Injecting and Sexual Networks and Sociodemographic Factors and Dual HIV Risk among People Who Inject Drugs: A Cross-sectional Study in Kermanshah Province, Iran

Background: Few studies suggest that social network factors, including size of sexual network may associate with drug-related and sexual high-risk behaviors. The objective of this study is to investigate injecting and sexual networks and sociodemographic factors that might be associated with dual HIV risk (DHR) among people who inject drug (PWID).Methods: The data from a cross-sectional study of 455 PWID that were recruited through peer-referral sampling were used in this study. The data were collected using a structured questionnaire consisted of modules on sociodemographic characteristics, sexual and injection-related risk behaviors during 12 months before the interview. DHR was defined as engaged in both using a syringe previously used by other PWIDs and unprotected sex during last 12 months. Data analysis was performed with descriptive and logistic regression. In final model, we considered variables with P 0.050).Conclusion: DHR was common in PWID in Kermanshah. Having multiple injecting and sexual partners increased the odds of engaging in dual risk behaviors, but regular visit of NSPs can reduce the DHR among PWID

Review: Exploration of Alzheimer\'s Disease

In the 8th edition (1910) of "Psychiatric: Ein Lehrbuch fur Studirende und Arzte", Kraepelin stated that a "particular group of cases with extremely serious cell alterations" were discussed by Alzheimer. Those changes were: "Excessively numerous plaques, dying of almost one-third of the cortical cells, and peculiar, deeply stained bundles of neurofibrils in place of them". According to Kraepelin, these changes: "represent the most serious forms of senile dementia". Kraepeline mentioned "Alzheimer's Disease" for the first time when he stated that: "The clinical interpretation of this Alzheimer's Disease is still unclear". Since that time, there were doubts about the diagnosis of Auguste Deter's illness (the first case that Alzheimer introduced in 1906), and why did Kraepelin name this condition as Alzheimer's Disease. Now after 99 years there seem to be reliable answers to these questions. Description of Auguste Deter's Dementia by Alzheimer in 1907, and then By Perusini in 1909, indicated the senile plaques and neurofibrillary tangles. Besides, Perusini restudied the brain of this case and found no significant signs of arteriosclerosis. In 1998, scientists at the Max Planck Institue of Neurobiology, Martinsried, Germany, and at the University of Munich, rediscovered brain sections of the first reported case of Alzheimer's disease. Examination of these tissue sections showed a large number of neurofibrillary tangles and amyloid plaques. So, this case represents a typical example of Alzheimer's disease according to today's standards. It is interesting, too, that in 1997 Dr. Graeber and his colleagues in Max Planck Institute of Psychiatry, Department of Neuromorphology, Martinsried, Germany, had identified well-preserved histological brain sections of Alzheimer's second case, known as Johann F. Examination of the patient's brain revealed numerous amyloid plaques, but no neurofibrillary tangles in the cerebral cortex, corresponding to a less common form of Alzheimer's disease which may be referred to as "Plaque only". The researchers in Max Panck Institute performed mutational screening of exon 17 of the amyloid precursor protein gene and genotyping for apolipoprotein E alleles. The patient was shown to be homozygous for aplipoprotein E allele epsilon 3 and lacked APP mutations at codons 692, 693, 713 and 717. With regard to the brain sections of Auguste D., genotyping for the apolipoprotein E epsilon 4 allele revealed absence of this Alzheimer's disease "risk factor" but at the same time demonstrated that mutation analysis of the more than 90 year old brain tissue was still feasible. In the hundredth anniversary of Dr. Alzheimer's historical exploration, his findings are newly confirmed

Review: Rehabilitation of Schizophernia: At the End or in the Beginning?

The majority of the long stay psychiatric patients who are in need of rehabilitation, consist of people suffering from schizophrenia. Most of them have entered old age with their above mentioned illness and besides the consequences of schizophrenia, are facing the deprivation and suffering due to their old ages. In contrast to the previous decades that there have not been an effective treatment for schizophrenia, today with the immediate diagnosis and treatment of schizophrenia with effective medications, one can prevent chronicity and resistance to their treatment. By these means one can improve the prognosis and the quality of life of patients and their caregivers. Since ten years ago the artificial discrimination of schizophrenic patients to chronic and non-chronic has lost its validity. It is recommended in spite of presenting the special and isolated hospitals for the mentally ill, also psychiatric wards in the general hospitals may be included. By all these measures the schizophrenics can have a better treatment and rehabilitation and can be saved from the social and psychological consequences of staying in the isolated mental hospitals

Study of the Effective Factors on Lenght of Stay among Psychiatric Patients in Razi Hospital

