Evaluation of the performance of general practitioners in a collaborative care program by employing simulated patients

OBJECTIVE

To compare the performance of the general practitioners (GPs) in a collaborative care (CC) program in Iran with a control group of GPs in the usual care by employing simulated patients.

METHODS

Six trained simulated patients (SPs) made unannounced visits to 26 GP offices participating in the CC program and to 26 age and sex matched controls. The SPs role played five clinical scenarios of mental disorders and filled out checklists to evaluate the GPs' performance regarding interviewing, taking history, establishing rapport, showing empathy, and giving advice to patients. Additionally, the GPs' plan of care and prescriptions were evaluated later by a psychiatrist based on the documents provided by the SPs.

RESULTS

There was a significant difference between collaborative care and control group physicians in their global performance; CC physicians built up better patient-physician relationship. They performed better in evaluating a psychotic patient, although not better in their management. CC physicians were marginally better in approach to patients with generalized anxiety disorder (GAD) and mild major depressive disorder.

CONCLUSION

The overall performance of physicians in CC was better than the GPs in the control group in making an effective patient-physician relationship, and evaluating a psychotic patient. The main weakness of the GPs was in proper treatment of the minor and more common psychiatric disorders and in evaluation of patients with suicidal ideations who were in need for emergent referral. Evaluating performance of the practitioners is feasible employing SPs and the findings can be translated into improvements in the available services.

Sensor-less force-reflecting macro-micro telemanipulation systems by piezoelectric actuators

This paper establishes a novel control strategy for a nonlinear bilateral macro-micro teleoperation system with time delay. Besides position and velocity signals, force signals are additionally utilized in the control scheme. This modification significantly improves the poor transparency during contact with the environment. To eliminate external force measurement, a force estimation algorithm is proposed for the master and slave robots. The closed loop stability of the nonlinear micro-micro teleoperation system with the proposed control scheme is investigated employing the Lyapunov theory. Consequently, the experimental results verify the efficiency of the new control scheme in free motion and during collision between the slave robot and the environment of slave robot with environment, and the efficiency of the force estimation algorithm.

Working Memory and Response Inhibition in Patients With Bipolar I Disorder During Euthymic Period

Background:

Several cognitive domains, including attention, memory, and executive functions are impaired in bipolar disorder.

Objectives:

This study aimed to investigate two executive functions (working memory and response inhibition) in patients with bipolar I disorder during remission of the symptoms.

Patients and Methods:

In this case-control design, 30 bipolar I patients (18 to 45 years old) were matched with 30 ones in the control group in terms of age, gender, and education. The patients were selected from Roozbeh Psychiatric Hospital (a hospital affiliated to Tehran University of Medical Sciences) from May to October 2013. They were evaluated and contrasted using working memory (Spatial Span and Spatial Working Memory (SSP and SWM)) and response inhibition (Stop Signal Task (SST)) tests.

Results:

We used independent t-tests for comparing and contrasting 2 groups on total and sub-scales scores of these 3 tests. In terms of SWM test there was a significant difference in between-group error between the two groups (P = 0.05); there was also a meaningful difference between the strategies used by two groups (P = 0.05). In SSP test, a significant difference appeared between averages of span length of the two groups. In the first and last item delays, there was also a clear difference, but the total error index was not noticeably different. In SST test, the direction error indicator in start-stop trials indicated a major difference, while in successful stops ratio, the case group had a lower ratio. In addition, reaction time to stop signs in bipolar group was meaningfully lower than the control group.

Conclusion:

In conclusion, even during remission phase, executive dysfunction is detectable at least in some areas in patients with bipolar disorder.

