Riyahi, Sanaz

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   ໊ඟﻣﺎناণﺘﺎن دا஺ه ﻋ࢖ﻮم ﭘﺰﺷਔﯽ و ೯ﺪﻣﺎت ঳ﮫﺪا তਠﯽ భﻣﺎ਩ﯽ   ਔﯽدا௉ه ﭘﺰﺷ     ﻋﻤﻮﻣﻲ ﭘﺰﺷﻜﻲﺟﻬﺖ درﻳﺎﻓﺖ      ﻋﻨﻮان:  در  و ﻗﻠﻴﺎن ﺑﺎ ﻣﺼﺮف ﺳﻴﮕﺎر ارﺗﺒﺎط ﺳﺮﺷﺖ ﻫﺎﻳﭙﺮﺗﺎﻳﻤﻴﻚ ﺑﻴﻤﺎري ﻃﻴﻒ دوﻗﻄﺒﻲ  7931 داﻧﺸﺠﻮﻳﺎن ﭘﺰﺷﻜﻲ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ ﻛﺮﻣﺎن در ﺳﺎل    دﻛﺘﺮ ﻣﻬﻴﻦ اﺳﻼﻣﻲ ﺷﻬﺮﺑﺎﺑﻜﻲﺧﺎﻧﻢ  اﺳﺘﺎد راﻫﻨﻤﺎ:    اﺳﺘﺎد ﻣﺸﺎور:ﺧﺎﻧﻢ دﻛﺘﺮ ﻓﺮزاﻧﻪ رﻋﺎﻳﻲ    ﭘﮋوﻫﺶ و ﻧﮕﺎرش:ﺳﺎﻧﺎز رﻳﺎﺣﻲ  8931آﺑﺎن        erman University Medical Sciences Faculty of Medicine Afzalipour School of Medicine  A Dissertation Submitted as a Partial Fulfillment of the Requirements for the Degree of Doctor of Medicine   Title:  The relationship Between Hyperthymic temperament of Bipolar Spectrum disorder and  cigarette smoking among medical students of Kerman University of medical sciences in year 1397  Supervisor: Dr Mahin Eslami Shahrbabaki Advisor: Dr farzane Roaee   By: Sanaz Riahi   November 2019       ﭼﻜﻴﺪه ﺷﺪه ﺑﺴﻴﺎر ﻒ دو ﻗﻄﺒﻲ از آن ﭼﻪ ﻗﺒﻼ ﺗﺼﻮر ﻣﻲﺷﻴﻮع اﺧﺘﻼل ﻃﻴاﺳﺖ. اﺧﺘﻼل دوﻗﻄﺒﻲ ﻳﻚ ﺑﻴﻤﺎري رواﻧﻲ ﺷﺎﻳﻊ و ﻧﺎﺗﻮان ﻛﻨﻨﺪه :ﻣﻘﺪﻣﻪﺗﻮاﻧﺪ ﻣﻨﺠﺮ ﺑﻪ ﻋﻮارض ﺟﺪي  ﺑﺮ ﺳﻼﻣﺖ ﺷﻮد. ﺷﻜﺴﺖ در درﻣﺎن ﻣﻲري اﻏﻠﺐ ﺗﺸﺨﻴﺺ داده ﻳﺎ درﻣﺎن ﻧﻤﻲﺑﻴﺸﺘﺮ اﺳﺖ. ﻣﺘﺎﺳﻔﺎﻧﻪ اﻳﻦ ﺑﻴﻤﺎﻫﺎي ﺑﻴﻦ ﻓﺮدي و ﺖ و درﮔﻴﺮيﺧﺸﻮﻧ ﺗﺠﺎوز، ﺧﻮدﻛﺸﻲ، ﺳﻮءاﺳﺘﻔﺎده ﻣﻮاد، ﺑﺤﺮان در رواﺑﻂ، ﻋﻤﻮﻣﻲ ﺟﺎﻣﻌﻪ از ﺟﻤﻠﻪ از دﺳﺖ دادن ﺷﻐﻞ،ﺪن ﻋﻼﻳﻢ در ﻫﺮ ﺳﺎل اﺳﺖ. در واﻗﻊ،ﺳﺮﺷﺖ ﻳﻚ ﮔﺮاﻳﺶ ﻣﻮروﺛﻲ در ... ﺷﻮد. ﭘﻴﺎﻣﺪ دﻳﮕﺮ، ﻣﺰﻣﻦ ﺷﺪن ﺑﻴﻤﺎري و ﺗﺸﺪﻳﺪ و ﺑﺪﺗﺮ ﺷﺑﻌﺪ آﺳﻴﺐ  4ﻛﻨﺪ و ﺷﺎﻣﻞ ﻫﺎي اوﻟﻴﻪ زﻧﺪﮔﻲ ﺗﻌﻴﻴﻦ ﻣﻲﻃﻔﻪ اﺳﺖ ﻛﻪ زﻣﻴﻨﻪ اﺗﻮﻣﺎﺗﻴﻚ رﻓﺘﺎرﻫﺎ و ﻋﺎدات ﻓﺮد را در ﺳﺎلﻳﺎدﮔﻴﺮي و ﻋﺎﻫﺎ ﻫﺎي اﻓﺮاد در اﻫﺪاف و ارزشوتﻣﻮﺿﻮﻋﺎت ﻣﺮﺑﻮط ﺑﻪ ﺧﻮد، ﺑﻪ ﺗﻔﺎ واﺑﺴﺘﮕﻲ و ﭘﺸﺘﻜﺎر اﺳﺖ. ﻣﻨﺶ ﺑﻪ ﻣﻌﻨﺎي-ﭘﺮﻫﻴﺰي، ﻧﻮﺟﻮﻳﻲ، ﭘﺎداش  ﺑﺎﺷﺪ. ﻮدراﻫﺒﺮي، ﻫﻤﻜﺎري و ﺧﻮدﻓﺮاوري ﻣﻲاﺳﺖ و ﺷﺎﻣﻞ اﺑﻌﺎد ﺧﻫﺎ ﻣﻮﺛﺮ ﺑﻮدهﻫﺎ و ﻣﻌﻨﻲ زﻧﺪﮔﻲ آنﻫﺎ، ﻧﻴﺖﻛﻪ ﺑﺮ اﻧﺘﺨﺎبﻃﻮر ﻟﻢ ﺑﻪدر ﻣﻘﺎﻳﺴﻪ ﺑﺎ ﮔﺮوه ﻛﻨﺘﺮل ﺳﺎاﻧﺪ ﻛﻪ ﺑﻌﻀﻲ از اﺑﻌﺎد ﺳﺮﺷﺖ و ﻣﻨﺶ در اﻓﺮاد ﻣﺒﺘﻼ ﺑﻪ اﺧﺘﻼل دوﻗﻄﺒﻲ ﻣﻄﺎﻟﻌﺎت ﻣﺘﻌﺪد ﻧﺸﺎن دادهت ﻣﺤﻮر ﻳﻚ ﻣﻌﻨﺎداري از اﻣﺘﻴﺎز ﺑﺎﻻﺗﺮي ﺑﺮﺧﻮردار