The Modification of the Education System in a Medical Faculty in Iran During the COVID-19 Outbreak

Background: The coronavirus disease 2019 (COVID-19) pandemic has had an important effect on medical education. Universities around the world responded to the crisis by announcing the immediate closure and substituted the in-person sessions with online ones.Methods: Iran University of Medical Sciences designed a platform for medical students. To maintain the social distance, only onethird of students living in the dormitory were present at the dormitory in this condition. Some training courses were divided into two parts and each group was supposed to participate in given courses in-person for 15 days. The crash courses were trained on all days of the week. Then, the first group left the dormitories and was replaced with the second group, and they used dormitories for 15 days after being disinfected. Besides, for the best use of time, students who could not present in these 15-day training courses took part in virtual training programs.Results: It is depopulate the educational sessions at hospitals and classes in educational sectors. Besides, using the virtual classroom software given by the university, students can take part in virtual training programs.Conclusion: Using this platform, the number of trainees, as well as the gathering of students at dormitories, was reduced

Attitude of Iranian medical specialty trainees toward providing health care services to patients with mental disorders

IntroductionThe stigma of mental illness has a negative impact on the diagnosis and treatment of these disorders. Considering the high prevalence of mental illness, the attitude of medical specialists toward mental disorders, who are front liners in diagnosing and treating these patients, is critical. Therefore, we examined the attitude of Iranian medical specialty trainees toward providing health care services for patients with mental illness.MethodsWe included 143 residents in the fields that have the most interactions with patients with mental disorders, including internal medicine, surgery, neurology, cardiovascular diseases, and psychiatry. A demographic checklist, as well as the opening minds scale for health care providers stigma assessment questionnaire, was provided, which measures five dimensions of improvement, social responsibility, social distance, exposure, and other (such as risk) in health care providers toward delivering the healthcare services to patients with mental disorders.ResultsThe mean score of stigma for mental illness in medical specialty trainees was 61.36 ± 4.83 out of 100. Psychiatric residents have the least stigmatizing attitude (58.38 ± 3.54), and internal medicine and cardiology residents have the highest score, respectively, (62.96 ± 6.05, 62.45 ± 3.80). As for comparing subscales between specialties, only the social responsibility subscale showed a significant difference, with psychiatry having less stigma toward social responsibility (12.93 ± 2.01) than cardiology (15.09 ± 1.50) trainees.ConclusionThe attitude of medical specialty trainees toward providing health care services for patients with mental illness is not uniform; internal medicine and cardiology residents have more stigmatizing attitude, while psychiatric residents have less stigmatizing attitude. It seems that not every contact could be useful in making a better attitude toward mental illness, but it needs preconditions, like a structured contact that leads to positive outcomes. Anti-stigma interventions are needed to improve the attitude of medical specialty trainees toward providing health care services to patients with mental illness

Does watching a movie improve empathy? A cluster randomized controlled trial

Background: We studied if watching a movie about the patient physician encounter alone or in combination with a communication skills training workshop could improve empathy score of medical students. Methods: One hundred and thirty three medical students participated in one of the following four groups of the study. Group A: a three hour workshop (42 students); group B: watching the movie “The Doctor” (23 students); group C: watching the movie “The Doctor”, then, participating in a three hour workshop the next day (22 students); group D: control group with no intervention (46 students). Participants completed Jefferson Scale of Empathy (JSE), Student Version to assess empathy score before and after the intervention, and one month later. A linear mixed effect model analyzed the effect of intervention across groups considering the effects of other significant variables. Results: All of the three interventions had an immediate improving effect on empathy scores compared to control group. However, the improvement effect remained significant only in groups A (p=.015) and C (p=.001) one month later. Conclusions: Watching selected movies has a significant but transient effect on empathy of students. Combining two methods of watching the movie and communication skills workshop, seems to add the beneficial effects

The comparison of Obsessive-Compulsive Personality Disorder and Traits in mothers of 4 -11 years children having OCD Vs control group

Objectives: Obsessive-compulsive disorder (OCD)   begins in childhood and adolescence and progresses along with aging .This  survy is conducted to compare temperament and character and Obsessive-Compulsive Personality Disorder (OCPD) and OCPD traits in parents of children with OCD and parents of healthy controls.Materials and Methods: In each group, 30 patients were studied. There were 11 boys (%36.7) in the study group (children with obsessive compulsive disorder), and 12 ones in control group (%40.0). In case group, four mothers (%13.3) had obsessive compulsive personality disorder, while the frequency in control group was one (%3.3) and the frequency difference was not considered statistically significant. There was also a case of borderline personality disorder in mothers of children with obsessive-compulsive disorder, but those in control group were not diagnosed with this disorder which showed thta there was still no significant difference between the two groups. No other personality disorders (including mixed personality disorder or NOS)  was detected in two groups.Results:The results indicated that the frequency of preoccupation with details was %46.7 in the case group (children with obsessive-compulsive disorder), and %10.0 in the control group that means no significant difference between the two groups (0.002). The frequency of perfectionism was %43.3 in the treatment group and %20.0 in the control group which again had no significant difference (0.052).Conclusions: The existence of the some symptomsof OCPD according to SCID in parents of children withOCD in comparison to parents of healthy children confirm the necessity of considering the role of personality factors in familial OCD.The results of this study showed that the four dimensions of temperament based on TCI-125 and triple dimensions of attitudes between mothers in the two groups was not statistically different