Rapid antidepressant effects of repeated doses of ketamine compared with electroconvulsive therapy in hospitalized patients with major depressive disorder

Accumulating evidence suggests that N-methyl-d-aspartate receptor (NMDAR) antagonists (e.g. ketamine) may exert rapid antidepressant effects in MDD patients. In the present study, we evaluated the rapid antidepressant effects of ketamine compared with the electroconvulsive therapy (ECT) in hospitalized patients with MDD. In this blind, randomized study, 18 patients with DSM-IV MDD were divided into two groups which received either three intravenous infusions of ketamine hydrochloride (0.5 mg/kg over 45 min) or ECT on 3 test days (every 48 h). The primary outcome measure was the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS), which was used to rate overall depressive symptoms at baseline, 24 h after each treatment, 72 h and one week after the last (third) ketamine or ECT. Within 24 h, depressive symptoms significantly improved in subjects receiving the first dose of ketamine compared with ECT group. Compared to baseline level, this improvement remained significant throughout the study. Depressive symptoms after the second dose ketamine was also lower than the second ECT. This study showed that ketamine is as effective as ECT in improving depressive symptoms in MDD patients and have more rapid antidepressant effects compared with the ECT.

Comparison of two different curricula in psychiatry clerkship at tehran university of medical sciences

OBJECTIVES

The aim of this study was to evaluate the efficacy of a new psychiatry clerkship curriculum which was designed to improve the knowledge and skills of medical students of Tehran University of Medical Sciences (TUMS), Iran.

METHODS

This quasi-experimental study was conducted in two consecutive semesters from February 2009 to January 2010. In total, 167 medical students participated in the study. In the first semester, as the control group, the clerks' training was based on the traditional curriculum. In the next semester, we constructed and applied a new curriculum based on the SPICES model (student-centered, problem-based, integrated, community-based, elective and systematic).At the end of the clerkship, the students were given two exams: Multiple Choice Questions (MCQ) to assess their knowledge, and Objective Structured Clinical Examination (OSCE) to assess their skills. Baseline data and test performance for each student were analyzed.

RESULTS

Compared to the control group, students in the intervention group showed significantly higher OSCE scores (P= 0.01). With respect to MCQ score, no significant difference was found between the two groups.

CONCLUSIONS

The results suggest that the revised curriculum is more effective than the traditional one in improving the required clinical skills in medical students during their psychiatry clerkship.

A multicenter randomized controlled trial of aftercare services for severe mental illness: study protocol

BACKGROUND

Severe mental illness is responsible for a significant proportion of burden of diseases in Iranian population. People with severe mental illnesses are more likely to have high rates of non-attendance at follow-up visits, and lack of an active follow-up system, particularly in the country's urban areas that has resulted in the revolving door phenomenon of rehospitalizations. Therefore, there is an increasing need for implementation of effective and cost-effective aftercare services.

METHOD/DESIGN

This is a randomized control trial with the primary hypothesis that aftercare services delivered to patients with severe mental illnesses in outpatient department and patient's home by a community care team would be more effective when compared to treatment as usual (TAU) in reducing length of hospital stay and any psychiatric hospitalization. Patients were recruited from three psychiatric hospitals in Iran. After obtaining informed written consent, they were randomly allocated into aftercare intervention and control (TAU) groups. Aftercare services included treatment follow-up (through either home care or telephone follow-up prompts for outpatient attendance), family psychoeducation, and patient social skills training that were provided by community mental health teams. Patients were followed for 12 months after discharge. The primary outcome measures were length of hospital stay and any hospitalization in the 12 month follow-up. Secondary outcome measures included patients' clinical global impression, global functioning, quality of life, and patient's satisfaction. The trial also allowed an assessment of direct cost-effectiveness of the aftercare services.

DISCUSSION

This paper presents a protocol for an RCT of aftercare services delivered to patients with severe mental illnesses within patients' home or outpatient department. The findings of this study can influence policy and program planning for people with severe mental illnesses in Iran.

TRIAL REGISTRATION

IRCT201009052557N2.

Senior medical students' attitudes toward psychiatry as a career choice before and after an undergraduate psychiatry internship in Iran

OBJECTIVES

The study aimed to assess 1) the attitudes of medical students in the sixth and seventh years (known as interns in Iran) toward psychiatry as a career choice, and 2) the degree of attractiveness of psychiatry as a career choice, with regard to various defined aspects, before and after an undergraduate psychiatry internship (similar to the medical school psychiatry rotation in the United States, but mandatory in Iran) in three major medical schools in Tehran, the capital of Iran.