ﻫﺴﺘﻨﺪ. ﻫﻤﭽﻨﻴﻦ ﻃﺒﻖ ﻣﻄﺎﻟﻌﺎت اﻧﺠﺎم ﺷﺪه  اﺧﺘﻼل ﻃﻴﻒ دوﻗﻄﺒﻲ ﻳﻜﻲ از اﺧﺘﻼﻻﻫﺎي اﺧﺘﻼل دوﻗﻄﺒﻲ وﻳﮋﮔﻲ در اﻳﻦ ﻣﻄﺎﻟﻌﻪ ارﺗﺒﺎط ﺑﻴﻦ ﻣﺼﺮف ﺳﻴﮕﺎر ﺑﺎﺗﺮﻳﻦ ارﺗﺒﺎط را ﺑﺎ ﻣﺼﺮف ﺳﻴﮕﺎر دارد. رواﻧﭙﺰﺷﻜﻲ اﺳﺖ ﻛﻪ ﺑﻴﺶ  ﺑﺮرﺳﻲ ﺷﺪ. 7931ﻫﺎي ﺳﺮﺷﺖ و ﻣﻨﺶ در داﻧﺸﺠﻮﻳﺎن ﭘﺰﺷﻜﻲ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ ﻛﺮﻣﺎن در ﺳﺎل و ﻣﻮﻟﻔﻪاز ﮔﻴﺮي ﺳﺎده ﺗﺼﺎدﻓﻲ و ﺑﻪ ﺻﻮرت ﻧﻤﻮﻧﻪﻫﺎي ﻣﻄﺎﻟﻌﻪ از ﻧﻮع اوﻟﻴﻪ ﺑﺎﺷﺪ. دادهاﻳﻦ ﻣﻄﺎﻟﻌﻪ ﻣﻘﻄﻌﻲ و ﺑﻪ ﺻﻮرت ﻛﻤﻲ ﻣﻲ  ﻫﺎ:ﻣﻮاد و روشﺠﺮ ﺳﺮﺷﺖ و ﻣﻨﺶ ﻛﻮﻟﻮﻧﻴﻨﻧﺎﻣﻪ ﭘﺮﺳﺶ ﭘﺮﺳﺶ ﻧﺎﻣﻪ اﺧﺘﻼﻻت ﺧﻠﻘﻲ و ﻫﺎي دﻣﻮﮔﺮاﻓﻴﻚ و ﻣﺼﺮف ﺳﻴﮕﺎر،ي: وﻳﮋﮔﻲﻧﺎﻣﻪﻃﺮﻳﻖ ﺳﻪ ﭘﺮﺳﺶ  erauqs-ihcﻫﺎ ﺗﻮﺳﻂ آزﻣﻮن . دادهﺑﻮدداﻧﺸﺠﻮ رﺷﺘﻪ ﭘﺰﺷﻜﻲ در ﻣﻘﺎﻃﻊ ﻣﺨﺘﻠﻒ رﺷﺘﻪ ﭘﺰﺷﻜﻲ  051ﺟﺎﻣﻌﻪ آﻣﺎري آوري ﺷﺪ. ﺟﻤﻊ  اﺳﺘﻔﺎده ﺷﺪ.  02ﻧﺴﺨﻪ  SSPSﺗﺠﺰﻳﻪ و ﺗﺤﻠﻴﻞ ﺷﺪ. ﺑﺮاي ﺧﺮوﺟﻲ ﻧﺘﺎﻳﺞ از ﻧﺮم اﻓﺰار ﻫﺎي ﺳﺮﺷﺖ و ﻣﻌﻨﺎداري ﻣﺸﺎﻫﺪه ﻧﺸﺪ. ﺑﻴﻦ ﻣﻮﻟﻔﻪ ﻫﺎي اﺧﺘﻼل دوﻗﻄﺒﻲ و ﻣﺼﺮف ﺳﻴﮕﺎر در داﻧﺸﺠﻮﻳﺎن ﭘﺰﺷﻜﻲ ارﺗﺒﺎطوﻳﮋﮔﻲﺑﻴﻦ   ﻧﺘﺎﻳﺞ:. ﺑﻮدﻣﺼﺮف ﺳﻴﮕﺎر ارﺗﺒﺎط ﻣﻌﻨﺎداري ﻣﺸﺎﻫﺪه ﻧﺸﺪ اﻣﺎ ﺗﻤﺎﻣﻲ اﺑﻌﺎد ﻣﻨﺶ در اﻓﺮاد ﻏﻴﺮ ﺳﻴﮕﺎري ﺑﻪ ﻃﻮر ﻣﻌﻨﺎداري ﺑﻴﺸﺘﺮ از اﻓﺮاد ﺳﻴﮕﺎري . ﻓﺮاواﻧﻲ ﺑﻮدﻫﺎي اﺧﺘﻼل دوﻗﻄﺒﻲ ﺑﻴﺸﺘﺮ ﻃﻮر ﻣﻌﻨﺎداري در اﻓﺮاد ﺑﺎ وﻳﮋﮔﻲ ﻫﻤﻜﺎري، ﺧﻮدﻓﺮآوري ﺑﻪ واﺑﺴﺘﮕﻲ، اشﻧﻮﺟﻮﻳﻲ، ﭘﺎد ﻫﺎي ﺪﺑﻌ  ﺑﻮد. ﻫﺎي اﺧﺘﻼل دوﻗﻄﺒﻲ در ﻣﻘﻄﻊ ﻛﺎرآﻣﻮزي و در داﻧﺸﺠﻮﻳﺎن ﻣﺠﺮد ﺑﻴﺸﺘﺮ وﻳﮋﮔﻲﻪﺠﻴﺘﻧ:يﺮﻴﮔ ﻲﻣ ﻪﻌﻟﺎﻄﻣ ﻦﻳا زاﻮﺗﻲﮔﮋﻳو ﺎﺑ داﺮﻓا ﻪﻛ دﺮﻛ ﺖﺷادﺮﺑ ناﻣ ياراد ،ﻲﺒﻄﻗود لﻼﺘﺧا يﺎﻫﻪﻔﻟﻮﺶﻨﻣ و ﺖﺷﺮﺳ يﺎﻫ  ﺎﺑ توﺎﻔﺘﻣﻲﮔﮋﻳو ﻦﻳا نوﺪﺑ داﺮﻓاﻲﻣ ﻦﻳا ﻪﻛ ﺪﻨﺘﺴﻫ ﺎﻫًﺎﺘﺒﺴﻧ عﻮﻴﺷ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ .ﺪﺷﺎﺑ ﺮﻈﻧﺪﻣ يرﺎﻤﻴﺑ ﻦﻳا سردوز ﺺﻴﺨﺸﺗ رد ﺪﻧاﻮﺗ  فﺮﺼﻣ يﻻﺎﺑﻲﮔﮋﻳو و رﺎﮕﻴﺳ .دراد ﺖﻳﻮﻟوا ﻲﻜﺷﺰﭘ نﺎﻳﻮﺠﺸﻧاد ناور ﺖﻣﻼﺳ ﻪﺑ هﮋﻳو ﻪﺟﻮﺗ ،ﻪﻌﻟﺎﻄﻣ ﻦﻳا يرﺎﻣآ ﻪﻌﻣﺎﺟ رد ﻲﺒﻄﻗود لﻼﺘﺧا يﺎﻫ ﺖﻬﺟ تﺎﻌﻟﺎﻄﻣ ﻪﺑ  ،طﺎﺒﺗرا ﻦﻳا ﺮﺘﻬﺑ كردگرﺰﺑ ﻪﻧﻮﻤﻧ ﻢﺠﺣ ﺎﺑ صﻮﺼﺧ ﻪﺑ ﺮﺘﺸﻴﺑ .ﺖﺳا زﺎﻴﻧ ﺮﺗ  هژاو ﺪﻴﻠﻛ:ﺎﻫ ﻲﺒﻄﻗود لﻼﺘﺧا_ رﺎﮕﻴﺳ فﺮﺼﻣ_ﻪﻔﻟﻮﻣﺶﻨﻣ و ﺖﺷﺮﺳ يﺎﻫ_نﺎﻳﻮﺠﺸﻧاد    Abstract Background: Bipolar disorder is a prevalent and disabling disease. The prevalence is much more than what is expected. Unfortunately the disease is mostly not diagnosed or treated. The failure in treatment can lead to