Trend of suicide in Iran during 2009 to 2012: Epidemiological evidences from national suicide registration

Background: Suicide behaviors cause a large portion of Disability adjusted life years worldwide. Objectives: The aim of this research was to study the trend, correlations and discrepancy of registered suicide incidents in Iran from 2009 to 2012 using data from the Iranian suicide registry. Materials and Methods: Suicide registry entries throughout the country between 2009 and 2012, including suicidal attempts and suicides, were collected. Data on age, gender, occupational, marital and residential status along with suicide method, history of previous attempt and history of medical or mental disorders were registered by health service provision staff at the service centers. Geographic mapping and statistical analysis were performed. Results: Amongst the 252911 attempted suicides during the period, we found suicide attempt and suicide rate of 30.5 - 44.8 and 1.76 - 2.23 per 100000 individuals, respectively, denoting overall suicide fatality rate of 2.63. The rate of suicide attempt in different provinces ranged between 0.7 and 271.1 and the rate of suicide between 0.17 and 17.7 per 100000 individuals. Attempted suicides showed more fatality in males, elderly, widow/widowers, divorced and unemployed subjects as well as in residents of rural areas. The most common attempt methods were medication overdose (84), and the mostcommonsuicide methods were hanging (30.3), medications overdose (28.1) and self-burning (17.9); these methods are found at different rates in various parts of the world. Conclusions: While the registry could provide us the most valid data on suicide, the wide range of suicide and suicide attempt rates in different provinces not only could question this statement but also could highlight the importance of studying the ethnic/geographic variations in suicide epidemiology with improved suicide registry and surveillance systems. � 2016, Mazandaran University of Medical Sciences

Demographic and diagnostic features of 3147 inpatients with mood disorders in Iran

Objectives: To assess and compare demographic and diagnostic characteristics of inpatients with mood disorders in Iran. Materials and Methods: We collected the demographic, clinical, and treatment characteristics of patients, who were hospitalized during five years from April 2006 to March 2010, in Iran hospital of psychiatry, a residency training center to evaluate the general clinical picture of the disorder. Results: Overall, 95.3 of subjects had a diagnosis of bipolar I disorder (BID), 2.5 were diagnosed as bipolar II disorder (BIID) and 1.3 and 0.9 met the criteria for major depressive disorder (MDD) and bipolar not otherwise specified (NOS), respectively. Compared to patients withMDDand BIID, the onset of BID was at an earlier age (32.2 ± 1, 34.8 ± 1.5 and 29.9 ± 1.9 years old, respectively, P < 0.001). In addition, a number of admissions, mean duration of each admission and number of treatments with electro-convulsive therapy (ECT) were significantly higher in patients with BID. Conclusions: Bipolar I disorder was the most common diagnosis for inpatients with mood disorders and a more severe course in BID may indicate more severe impairments that would result in more severe disabilities. © 2016, Mazandaran University of Medical Sciences

Endolaryngeal neurofibroma

Neurofibromatosis is a benign neurogenic tumor, originating from Schwann cells of the nerve sheath. This tumor forms a round, white mass on the course of the involved nerve. It occurs sporadically or in association with von Recklinghausen's disease. Laryngeal involvement is a rare occasion that affects women more than men (F/M ratio 3:2). The most common symptoms are hoarseness, dyspnea and dysphagia. The most common sites of origin are arytenoids and aryepiglottic folds. Because of benign nature of this tumor, conservative surgery is recommended as the management of choice. Only few cases of laryngeal involvement have been reported in literature and this article presents two cases of laryngeal neurofibroma with brief review of literatures. Both cases presented with submucosal, non-ulcerated, endolaryngeal mass with signs and symptoms of airway compromise. In both cases surgical approach was endolaryngeal conservative surgery with CO2 laser. © 2008 Tehran University of Medical Sciences. All rights reserved

Stress as a risk factor for noncompliance with treatment regimens in patients with diabetes and hypertension

BACKGROUND: We have assessed the role of stress on compliance of patients with diabetes mellitus (DM) and hypertension (HTN) with taking prescribed medications and following dietary and exercise regimens. METHODS: A total of 9544 individuals more than 19 years of age were selected from three counties in central Iran. The presence of DM and HTN were asked from participants. We defined treatment adherence (compliance) based on agreement of individual�s self-report behavior with recommendations from a physician. RESULTS: Awareness about DM and HTN was 82.6 and 49.9, respectively. Multivariate analysis showed that odds ratio (OR) of high to low stress level was lower than one for both �usage of medication� and �following exercise regimen� in diabetics even after adjustment for either �age and sex� or �age, sex and education�. In hypertensive patients, OR of high to low stress level was lower than one for �usage of medication� even after adjustment for either �age and sex� or �age, sex and education� and also lower than one for �following exercise regimen� only as crude index. CONCLUSION: Cases with higher stress level had lower compliance for accepting either medication or exercise as a treatment option for their DM or HTN. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved

Comparison of two brands of methylphenidate (Stimdate® vs. Ritalin®) in children and adolescents with attention deficit hyperactivity disorder: A double-blind, randomized clinical trial