METHOD

Sixth- and seventh-year medical students (locally called interns, N=347) at Tehran, Shahid Beheshti, and Iran Universities of Medical Sciences were consecutively invited to complete anonymous self-report questionnaires designed to assess their perceptions of careers in psychiatry before and after internship in psychiatry wards. Also, students evaluated psychiatry in terms of the factors that reflected the degree of attractiveness of this specialty.

RESULTS

Positive responses toward choosing psychiatry as a career were seen in 18.8% before and 20.0% after psychiatry rotation. No significant differences were observed in the positive responses before and after psychiatry internship. The students' opinions changed to a more attractive degree in terms of only 3 out of the 13 defined aspects. There was also no significant difference in the total score on attractiveness of psychiatry before and after the psychiatry internship.

CONCLUSIONS

The study indicated that undergraduate psychiatry internship might not induce more students to consider psychiatry as a possible career. The present pattern of psychiatry education in Iran seems not to positively affect most aspects of medical students' attitudes toward psychiatry.

How Mental Illness is Perceived by Iranian Medical Students: A Preliminary Study

The study aimed to assess medical students' attitudes toward mental illness following a 4-week psychiatry clerkship. All fifth-year medical students from three academic centers in Tehran were asked to participate in the study. They completed the questionnaire on the last day of their 4-week psychiatry clerkship. A self-administered questionnaire was used to examine participants' Attitudes Toward Mental Illness (ATMI). One hundred and sixty eight students completed the questionnaires (88.9% response rate). In general, the students had favorable attitudes toward mental illness at the end of their clerkship, with mean (± SD) ATMI total score of 78.6 (± 8.1) (neutral score, 66.0). The students showed the most favorable opinion (95.2%) about Category 5 (stereotypic attitude toward people with mental illness) whilst they revealed the least favorable opinion (64.3%) regarding Category 1 (social relations with people affected by mental illness). In addition, the students thought that movies were on the top of influential media on shaping the attitudes toward mental illness. Overall, most of Iranian medical students had generally favorable attitudes toward people with mental illness at the end of their clerkship. Therefore, it may be expected next generation of medical doctors show more favorable attitude toward mental illness.

Iranian medical students' perception of psychiatry: before and after a psychiatry clerkship

OBJECTIVE

We aimed to compare the medical students' attitude towards psychiatry before and after psychiatry clerkship, and to examine the association of choosing psychiatry as a future career with some personal characteristics.

METHOD

In a self-controlled, quasi-experimental study, all of the medical students entering the psychiatry clerkship in three major medical schools of Iran located in Tehran (Tehran, Shahid Beheshti, and Iran University of Medical Sciences) were asked to participate anonymously in the study on the first and the last 3-days of their psychiatry clerkship. From 346 invited 4th-5th year medical students, 225 (65%) completed anonymous self-report questionnaires before and after a 4-week psychiatry clerkship.

RESULTS

Positive response to choose psychiatry as a career was seen in 13.3% and 18.3% before and after psychiatry rotation, respectively. However, the difference was not statistically significant; about one-quarter of the students were turned on to psychiatry and 25% were discouraged during the clerkship. Individual pair wise comparisons revealed significant improvements only in two out of 13 measured aspects of psychiatry. Seventeen out of 38 (47.7%) students who identified psychiatry as the career of choice or strong possibility reported that one of their family members or close friends' mental illness had an impact on their choice. Those students who considered psychiatry as the strong possibility claimed that they are more interested in humanities (OR = 2.96; 95% CI: 1.17, 7.49), and playing a musical instrument (OR = 2.53; 95% CI: 1.15, 5.57).

CONCLUSION

It may be concluded that exposure to psychiatry clerkship could influence medical students' opinion about psychiatry positively, or negatively. Personal characteristics and individual interests of students may play an important role in choosing psychiatry as their future career.

