Culture, Gender, and Aggression in Psychodynamic Group Therapy: A Case of a Male-Only Group with Female Leaders in Iran.

The article focuses on a male-only therapy group that has been functioning for the last nine years in the Middle East, in Iran. The group has a permanent main female therapist and temporary, mostly female trainee cotherapists. We explore culturally specific factors that we believe impact expressions of aggression in the group. These factors include the Iranian gender segregation culture, the ideal of masculinity relating to the concept of "Gheirat" (moral vigilance), the legal acceptance of multiple wives in Iran (which often leads to family instability), and the cultural belief about the uncontrollability of sexual desires in men. We also comment on the role of a common dynamic in Iranian families, in which the relationships between mothers and sons are usually overwhelming while the emotional relationships between parents are somehow restrained. We close by discussing future directions for this area of study as well as by proposing interventions therapists may consider when encountering related group dynamics.

Psychiatric Onset Alexander Disease: An Important Challenge in Neuropsychiatric Diagnosis: A Case Report.

Introduction: Alexander disease is a heterogeneous group of diseases with various manifestations based on the age of disease onset. This rare leukodystrophy syndrome with mutations in the GFAP gene could present with developmental delay and seizure in the infantile form to ataxia and bulbar palsy in adulthood. However, psychiatric symptoms are not well-defined and are usually evaluated after disease diagnosis, not before disease investigations. Case Report: Our patient is a 52-year-old Iranian woman with a history of depression since 17 years ago, a suicidal attempt two years ago, and ingestion of a large amount of opium with the intention of suicide 2 months ago. She was presented with disorientation and probably a delirious state in the last interview. Eventually, in comprehensive investigations, white matter hyperintensity in MRI and leukodystrophy was diagnosed to determine the cause of these changes, we did a gene study, found whole exon deletion of the GFAP gene, and made a diagnosis of late-onset Alexander disease. Conclusion: Neurological-onset manifestation of Alexander disease, specifically late-onset form, is the most common clinical picture of disease and was seen in about 90% of patients, but psychiatric symptoms are not well-known, and psychiatric-onset disease was not described yet. Various gene mutations were described in late-onset Alexander disease; however, the large whole exon deletion which was revealed in our patient is a novel mutation and significantly needs to be explored. Here authors describe a late-onset Alexander disease with psychiatric-onset symptoms and novel large exon deletion in the GFAP gene. Highlights: Alexander disease is a rare heterogeneous disorder that could have various symptoms of the central nervous system involvement.The whole-exons deletion of the GFAP gene in an adult patient with features of Alexander disease is the first Gene mutation that was revealed in this case.Psychiatric onset Alexander disease is the one differential diagnosis in the patients with atypical psychiatric symptoms combined with soft neurological signs.Neurologic consultation and appropriate imaging and laboratory procedures could help early diagnosis and potential treatment. Plain Language Summary: Patients with atypical psychiatric symptoms are usually visited more times in the year without any significant benefit. They receive numerous medications and encounter significant complications due to mentioned polypharmacy. However, genetic, metabolic, or neurological causes could be considered in some treatment-resistant cases. We described the rare genetic disorder(Late-Onset Alexander disease) in the Iranian woman with atypical and treatment-resistant depression with suicidal attempts. We proposed holistic assessment in the patients with psychiatric symptoms which have atypical course or response to treatment or are accompanied by neurological and cognitive symptoms.

The Effect of Brief Crisis Intervention Package on Improving Quality of Life and Mental Health in Patients with COVID-19.

Objective: COVID 19 is having a devastating effect on mankind's life. Individuals with COVID-19 will experience high levels of stress, depression, anxiety, and low quality of life. The goals the of present study were to investigate the effect of brief crisis intervention package on stress, depression, anxiety, and quality of life in patient with COVID-19. Method : In this randomized controlled clinical trial, 30 patients were randomly selected and divided into control and experimental groups. The experimental group was examined in four 60-minute sessions for one month. During this period, the control group received only routine treatment and therapy. Before and after the intervention, DASS21, the Symptom Checklist (SCL-25), and WHO-QOL were used to measure and record patient mental health and quality of life. Finally, data were analyzed using SPSS 24 software. Results: The average mental health score was assessed with WHO-QOL, DASS21, and SCL-25 before intervention and was not statistically significant (P = > 0.05), and the mean score of stress, anxiety, depression, WHO-QOL, SCL-25 after intervention was statistically significant (P < 0.001). Therefore, results showed the brief crisis intervention package was effective in improving the quality of life (P < 0.05) and mental illnesses (P < 0.05) in patients with COVID-19. Conclusion: The brief crisis intervention package can reduce the negative effect of patients with COVID-19. Therefore, this intervention can be used as a beneficial treatment to improve mental disorder symptoms and to improve the condition of people who suffer from COVID-19.

Effects of celecoxib on inflammatory markers in bipolar patients undergoing electroconvulsive therapy: a placebo-controlled, double-blind, randomised study.

PRINCIPAL: Electroconvulsive therapy (ECT) is a treatment option for patients with bipolar disorder (BD). Alterations of markers have been reported following ECT. AIM: the aim of the present study was to assess the effect of adjunctive celecoxib on the serum cytokines of patient with BD who were undergoing ECT. METHODS: This study was a randomised, double-blind, placebo-controlled trial in 48 patients who were diagnosed with BD and ordered to undergo six or more ECT sessions. Patients were randomly assigned to receive either placebo or celecoxib (200 mg twice daily) starting a day before the first ECT and continuing throughout the end of the sixth ECT. Blood levels of interleukin-1ß (IL-1ß), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hsCRP) were measured before the first ECT and repeated after the first, the third and the sixth ECT sessions. Data were analysed by using SPSS version 13. RESULTS: Twenty-five patients (mean ± standard deviation age of 33.64 ± 9.97 years) were assigned to the celecoxib group and 23 patients (mean age of 32.61 ± 9.82 years) to the placebo group. This study found that the level of TNF-α was significantly lower (p = 0.04, t = 2.14, degrees of freedom 46) in patients receiving celecoxib compared with those on placebo at the last session of ECT. However, the other factors studied did not show any significant changes throughout the trial. CONCLUSIONS: Celecoxib was concluded to reduce TNF-α levels significantly in the patients at the end of the study. However, the differences in IL-1ß, IL-6 and hsCRP between the two groups were not significant. TRIAL REGISTRATION NUMBER: IRCT201201247202N2.

Persian translation of perception of psychiatry survey questionnaire and evaluation of its psychometric properties.

OBJECTIVE: Test the psychometric properties of the Persian version of the Perception of Psychiatry Survey questionnaire, which is being used in a large multi-site international study, of which we were part. This instrument was designed to measure the attitudes of medical educators to psychiatry. METHOD: We used World Health Organization guideline as the methodological model for Persian translation. The Persian version of Perception of Psychiatry Survey questionnaire was administered to a convenience sample of 100 medical teachers at Tehran University of Medical Sciences and Azad University. The content validity, internal consistency, and test-retest reliability of the instrument were assessed. RESULTS: No item changed completely during the process of translation and cultural adaptation. The content validity of translation and back translation was 0.74 and 0.86 according to Feliss Kappa Statistic. The Cronbach's α coefficient was 0.76 for the Persian version and for its subdivisions ranged from 0.59 to 0.81. The inter class correlation (ICC) coefficient for test-retest reliability of the whole instrument was 0.89. CONCLUSION: The Persian version of Perception of Psychiatry Survey questionnaire could be considered as a good cross-cultural equivalent for original English version. The instrument is a reliable instrument in terms of internal consistency and test-retest reliability.