serious consequences on the general health of the society such as Job loss, Relationship crisis,Drug Abuse,Suicide,Family massacre and etc. The other consequences to mention are the chronicity of the disorder,exacerbation and worsening of the symptoms each year. ”Temperament” is heritable biases in emotionality and learning that underline the acquisition of emotion-based,automatic behavioral traits and habits observable early in life and includes 4 major dimensions:  Harm-Avoidance,Novelty-seeking,Reward-Dependence and Persistence. ”character” is  related to topics about self,people’s differences in goals and values which affects one’s choices,aims and meaning of life. It includes 3 dimensions:Self-directedness,cooperation and Self-transcendence.  It is shown in different studies that some of the Temperament and character dimensions are more frequent in people with bipolar disorder than the healthy control group. They have also demonstrated that Bipolar disorder is one of the number one Axis psychiatric disorders which is seen to have the most comorbidity with cigarette smoking.  This study was aimed to firstly screen Bipolar disorder traits in Medical students of Kerman University of medical sciences in year 1397 and then investigate Temperament and character traits in them. its other purpose was to demonstrate the relationship between cigarette and Water pipe smoking,Bipolar disorder traits and Temperament and character traits.  Methods: The study is a cross-sectional and quantitative study. The data of the study was of primary type and was collected by 3 different questionnaires:The demographic and cigarette smoking Questionnaire,The mood Disorder Questionnaire(MDQ) and The Cloninger Temperament and Character Inventory (TCI).  