Evaluation of the Persian version of modified fatigue impact scale in Iranian patients with multiple sclerosis

BACKGROUND

Fatigue, a major cause of disability in individuals with multiple sclerosis (MS), is associated with reduced quality of life. The aim of this study was to evaluate the reliability and reproducibility of the Persian version of Modified Fatigue Impact Scale (MFIS) in Iranian patients with MS.

METHODS

This study included 15 subjects with clinically definite MS, 15 hospitalized patients with MS, and 15 hospitalized patients with other chronic illnesses (as controls). They filled in the Persian version of the MFIS twice with a three-day interval. MFIS items were analyzed and the correlation coefficient was calculated.

RESULTS

THERE WAS A GOOD CORRELATION BETWEEN THE SCORES OF THE TWO MEASUREMENTS (CORRELATION COEFFICIENT: 0.984, P < 0.001) especially in physical and cognitive subgroups. The reproducibility of psychosocial subscale was lower than physical and cognitive subscales.

CONCLUSION

According to our findings, the Persian version of the MFIS has a good reliability and reproducibility for assessment of fatigue in patients with MS.

Anger in Adolescent Boy Athletes: a Comparison among Judo, Karate, Swimming and Non Athletes

OBJECTIVE

Karate and judo are originally Japanese martial arts which may have different influences on adolescents' behavior. This study was conducted to examine the total anger rate and its subscale-reactive anger, instrumental anger, and anger control-rates in young karateka and judoka.

METHODS

A cross-sectional study was carried out in 11 to 19-year old boys. Adolescents included in the study were judoka (n=70), karateka (n=66), swimmers (n=59), and non athletes (n=96). One stage cluster sampling method was used to select judoka, karateka, and swimmers from sport clubs in Tehran. Students of governmental schools at the same area were chosen as the non-athletes group. The "Adolescent Anger Rating Scale" questionnaire was utilized to assess the anger rate.

FINDINGS

The mean age of participants was 12.90(±2.06) years. The total anger rates were 45.40 (±5.61) in judoka, 41.53(±5.63) in karateka, 41.19(±5.33) in swimmers, and 45.44 (±8.58) in non athletes. In total anger scale karateka and swimmers had a significantly lower score compared to judoka and non athletes. In instrumental anger subscale the difference was significant just between karateka and non athletes. In reactive anger subscale judoka showed higher scores than swimmers. In anger control subscale the difference was significant between judoka and swimmers and also judoka and karateka. The difference of anger control between karateka and non athletes was significant.

CONCLUSION

The findings of this study propose a difference in the anger rate between judoka and karateka. In contrary to the results of previous studies, judo training may have no influence on anger control, while karate training could be beneficial.

Association of serum retinol-binding protein 4 with insulin resistance and metabolic parameters during olanzapine therapy

OBJECTIVE

Retinol-binding protein 4 (RBP4) has been shown to be associated with insulin resistance (IR), metabolic indices and metabolic syndrome (MetS) in various patient populations and in obesity. We investigated the association between metabolic parameters, IR and RBP4 during olanzapine therapy.

DESIGN

A prospective study.

PATIENTS

Thirty-seven participants with psychiatric disorder who were atypical antipsychotic naive and newly initiated on olanzapine were assessed.

MEASUREMENTS

Fasting RBP4, anthropometric and metabolic variables were measured before and after 3 months of olanzapine therapy.

RESULTS

Participants who developed MetS showed higher RBP4 levels compared with those without MetS, although not significant (P = 0·053). The variation in RBP4 level was correlated with changes in systolic blood pressure (r = 0·423, P = 0·009), diastolic blood pressure (r = 0·390, P = 0·017), total cholesterol (r = 0·446, P = 0·006) and low-density lipoprotein (LDL) (r = 0·407, P = 0·012). Multiple linear regression analysis illustrated that end-point log insulin level was the most significant independent predictor of final log RBP4 levels (standardized ß = 0·353, P = 0·024).