Objective: One of the most important of mental health problems is care and management of psychiatric patients. In order to assess, effective factors on duration of stay on hospitalized patients a study has done in Razi psychiatric center. Materials & Methods: This study has done in retrospective - descriptive way. Results: The results of this study showed, there is no relationship between factors such as age, sex, place of birth and residence, occupational situation, source of reference and kind of treatment with length of stay in hospital. Moreover, this study suggested patients with schizophrenic disorders, had longer stay than patients with Mood Disorders and other mental disorders (P<0.05). Conclusion: Besides, patients with previous recurrent admit, longer duration of illness, comorbidity (Physical or Mental) had longer stay (P<0.05). Single and divorced patients had longer stay than married patients (P<0.05) and patients under insurance policy stayed more time than other patients

Therapeutic Effect of Comedy Films on Decreasing of Depression in the Schizophrenic Patients

Objective: This research is an evaluation of the theraputic efficacy of comedy films in improving the mood of the long – stay schizophrenic inpatients. Materials & Methods: 50 schizophrenic patients in 2 rehabilitation wards of Razi Psychiatric – Center were selected on the basis of available sampling. They were divided into 2 groups (Experimental and Control), each group consisted of 25 patients. Before any therapeutic procedure, the magnitudes of their depression were measured by Beck Depressive Inventory. Afterwards, the experimental group was exposed to silent comedies of Charles Chaplin and Mr. Bean (Roan Atkinson) for 30 minutes every other day for two weeks. Meanwhile, the control group were shown a documentary film about the formation of planet Earth. At the end of the second week, the magnitude of depression of all cases were again measured by B.D.I. Furthermore, in order to investigate the statistical significance of differences between depression magnitude among both groups before and after the experiment, Mann Withney – U test, was utilized. Also for defining and explaining the data and drawing the scales, SPSS and Excel softwares were employed as well. Results: According to the findings of this research, the difference between depression magnitude in both groups before and after the exposure to comedy films was significant at P=0.05. Conclusion:  This result shows that comedy films can improve the depressed mood in the long–stay schizophrenic people

The Application of Drawing and Painting to Decrease the Anixiety of the Schizophrenic Patients

Objective: People with schizophrenia continuous type (previously labeled as chronic), constitute the majority of inpatients in rehabilitation wards. These patients, apart from the characteristic signs and symptoms of schizophrenia, suffer from anxiety. This anxiety, not influenced by antipsychotic medications, can be a part of the schizophrenia per se, but it may be due to the unfavorable frame and quality of life in mental hospital wards. Every attempt in decreasing the anxiety of these patients, can be regarded as a step toward a more perfect treatment and rehabilitation plan, and elevating the quality of their lives. In this research the application of drawing and painting as a method to decrease the anxiety of these patients was evaluated. Materials & Methods: 100 schizophrenic patients (according to DSM-IV criteria) who were hospitalized in long stay rehabilitation wards of Razi psychiatric center for at least 2 years, entered the research procedure. Their anxiety level was measured by the Cattel anxiety questionnaire. 50 patients, who were selected as experimental group, had 15 one hour sessions of drawing and painting. For the remainder 50 patients who were the control group, various neutral activities (as placebo) were performed, during those hours. Medications were unchanged during the research. After the 15th session the anxiety levels of patients were evaluated for the second time. The scores obtained in the first and second evaluations in each group and between two groups were analyzed by appropriate statistical methods. Results: In comparing the mean scores obtained from the first and second measurements in experimental group by applying the t-test (in correlated groups), the difference was statistically significant (t=67.5, P<0.0l). Conclusion: Sessions of drawing and painting with appropriate duration and frequency can significantly diminish the anxiety in long stay schizophrenic patients in rehabilitation wards

Identifying Some Risk Factors of Time to Relapses in Schizophrenic Patients using Bayesian Approach with Event-Dependent Frailty Model

Objectives: Schizophrenia patients often experience relapses once and even more with no limit on number of relapses. The time among relapses are rarely considered in studies. The aim of this study was to identify some risk factors of time to elapses in schizophrenic patients with recurrent events model in survival analysis. Methods: In a retrospective longitudinal study, the medical records of 159 schizophrenic patients who referred to Razi hospital in Tehran from 2003 to 2005 were conveniently sampled, investigated and followed until the end of 2009. The time to recurrent relapses were considered in weeks. The patients with at least one relapse in this duration were included in the study. Event-dependent frailty model, using Bayesian approach, was applied to fit the data and identify the risk factors of time to relapses. Results: In this recurrent failure time model, the effects of age of onset (95% CI = (0.058, 0.086)), gender (95% CI = (0.146, 0.686)), marital status (95% CI = (0.475, 0.965)) and family history (95% CI = (0.115, 0.543)) were significant on the hazard time to relapses. According to the credible interval of frailty variance, elapsed time to relapse is dependent on patients’ characteristics (95% CI = (0.084, 0.369)). Subsequent relapses are likely to be influenced by the occurrence of the first relapse, too (95% CI = (2.504, 3.079)), with decreasing hazard of time to relapse. Conclusions: Subsequent relapses are likely dependent on the first and previous relapses. Age of onset, gender, marital status and family history are important risk factors influencing hazard of time to relapses. More studies are required to clear out the effect of other covariates with this model