Objective: To compare the effectiveness and safety of the methylphenidate produced in Iran (Stimdate®) with its original brand (Ritalin®) in children with Attention deficit hyperactivity disorder (ADHD). Methods: In this double-blinded randomized clinical trial, 30 patients with ADHD who were 6 to 16 years old, were divided into two groups: 15 in Stimdate® and 15 in Ritalin® group. The two groups were compared for side effects profile, Conner's Parent's Rating Scale-Persion version (CPRS-R), Child Symptom Inventory-4 (CSI-4), Clinical Global Impressions (CGI), and Children's Global Assessment Scale (CGAS), at baseline and at the 4 th and 6 th weeks. Results: The subjects showed significant decreases in the CPRS-Rand CSI-4 scores and significant increase of CGAS scores during the follow-up, but there were no significant difference between Stimdate® and Ritalin® group, regarding the pattern of changes observed. The mean therapeutic dose and the number of side effects were not significantly different between the two studied groups. Conclusions: Both Stimdate® and Ritalin® had comparable clinical efficacy and safety in children with ADHD

The epidemiology of suicide behaviors among the countries of the eastern Mediterranean region of WHO: A systematic review

This systematic review aimed to help better to understand the epidemiology of suicidal behaviors among Eastern Mediterranean Region (EMR) countries. The PubMed, EMR medex, Scopus, PsychInfo, ISI, and IMEMR were searched with no language limitation for papers on the epidemiology of suicidal behaviors in the general population, published up to August 2013. A total of 13 articles were reviewed. The incidence (per 100.000) of committed suicide ranged from 0.55 to 5.4. The lifelong prevalence of attempted suicide, suicidal plan and thoughts were 0.72-4.2, 6.2-6.7, and 2.9-14.1, respectively. The figures for suicide are higher than those officially reported. Suicide behaviors� statistics is susceptible to underestimation presumably due to the socio-cultural, religious and legal barriers, not to mention the lack of well-organized registries and methodologically sound community-based surveys. © 2015 Tehran University of Medical Sciences. All rights reserved

The effect of the virtual social network-based psycho-education on the hope of family caregivers of clients with severe mental disorders

Psycho-education may have a positive effect on family caregivers of clients with mental disorders, and promote positive psychological states such as hope. The present study aims to investigate the effect of virtual social network-based psycho-education on the hope of family caregivers of clients with severe mental disorders. This study is a quasi-experimental research with a control and experimental groups. The participants of the study were 72 family caregivers of clients with severe mental disorders (36 in each group). Data were collected using demographic questionnaire and Adult Hope Scale before the study, immediately after the end of the training (first post-test), and 4 weeks afterwards (second post-test). The experimental group received psycho-education through Telegram App for four weeks. The results of the demographic questionnaire showed that both groups were homogeneous. The results of the Adult Hope Scale indicated that the mean score of both control and experimental groups were statistically significant and increased in the experimental group (P < 0.001). In addition, the changes of hope score in the experimental group were statistically significant in the first post-test than the pre-test, and in the second post-test than the first post-test and pre-test (P < 0.001). The findings of this study suggested that virtual social network-based psycho-education promotes the hopes of the family caregivers of clients with severe mental disorders. Due to the low cost and fast access of people to virtual networks, the content of this educational program can be widely used for family caregivers. © 2021 Elsevier Inc

Non-compliance and related factors in patients with bipolar I disorder: A six month follow-up study

Background: Medication treatment compliance among bipolar patients is quite widespread. Objectives: Treatment compliance depends on multiple factors. The aim of this study was to evaluate the predicting factors of noncompliance in patients with bipolar I disorder admitted to an Iranian hospital during a six-month follow up period. MaterialsandMethods: This cross-sectional study included 47 bipolar I disorder subjectswhowereadmitted to the Iran psychiatric hospital and that were chosen using a non-randomized convenient sampling model. The patients were assessed at baseline, and at two and six months after admission. For evaluating the patients, we used the medication possession ratio (MPR), the drug attitude inventory (DIA-10), the young mania rating scale (Y-MRS) and the scale for the assessment of positive symptoms (SAPS). The data were analyzed using a general linear model by SPSS 16 software. Results: The repeated measures analysis revealed that medication compliance increased successively (P = 0.045), and age, gender and symptom severity did not alter the pattern. Conclusions: There is an increasing pattern in treatment compliance in bipolar I disorder patients, regardless of the known predicting factors for nonadherence. © 2016, Mazandaran University of Medical Sciences

Comparison of demographic and diagnostic characteristics of Iranian inpatients with bipolar I disorder to western counterparts

Background: Patients' characteristics influence the disorders outcome, so it is valuable to compare mood disorders and inpatients' attributes in different large samples. Objectives: This study was designed to assess demographic and diagnostic characteristics of 3000 Iranian inpatient with bipolar disorders. Patients and Methods: We collected the information of demographic, clinical, and therapeutic characteristics of the patients who were hospitalized in Iran Hospital of Psychiatry, a university affiliated hospital in Tehran, during the 5 years from 2006 to 2011. Results: About 66.1 of the subjects were males and 33.9 were females. Iranian patients are characterized by a higher rate of unemployment, being more single, having health insurance and lower rate of divorce and education compared to the other clinical samples. In the majority of the patients, the disorder had begun with manic phase. Conclusions: Clinical and therapeutic features of Iranian patients are different from patients in western countries. © 2015, Mazandaran University of Medical Sciences