CONCLUSIONS

Our results suggest that RBP4 levels might be associated with at least some olanzapine-induced metabolic abnormalities and cardiovascular disease risk factors.

Persian translation of perception of psychiatry survey questionnaire and evaluation of its psychometric properties

OBJECTIVE

Test the psychometric properties of the Persian version of the Perception of Psychiatry Survey questionnaire, which is being used in a large multi-site international study, of which we were part. This instrument was designed to measure the attitudes of medical educators to psychiatry.

METHOD

We used World Health Organization guideline as the methodological model for Persian translation. The Persian version of Perception of Psychiatry Survey questionnaire was administered to a convenience sample of 100 medical teachers at Tehran University of Medical Sciences and Azad University. The content validity, internal consistency, and test-retest reliability of the instrument were assessed.

RESULTS

No item changed completely during the process of translation and cultural adaptation. The content validity of translation and back translation was 0.74 and 0.86 according to Feliss Kappa Statistic. The Cronbach's α coefficient was 0.76 for the Persian version and for its subdivisions ranged from 0.59 to 0.81. The inter class correlation (ICC) coefficient for test-retest reliability of the whole instrument was 0.89.

CONCLUSION

The Persian version of Perception of Psychiatry Survey questionnaire could be considered as a good cross-cultural equivalent for original English version. The instrument is a reliable instrument in terms of internal consistency and test-retest reliability.

Emotional Intelligence in a group of patients with first-episode psychosis in Iran

This study was aimed to evaluate the Emotional Intelligence (EI) of a group of patients with first episode psychosis in Iran as compared with a healthy control group. A case-control design was used. EI was assessed using Persian version of Bar-On Emotional Quotient inventory (EQ-i) administered on 25 patients with history of a single psychotic episode in the last two years, as well as 64 healthy participants. The mean (±SD) of EI scores of patients' and healthy controls' group was 319.8 (±40.9) and 328.8 (±33.3), respectively. Two-independent sample t-test revealed no significant difference in the EI scores of two groups (P=0.29). In contrast with chronic schizophrenia, the patients with first-episode psychosis were not different from the healthy subjects in terms of emotional intelligence score. It might be implied that the low emotional intelligence of the patients with chronic psychotic disorders is an accumulative result of the underlying disease over time.

Isolation of free-living amoebae from sarein hot springs in ardebil province, iran

BACKGROUND

Free-living amoebae (FLA) are a group of ubiquitous protozoan, which are distributed in the natural and artificial environment sources. The main aim of the current study was to identify the presence of FLA in the recreational hot springs of Sarein in Ardebil Province of Iran.

METHODS

Seven recreational hot springs were selected in Sarein City and 28 water samples (four from each hot spring) were collected using 500 ml sterile plastic bottles during three month. Filtration of water samples was performed, and culture was done in non-nutrient agar medium enriched with Escherichia coli. Identification of the FLA was based on morphological criteria of cysts and trophozoites. Genotype identification of Acanthamoeba positive samples were also performed using sequencing based method.

RESULTS

Overall, 12 out of 28 (42.9%) samples were positive for FLA which Acanthamoeba and Vahlkampfiid amoebae were found in one (3.6%) and 11 (39.3%) samples, respectively. Sequence analysis of the single isolate of Acanthamoeba revealed potentially pathogenic T(4) genotype corresponding to A. castellanii.

CONCLUSION

Contamination of hot springs to FLA, such as Acanthamoeba T(4) genotype (A. castellanii) and Vahlkampfiid amoebae, could present a sanitary risk for high risk people, and health authorities must be aware of FLA presence.

Relationship between GDx VCC and Stratus OCT in juvenile glaucoma

PURPOSE

To compare the ability of scanning laser polarimetry (GDx VCC) and optical coherence tomography (OCT) to discriminate eyes with juvenile glaucoma from normal eyes and to assess the relationship between their parameters.

