.2].The average number of articles in journals with official academic ranking certificate was higher than the journals without the certificate.There seems to be a relatively adequate number and variety of scientific mental health journals in the country,but too few articles are printed in them. For further progress in the upcoming years, the followings are suggested: quality improvement of the journals, more publication of indigenous research articles, publication of domestic periodicals in English, and indexing them on credible international information banks

Development, validation and reliability of child abuse self report scale [CASRS] in Iranian students

Diagnosing and assessing child abuse is a critical and difficult process in clinical psychology, because this phenomenon has several negative behavioral and psychological consequences on victims. The aim of this research is to create a scale for assessing child abuse and neglect. Through a multiclustral sampling, 3042 secondary school students [boys and girls] were selected to fill [1] a list of 54 items [Child Abuse and Self Report Scale, CASRS] which assess four categories of child abuse and neglect, after approving through content validity and [2] Trauma Symptom Checklist for Children [TSCC-A] in order to assign construct validity and comorbid psychopathology. Then, we did a clinical interview with a sample group who were diagnosed as abused children according to CASRS and TSCC-A. In addition, these scales were completed by a group of abused children as criterion group, for assigning criterion validity. In order to assign the reliability of CASRS and TSCC-A, after 3 weeks test-retest was done. Through a factor analysis, the best items were assigned. The results showed that CASRS and TSCC-A have excellent reliability and validity. Also, its stability was at an appropriate level. In addition, factor analysis showed that 38 items were the best questions for assessing child abuse. We believe that CASRS is an instrument which measures child abuse during the current life. It is brief [6 to 8 minutes for the core scales] and practical for epidemiological researches on child abuse, maltreatment and clinical screening. Methodological issues inherent in child self-report measures of abuse are discussed