The data was collected by simple random sampling. The statiscal population of the research was 150 medical students in different stages of their medical study. The data were analyzed using Chi-square test. SPSS software version 20 was used to analyse data and create output.  Results: There was no statistically significant realtionship between bipolar disorder traits and cigarette smoking. There was also no significant relationship between Temperament traits and cigarette smoking but all Character traits were higher in the non-smoker group than in the smoker one. The “Novelty-seeking”,”Reward-dependence”,”cooperation” and” self-transcendence” dimensions were significantly higher in students with bipolar traits in comparison with their Non-Bipolar fellow students. The bipolar disorder traits was also mostly seen among students in the externship stage of the medical study and in the single students.  Conclusion: Based on this study we can assume that people with Bipolar disorder traits may have different Temperament and Character traits comparing to the Non-Bipolar trait group which should be considered in the early diagnosis of this disorder. Concerning the relatively high prevalence of bipolar disorder traits and smoking in the statistical population of this research,It is critical to pay more serious attention to medical students’s mental and psychiatric health. More studies, especially in larger samples is required for further understanding of this subject.  Keywords: Bipolar disorder, Cigarette smoking, Temperament and Character traits, Students     

=The relationship Between Hyperthymic temperament of Bipolar Spectrum disorder and  cigarette smoking among medical students of Kerman University of medical sciences in year 1397

http://eprints.kmu.ac.ir/32154/1/7544.pdf

=The relationship Between Hyperthymic temperament of Bipolar Spectrum disorder and cigarette smoking among medical students of Kerman University of medical sciences in year 1397

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