Methadone Treatment in Iranian Opiate Addicts: A Preliminary Report

Background: This study aimed to investigate the initial dosage of methadone and factors affecting it in maintenance therapy.Methods: This cross-sectional, descriptive-analytic study was conducted on 157 individuals referring to a methadone maintenance therapy (MMT) clinic. The initial dosage of methadone was 20-45 mg which was adjusted during the treatment based on each patient's evaluation. Three groups were formed according to methadone dosage (less than 30 mg, between 30-50 mg, and more than 50 mg).Findings: Significant relations were observed between increased methadone dosage in the initial phase and marital status (P = 0.03), injection (P = 0.03), medical comorbidity (P = 0.009), and borderline personality disorder (P < 0.001).Conclusion: Further studies with larger sample size and including the history of previous detoxification, substance abuse, omission of self-recording, evaluation of women’s addiction and MMT program performance with counseling support should be performed.Keywords: Addiction, Methadone, Personality disorder

Comparison of Internalizing Disorders in 8-14-Year-Old Offsprings of Opium and Heroin Dependent Parents: A Case- Control Study

Abstract Background:In general, parental substance abuse is associated with children's emotional and behavioral problems. This study only investigated the internalizing problems (depression, anxiety and physical complains) in children of opioid or heroin-dependent parents in comparison with non-opioid dependent parents in order to determine the effects of drug dependency after excluding the confounding factors. Methods:This case-control study compared the internalizing problems of one hundred twenty eight 8 to 14-year-old students in two offspring groups of opioid or heroin-dependent parents (n = 64) and non opioid dependent parents (n = 64). Then we used the Child Behavior Checklist (CBCL). Parents in both groups had no major psychiatric disorders (e.g., personality disorders, mood and anxiety disorders or psychosis), no history of major medical diseases, and no history of divorce. Analysis was performed using chi square or Fisher’s exact test. Findings:The anxiety/depression subscales in children of non opioid dependent parents were significantly higher in comparison with children of opioid or heroin-dependent parents. Conclusion:Substance dependence in addition to reducing parental supervision on children may cause lack of knowledge and unawareness of their children's anxiety and mood problems. Considering study limitations, study repetition in larger statistical population is necessary for generalizing the study findings. In order to assess internalizing problems in further studies, usage of behavioral checklists for self-report of children and youth is recommended. Keywords: Internalizing problem, Child Behavior Checklist (CBCL), Opium, Heroin, Opioi

Methadone Treatment in Iranian Opiate Addicts: A Preliminary Report

Abstract Background: This study aimed to investigate the initial dosage of methadone and factors affecting it in maintenance therapy. Methods: This cross-sectional, descriptive-analytic study was conducted on 157 individuals referring to a methadone maintenance therapy (MMT) clinic. The initial dosage of methadone was 20-45 mg which was adjusted during the treatment based on each patient's evaluation. Three groups were formed according to methadone dosage (less than 30 mg, between 30-50 mg, and more than 50 mg). Findings: Significant relations were observed between increased methadone dosage in the initial phase and marital status (P = 0.03), injection (P = 0.03), medical comorbidity (P = 0.009), and borderline personality disorder (P < 0.001). Conclusion: Further studies with larger sample size and including the history of previous detoxification, substance abuse, omission of self-recording, evaluation of women’s addiction and MMT program performance with counseling support should be performed

Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents

Objective: Considering the impact of rapid sociocultural, political, and economical changes on societies and families, population-based surveys of mental disorders in different communities are needed to describe the magnitude of mental health problems and their disabling effects at the individual, familial, and societal levels. Method: A population-based cross sectional survey (IRCAP project) of 30 532 children and adolescents between 6 and 18 years was conducted in all provinces of Iran using a multistage cluster sampling method. Data were collected by 250 clinical psychologists trained to use the validated Persian version of the semi-structured diagnostic interview Kiddie-Schedule for Affective Disorders and Schizophrenia-PL (K-SADS-PL). Results: In this national epidemiological survey, 6209 out of 30 532 (22.31%) were diagnosed with at least one psychiatric disorder. The anxiety disorders (14.13%) and behavioral disorders (8.3%) had the highest prevalence, while eating disorders (0.13%) and psychotic symptoms (0.26%) had the lowest. The prevalence of psychiatric disorders was significantly lower in girls (OR = 0.85; 95% CI: 0.80-0.90), in those living in the rural area (OR = 0.80; 95% CI: 0.73-0.87), in those aged 15-18 years (OR = 0.92; 95% CI: 0.86-0.99), as well as that was significantly higher in those who had a parent suffering from mental disorders (OR = 1.96; 95% CI: 1.63-2.36 for mother and OR = 1.33; 95% CI: 1.07-1.66 for father) or physical illness (OR = 1.26; 95% CI: 1.17-1.35 for mother and OR = 1.19; 95% CI: 1.10-1.28 for father). Conclusion: About one fifth of Iranian children and adolescents suffer from at least one psychiatric disorder. Therefore, we should give a greater priority to promoting mental health and public health, provide more accessible services and trainings, and reduce barriers to accessing existing services