Determining the Relationship between Handedness Function and Self-Care Skills and Comparing them in Mental Retardedand Normal Students

Objective: Handedness and self-care skills are important in occupational therapy. This research was done in schools of the eleventh zone of Tehran in 2002. This study took place in 61 normal students (32 right-handed, 29 left-handed) and 59 mental retarded student (40 right-handed, 19 left-handed) in preschool, first and second grade. Materials & Methods: Average age for normal students was less than mental retarded students (P=0.001). Some data were taken from students through questionnaire and applying special tests for students got special data. Handedness and self-care skills were statistically compared between the two groups and relationship between them was calculated. Results: There was a significant difference between the mean grip strength of right and left hand in right-handed normal students (P=0.001) but not in left-handed students (P= 0.234). There was significant relationship between self-care skills and grip strength in normal and mental retarded students (P=0.001). The difference of correlative comparison between manual skills and self-care skills was more than significant in mental retarded students than normal students (P<0.05). Conclusion: In this study correlation between handedness and foot preference was more than the correlation between handedness and eye preference. There are significant relationships in comparing right-handed and left-handed in normal students based on birth rank (P=0.00l) but there aren't significant difference based on history of left-handed in family (P=0.963). It is recommended to evaluate and determine the handedness by means of many aspects like strength and handwriting alone is not enough

Time to Recurrent Relapses Analysis in Schizophrenic Patients by Using Recurrent Events Model

Objective: Schizophrenia is to be emphasized due to its high prevalence, severity of symptoms and frequent recurrences. In this study the hazard of recurrence of Schizophrenia was analyzed by using recurrent events models. Materials & Methods: This study was an observational prospective study. Data was gathered from 159 registered schizophrenia patients at Razi Psychiatric Center. The type II conditional model and the frailty model were used for analyzing times of recurrence. SAS (version 9.1) and R (version 2.11.0) were used for analysis of data. Significance level for the statistical tests was considered to be 0.05. Results: In the type II conditional model, age at onset of disease (P=0.021) and marital status (P<0.001) only significantly affected the hazard of the first relapse. The effects of age at onset of disease, sex, marital status, how the disease began, history of head trauma and family history of schizophrenia were not significant on the hazard of the second relapse. History of head trauma had significant effect only on the hazard of the third relapse (P=0.020). In the frailty model only the effects of sex (P=0.014) and history of head trauma (P=0.014) were significant on the hazard of recurrent relapses. Conclusion: The effects of some covariates on the hazard of recurrent relapses were significant under type II conditional model, and some covariates had significant effect under the frailty model. Further research is needed to investigate the effect of other prognostic factors on the hazard of recurrent relapses and time of recurrent relapses

Association of the Dopamine Transporter Gene (DAT1) Core Promotor Polymorphism-67T Allele with Schizophrenia

Objective: Dysfunction of the central dopaminergic neurotransmission has been suggested to play an important role in the etiology of schizophrenia. The dopamine transporter (DAT1) mediates the active reuptake of dopamine from the synapses and thereby plays a key role in the regulation of the dopaminergic neurotransmission. In this study, we sought to determine the possible association of the DAT1 gene core promoter polymorphism-67A/T with schizophrenia in a case control study. Materials & Methods: The allele and genotype frequencies of the polymorphism were studied in 100 patients and 100 controls, which were matched on the basis of sex, age and ethnicity. Results: The genotype frequencies in the patients group were as follows: AA 29%, AT 59%, TT 12% vs. the genotype frequencies in the control group: AA 57%, AT 38%, TT 5%, IX2=16.54, df-2, OR=2.25 (95%CI1.46-3, 45, P&le0.0003)]. Conclusion: For the first time, these findings provide tentalive evidence for the contribution of the DAT1 gene core promoter polymorphism to the etiopathology of schizophrenia at least in the Iranian male population that we studied. Replication studies of independent samples and family-based association studies are necessary to further evaluate the significance of our findings