Demographic Profiles of Iranian Individuals with Personality Disorder

Background and Aim:Personality disorders (PDs) are widespread, rigid, and maladaptive with collections of traits that impair individuals and limit their capacity to function effectively. Recent studiesindicate that PDs are consistently associated with several demographic characteristics. The present study was conducted toinvestigate the differences between the demographic characteristics of DSM-5 Sections II and III PDs in an Iranian clinical sample. Materials and Methods:Data on the demographic distribution of DSM-5 Sections II and III PDs were derived from a total of 430 Iranian patients with PDs presenting to four clinical centers in Tehran using well-established measures. Different statistical analysis methods were used to compare demographic differences between DSM-5 Sections II and III PDs. These analyzes were performed using SPSS software V. 22. Results:Data analysis indicated that educational level, gender, age, marital status, average monthly household costs, and ethnicity had an impact on most PDs. In return, birth order accounted for the changes in only DSM-5 Section II histrionic PD. Conclusion:Current research reveals that certain demographic subgroups have an impact on PDs. Accordingly, the need for psychiatric services for these individuals needs to be explored

Characterization of DEFB103 gene structure, gene expression and its haplotype association with three common diseases in Beef and Holstein cattle

The DEFB103 gene is a member of the β-defensin gene family, and it has not been well studied in cattle. In this study DEFB103 gene expression, gene structure and its haplotypes association with three diseases were studied. DEFB103 gene expression was profiled for 27 tissues in nine two-week old calves and the transcript was most abundant in tissues with stratified squamous epithelium. An age-dependent decrease (P <0.05) in DEFB103 gene expression was observed in buccal epithelium when comparing healthy two-week old and 10- to 12-month-old calves. A bovine herpesvirus-1 respiratory infection did, however, significantly (P < 0.05) up-regulate DEFB103 gene expression in the buccal epithelium of 6- to 8-month-old calves. Immunohistochemistry was used to identify cells expressing DEFB103 protein within tissues with stratified squamous epitheliums to confirm the DEFB103 gene expression results. DEFB103 protein was most abundant in basal epithelial cells and was present in these cells before birth. A close association was observed between the dendritic cells and epithelial cells expressing DEFB103 in both the fetus and newborn calf, and this is consistent with the β-defensin regulatory effect on dendritic cell responses. DEFB103 cDNA boundaries were determined using RT-PCR. A newly discovered non-coding exon 1a and a 261 bp intron 1a were identified in cattle. At least two complete copies of DEFB103 with an ATG start codon are present in cDNA in some cattle. DEFB103 sequence assemblies and partial cloning cloning sequences revealed two types of deletion (4-bp and 8-bp) in the 5′UTR. Two novel SNPs were identified in the 5′UTR of the DEFB103 (c.-383A>G, c.-241G>A) in addition to five (c.-319A>G, c.-264C>T, c.-69A>G, c.-42A>G, and c.-34G>A) previously reported SNPs in the 5′UTR of DEFB103 gene. The association among three diseases and four haploid haplotypes was studied. Diploid haplotype analysis shows a trend toward increased risk of mastitis (1/4; P= 0.053) in the Saskatchewan population and a decreased risk of mastitis (4/4; P= 0.06) in the Pennsylvania population. An inconsistent trend toward decreased (2; P=0.09) or increased (4; P=0.09) risk of mastitis also were determined when the haploid haplotypes were compared to others in the Saskatchewan and the Pennsylvania populations. There was no significant difference in the haplotype frequencies of the control group and cattle with Cancer-eye (P= 0.43). No significant difference was determined in the survival curve (P=0.50), the level of serum haptoglobin (P=0.65), or the level of interferon-gamma (P= 0.50) between cattle with diploid haplotypes 2/2 and 2/4 and shipping fever

A Comparative study of nurses as case manager and telephone follow-up on clinical outcomes of patients with severe mental illness

Background: Providing community-based mental health services is crucial and is an agreed plan between the Iranian Mental Health Office and the Regional Committee for the Eastern Mediterranean (affiliated with WHO). The aim of this study was to determine the effectiveness of home-visit clinical case-management services on the hospitalization rate and other clinical outcomes in patients with severe mental illness. Methods: A total of 182 patients were randomly allocated into three groups, namely, home-visit (n=60), telephone follow-up (n=61) and as-usual care (n=61) groups. Trained nurses as clinical case-managers provided home-visit services and the telephone follow-up tasks. Hospitalization rate as a measure of recurrence, as well as burden, knowledge, general health condition of caregivers with positive/negative symptoms, satisfaction, quality of life, and social skills of the consumers were assessed as the main and secondary outcomes, respectively. Results: Most clinical variables were improved in both intervention groups compared with the control group. During the one year follow-up, the rate of rehospitalization for the telephone follow-up and as-usual groups were respectively 1.5 and 2.5 times higher than the home-visit group. Conclusion: Trained clinical case-managers are capable of providing continuous care services to patients with severe mental illness. The telephone follow-up services could also have beneficiary outcome for the consumers, their caregivers, and the health system network. © 2016, Shiraz University of Medical Sciences. All rights reserved