Breastfeeding: Neglect or Excessive Support? A Case Report of Child Abuse by a Negligent Heroin-Dependent Mother

Abstract Background: Breastfeeding is one of the best ways to promote, develop, and secure the health of infants. Child abuse is one of the most common and most important problems in the world, and one of the factors that increase its incidence is substance dependency of the parents. Breastfeeding beyond the normal age range can be harmful to the health of the mother and baby, and may represent a pathological parent-child relationship. Case Report: A little girl, who was breastfed until the age of 8 years by her heroin-dependent mother, was hospitalized in a child and adolescent psychiatric ward due to heroin dependency. During the investigations, it was found that not only had the girl been breastfed until this age, but she had also not been enrolled into a school. In other words, due to the mother’s heroin dependency, her infant was also dependent on the drug. Conclusion: In the assessment and treatment of parents with substance related disorders, the possibility of child abuse should also be considered. When breastfeeding is continued beyond the normal age range, it is necessary to find the reason. By early detection and timely intervention, negative consequences for the child can be prevented. Keywords: Breastfeeding, Child abuse, Heroin dependenc

Breastfeeding: Negligence or Extreme Support? A Case Report of Child Abuse by a ‎Negligent Heroin-Dependent Mother

Background: Breastfeeding is one of the best ways to promote, develop, and secure the health of infants. Child abuse is one of the most common and most important problems in the world, and one of the factors that increase its incidence is substance dependency of the parents. Breastfeeding beyond the normal age range can be harmful to the health of the mother and baby, and may represent a pathological parent-child relationship. Case Report: A little girl, who was breastfed until the age of 8 years by her heroin-dependent mother, was hospitalized in a child and adolescent psychiatric ward due to heroin dependency. During the investigations, it was found that not only had the girl been breastfed until this age, but she had also not been enrolled into a school. In other words, due to the mother’s heroin dependency, her infant was also dependent on the drug. Conclusion: In the assessment and treatment of parents with substance related disorders, the possibility of child abuse should also be considered. When breastfeeding is continued beyond the normal age range, it is necessary to find the reason. By early detection and timely intervention, negative consequences for the child can be prevented

Comparison of Internalizing Disorders in 8-14-Year-Old Offspring of Opium and Heroin Dependent Parents: A Case-Control Study

Abstract In general, parental substance abuse is associated with children's emotional and behavioral problems. This study only investigated the internalizing problems (depression, anxiety and physical complains) in children of opioid or heroin-dependent parents in comparison with non-opioid dependent parents in order to determine the effects of drug dependency after excluding the confounding factors. This case-control study compared the internalizing problems of one hundred twenty eight 8 to 14-year-old students in two offspring groups of opioid or heroin-dependent parents (n = 64) and non opioid dependent parents (n = 64). Then we used the Child Behavior Checklist (CBCL). Parents in both groups had no major psychiatric disorders (e.g., personality disorders, mood and anxiety disorders or psychosis), no history of major medical diseases, and no history of divorce. Analysis was performed using chi square or Fisher’s exact test. The anxiety/depression subscales in children of non opioid dependent parents were significantly higher in comparison with children of opioid or heroin-dependent parents. Substance dependence in addition to reducing parental supervision on children may cause lack of knowledge and unawareness of their children's anxiety and mood problems. Considering study limitations, study repetition in larger statistical population is necessary for generalizing the study findings. In order to assess internalizing problems in further studies, usage of behavioral checklists for self-report of children and youth is recommended

Prevalence, comorbidity and predictors of anxiety disorders among children and adolescents

Childhood anxiety may lead to serious health consequences in later life. The present study provides the prevalence, comorbidity, and predictors of anxiety disorders among children and adolescents. This was a cross-sectional national project that was implemented on 28,698 children and adolescents in Iran. Participants entered the study by multistage cluster sampling with an equal number of each gender and three age groups (6-9, 10-14, and 15-18 years) within each cluster. The tools used in this research were the demographic questionnaire and K-SADS-PL. To analyze the data logistic regression and chi-square tests were used in SPSS (ver. 16). The prevalence of anxiety disorder in children and adolescents was 13.2 in boys and 15.1 in girls. Furthermore, gender, age, place of residence and history of psychiatric hospitalization of parents could predict anxiety disorders. Anxiety disorders had comorbidity with behavioral disorders, neurodevelopmental disorders, mood disorders, psychotic disorders, substance abuse disorders, and elimination disorders. According to our findings in this study, anxiety disorders affect the performance, health and life of children and adolescents, identifying the childhood anxiety, as well as finding diseases that are associated with anxiety disorders, can help in the prevention of the disorder. Keywords: Anxiety disorder; Children and adolescents; Comorbidity; Predictors; Prevalence