The World Psychiatry Exchange Program in Iran: a unique academic and personal experience

The World Psychiatry Exchange Program in Iran is an academic experience we are delighted to share. As two participating early career psychiatrists, a local psychiatry faculty member manager, and the lead founder and international coordinator of the programme, we focus in this article on the unfolding of this new learning experience, the difficulties we encountered and the main lessons learned by the participants: commonalities and differences in training and practice in general adult psychiatry and child psychiatry in Tunisia and Iran, as well as in idioms of distress between the Arab and Persian cultures

Comparison of Online Sexual Activity Among Iranian Individuals With and Without Substance Use Disorder: A Case-Control Study

The most important practical concerns in addiction medicine are the non-substance addiction and related addictive behaviors among individuals with substance use disorder. On the other hand, technological advances, and easy access have increased the frequency of online sexual activities (OSAs) as one of these behaviors. This study aimed to compare the prevalence of OSAs, based on the Internet Sex Screening Test (ISST) scores, among 60 patients with substance use disorder referred to Iran Psychiatric Hospital and 60 non-dependent individuals. The results showed significant negative correlations between the ISST scores and age, age at the onset of substance use, and substance use duration. There was a significant difference between the ISST scores of the case and control groups (P = 0.001). Patients who start using substances at an early age and have a great duration of substance use are more likely to engage in other addictive behaviors such as OSAs. Therefore, it is critical to consider OSAs and other addictive behaviors in patients with substance use disorder to provide better care for this vulnerable community

Whole exome sequencing revealed a novel dystrophin-related protein-2 (DRP2) deletion in an Iranian family with symptoms of polyneuropathy

Objective(s): Charcot-Marie Tooth disease (CMT) is one of the main inherited causes of motor and sensory neuropathies with variable expressivity and age-of onset. Although more than 70 genes have been identified for CMT, more studies are needed to discover other genes involved in CMT. Introduction of whole exome sequencing (WES) to capture all the exons may help to find these genes.Materials and Methods: Here, we tried to find the genetic cause of the neuropathy in two Iranian brothers using WES. Blood sample was collected from probands and their family members to extract the genomic DNA. The extracted DNA from one of the affected case was subjected for WES. The variant calls were filtered  to reveal the pathogenic variant. Presence of the candidate mutation was confirmed using Sanger sequencing. The pathogenic potential of the variant was examined using in silico software. Using ClustalW multiple alignment, the presence of variant in conserved domain of protein was investigated. The parent and another affected boy were also checked for presence of the variant using PCR-sequencing. Results: The obtained data presented a novel TTC del mutation in CDS 738 of dystrophin related protein 2 (DRP2) gene, which was validated by sequencing. The variant was located in a conserved domain of DRP2 protein and predicted as pathogenic. Two affected boys were hemizygous for the mutation and received the mutation from mother. Conclusion: Here, we provided the evidence for the contribution of DRP2 in CMT. Also, the symptoms shed light on molecular aspect of this genetically heterogeneous disease

Factors associated with pharmacological and psychotherapy treatments adherence in patients with borderline personality disorder

BackgroundBorderline personality disorder is a major mental illness characterized by sustained relationship instability, impulsive behavior, and intense affects. Adherence is a complex behavior, from minor refusals to abandonment of treatment, which can be affected by various factors. Therefore, the present study aimed to investigate the factors affecting pharmacological and psychotherapy adherence, patients' attitude toward medication, and assessing medication and treatment adherence in patients with borderline personality disorder referred to an outpatient referral clinic in Tehran, Iran.MethodsThe study was a cross-sectional study. The files of patients with borderline personality disorder referred to the outpatient clinic of the Tehran Psychiatric Institute were reviewed as the first step. Data were collected using the Drug Attitude Inventory-10 (DAI-10) questionnaire and a questionnaire to determine the attitude of patients toward pharmacological and psychotherapy treatment as well as therapeutic adherence. After collecting data, patients' therapeutic adherence was divided into poor, partial, and good compliance.ResultsNinety-four patients were involved in the study, and fifty-four were women. Findings of DAI showed that 54 (57.4%) participants had negative attitudes toward medication, while 38 (40.4%) participants showed a negative attitude toward psychotherapy treatment. Additionally, the percentage of patients with good psychotherapy adherence (44.7%) was higher than that of patients with good medication adherence (31.9%). The most common reasons for discontinuation of treatment were medication side effects (53.1%), dissatisfaction with the therapist (40.3%), and then fear of medication dependence (40%). Patients with higher education levels and a positive history of hospitalization in a psychiatric ward had better adherence to psychotherapy (P < 0.05).ConclusionResults of the current study show that attitude toward psychotherapy is more favorable than pharmacotherapy among patients with BPD. The rationale may be that medications are mainly prescribed for comorbid conditions and do not have substantial effects on the BPD symptoms, resulting in low medication adherence