Domestic violence and its associated factors in Iran: according to World Health Organization model

Background and Aim: Domestic violence is a global problem that led to many maternal and neonatal complications. Among the factors associated with domestic violence, social determinants of health are the most controversial issues in health policy domain. According to the WHO conceptual framework of Commission on Social Determinants affecting on health this study has been designed to investigate the articles that have been published on its prevalence and related factors in Iran. Materials and Methods: This descriptive study reviews the Iranian articles published in four data bases (PubMed, SID, Iran Medex, Magiran) between 2000-2013, by searching violence, abuse, pregnancy in title, abstract and keywords of the articles. Results: Overall, 38 articles, 5 English and 33 Persian, were selected according to inclusion criteria and assess. 35 articles were descriptive (longitudinal and cross-sectional) and 3 were analytic (cohort and case-control). Prevalence of domestic violence in pregnancy was reported between 19.3% to 94.5%. Among domestic violence related factors, the most prevalent factors in structural determinant were maternal education and in intermediary determinant were material circumstance: housing, psychosocial circumstance: unwanted pregnancy, behavioral factors: partner substance abuse and health system: lack of prenatal care. ‍Conclusion: The prevalence of domestic violence during pregnancy in Iran is a matter of concern and can be reduced by identifying high risk groups. Since many social determinants may affect domestic violence, performing etiological investigations is recommended

Clinical outcomes and cost effectiveness of two aftercare models provided by general physicians and nurses to patients with severe mental illness

Background: Implementing community-based psychiatric services is one of the priorities of the WHO/EMRO mental health programs. This study presents an aftercare service, as a community based-service, for patients with severe mental illness (SMIs). Methods: In this randomized controlled clinical trial design, 176 patients, who attended selective hospitals with SMI, were allocated into three groups: clinical case managers provided by general practitioners, nurses and the control group (usual treatment). The clients and their caregivers received monthly home visits (education and treatment supervision). The effectiveness of the intervention was measured by indicators of psychopathology such as scores of YOUNG, caregivers' knowledge and satisfaction with the services. Health-related quality of life (SF-36) was considered as the primary outcome variable. Data were collected at baseline and at 12 months follow-up. Direct and indirect medical costs were obtained through a periodic completion of questionnaires and interviews by care-givers. Cost effectiveness ratio was estimated as cost per QALY gained in each group. SPSS 16.0 was used in this survey and statistical methods were chi-square, ANOVA, Scheffe as post-Hoc test and paired sample t-test with 95 confidence interval and 0.05 significance level. Results: The results of our study revealed that the score of YOUNG, caregivers' knowledge and satisfaction with service were improved in both intervention groups after 12 months. Improvement in health-related quality of life was observed in the general practitioner and nurse group. The incremental cost effectiveness ratio was 5740807 IRR and 5048459 IRR per QALYs gained in the general practitioner and nurse groups, respectively. Conclusion: The model of aftercare services provided by trained nurses is the most cost- effective and feasible model for Iran's socio-economic conditions with low resource allocations

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

Reliability, validity and factor structure of the GHQ-28 used among elderly Iranians

Background: The object of this study was to develop an Iranian version of the General Health Questionnaire-28 (GHQ-28) for use with elderly subjects. Methods: The GHQ-28 Farsi version was evaluated for face validity among 204 elderly subjects aged 59 years or older, chosen randomly from residents of Tehran. The Composite International Diagnostic Interview (CIDI) was used to establish a gold standard diagnosis of mental disorders. Results: The GHQ-28 was an internally consistent measure. Cronbach's α, split-half coefficients and test-retest reliability were 0.9, 0.89 and 0.58 respectively. Four factors were extracted using factor analysis: "depression," "psychosocial activity," "anxiety," and "somatic." Using receiver operating curve (ROC) analysis, the optimum cutoff score for the GHQ-28 in this group was 19/20 (sensitivity 0.83, specificity 0.76). Using a loading of 0.6 or greater, a short form of the instrument (GHQ-15) (α = 0.9) was derived and correlated well with the longer form of the scale (r = 0.97). Using ROC analysis, the optimum cutoff score was 10/11 (sensitivity 0.83, specificity 0.69). Conclusions: The short and long forms of the GHQ-28 are suitable screening instruments for elderly Iranian residents, particularly those living in urban areas. © 2006 International Psychogeriatric Association

The Relationship between the Structures of Personality Inventory for the Diagnostic and Statistical Manual, Fifth Edition (PID-5) and Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF)

Objective: The Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PID-5), is a trait-based measure of pathological personality designed to assess Criterion B of an alternative diagnostic system for personality disorders (PDs). In this study, we aimed to evaluate the relations among the PID-5 and the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF); a commonly used self-report instrument with a hierarchical structure. Method: We examined the joint structure of the PID-5 scales along with levels of the MMPI-2-RF hierarchy to understand whether conceptually expected structures tend to be loaded with each other. Data were collected from 536 participants from the general population of Iran. Results: Findings of Pearson’s correlation analyses exhibited the generally expected patterns between the two mentioned measures on most scales, with some divergences. Similarly, although applying a set of joint exploratory structural equation modeling (ESEM) exhibited some factor loadings for PID-5 facets within the hierarchical framework of MMPI-2-RF scales that were different to what was theoretically expected, both measures were generally loaded in a conceptually expected way, indicating that they have a similar dimensional structure. Conclusion: Our findings provide support for adequate convergence of maladaptive personality traits and psychopathology structures, as well as for utilizing MMPI-2-RF to measure personality psychopathology from a dimensional perspective. The implications of these results are discussed by the authors

Reliability, validity and factor structure of the GHQ-28 used among elderly Iranians

Background: The object of this study was to develop an Iranian version of the General Health Questionnaire-28 (GHQ-28) for use with elderly subjects. Methods: The GHQ-28 Farsi version was evaluated for face validity among 204 elderly subjects aged 59 years or older, chosen randomly from residents of Tehran. The Composite International Diagnostic Interview (CIDI) was used to establish a gold standard diagnosis of mental disorders. Results: The GHQ-28 was an internally consistent measure. Cronbach's α, split-half coefficients and test-retest reliability were 0.9, 0.89 and 0.58 respectively. Four factors were extracted using factor analysis: "depression," "psychosocial activity," "anxiety," and "somatic." Using receiver operating curve (ROC) analysis, the optimum cutoff score for the GHQ-28 in this group was 19/20 (sensitivity 0.83, specificity 0.76). Using a loading of 0.6 or greater, a short form of the instrument (GHQ-15) (α = 0.9) was derived and correlated well with the longer form of the scale (r = 0.97). Using ROC analysis, the optimum cutoff score was 10/11 (sensitivity 0.83, specificity 0.69). Conclusions: The short and long forms of the GHQ-28 are suitable screening instruments for elderly Iranian residents, particularly those living in urban areas. © 2006 International Psychogeriatric Association

Correlation between self-esteem and perceived stress in pregnancy and ways to coping with stress

Background and Aim: Stress during pregnancy can have long-term negative consequences on both mother and fetus. Therefore, recognizing the factors that contribute to controlling stress can have a major role in pregnant women’s mental health. The current research was designed to determine the role of self-esteem on the level of stress during pregnancy and the ways to cope with it. Materials and Methods: In this regard, a cross-sectional study was conducted. The city of Tehran was divided into 4 geographic districts including north, south, east and west. A state hospital was elected for each district, and 450 pregnant women (24-32 of gestational week) were randomly chosen from the hospitals. After explaining the purpose of the study and obtaining an informed consent from the qualified pregnant women, they filled out the perceived stress, Rosenberg Self-Esteem and Coping Inventory for Stressful Situations (CISS) questionnaires. Data were analyzed using SPSS software version 19. The level of significance was considered p<0.05. Results: The age of the 450 participating pregnant women was 28.55 years, 78.9 percent had high school or lower education, and 90 percent were housewives. In this study, self-esteem was 21.918.33 and the perceived stress was 20.094.5, respectively. There was a significant inverse correlation between self-esteem and perceived stress. A significant difference was observed between individuals with different levels of self-esteem and the coping styles. ‍Conclusion: It appears that the level of self-esteem of pregnant women is effective on their level of stress and their coping style. By teaching techniques, which increase self-esteem, the level of stress can be decreased in pregnant women