METHODS

A total of 24 glaucomatous eyes of 24 patients and 24 normal eyes were enrolled. The age range of the patient was 11-40 years with a mean age of 25.1+/-8.2 years. Control groups consisted 24 eyes of 24 individuals without glaucoma with a mean age of 33.2+/-8.2 years. All subjects underwent a full ophthalmic examination, automated perimetry, GDx VCC, and OCT. Correlation coefficients between the parameters of OCT and GDx VCC were calculated. We calculated the area under the receiver operating characteristic curve (AROC) for the main parameters of GDx VCC and OCT.

RESULTS

Statistically significant correlations were observed between GDx VCC and OCT parameters. Pearson coefficients ranged from 0.75 for inferior average to 0.86 for nerve fibre indicator (NFI)/average thickness OCT. The greatest AROC parameter in OCT (inferior average: 0.92) had a lower area than that in GDx VCC (NFI: 0.99). There was a significant statistical significance in all visual field, GDx VCC, and OCT variables between two groups (P<0.05).

CONCLUSIONS

Many GDx VCC parameters were significantly correlated with those of the OCT in patients with juvenile glaucoma. Inferior average and NFI had the greatest AROC parameter in OCT and GDx VCC, respectively. NFI had high sensitivity and specificity for the diagnosis of JOAG.

Freshmen versus interns' specialty interests

PURPOSE

The purpose of this study was to determine career preferences of medical students at the time of entering medical school compared with interns who were graduating; and to determine what factors influence the choice of a special discipline as a career.

METHODS

A cross-sectional, questionnaire-based survey study involving freshmen and interns at Tehran University of Medical Sciences was conducted in 2006 - 2007. Respondents anonymously completed a specialties questionnaire developed by Feifel et al. The questionnaire was translated into Persian (Farsi) and several items were modified based on the circumstances.

RESULTS

The response rate was 91 (73%) among freshmen and 137 (77%) among interns. Forty-six freshman students (50%) and 71 interns (51.8%) indicated that they had not developed a strong decision about any particular field of medicine and needed more time. The preferred specialties among freshmen were surgery and internal medicine; whereas graduating students were more interested in "other specialties". There was no significant difference between pediatrics, gynecology, psychiatry, and general practice among the two groups. There was a significant difference in rating when it came to "anticipated income", "prestige" and "helping patients" of which interns were less interested compared to freshmen in these three areas.

CONCLUSION

Approximately one-half of the medical students were unclear about their future goals. The experience of medical school may play a role in diminishing students' interest in surgery and internal medicine as prospective careers.

Buspirone versus methylphenidate in the treatment of attention deficit hyperactivity disorder: a double-blind and randomized trial

The efficacy and side effects of buspirone compared with methylphenidate (MPH) in the treatment of children with attention-deficit/hyperactivity disorder (ADHD). A total of 34 children with ADHD as defined by DSM-IV-TR were randomized to buspirone or methylphenidate dosed on weight-adjusted basis at buspirone (0.5 mg/kg/day) and methylphenidate (0.3-1 mg/kg/day) for a 6-week double-blind clinical trial. The principle measures of outcome were the teacher and parent ADHD Rating Scale. The side effects were assessed by the special side effect checklist of each drug. In both groups, the scores of teacher and parent ADHD Rating Scale significantly declined on the 6th week as compared to baseline (p = 0.001). These effects were observed in the subscales too. No significant differences were observed between the two protocols on the total scores of parent and teacher ADHD Rating Scale, but methylphenidate was superior to buspirone in decreasing the symptoms of inattention. The side effects of buspirone were mild and rare in comparison with MPH. Buspirone has a favorable side-effects profile. It also has clinically and statistically significant impacts on improving the ADHD symptoms in children. These preliminary findings of the efficacy of buspirone in children with ADHD need large and cross-over studies.

Duration of untreated psychosis and pathways to care in patients with first-episode psychosis in Iran

AIM

This is the first study on the duration of untreated psychosis and pathways to care among patients with first-episode psychosis in Iran as a developing country.

METHODS

Ninety-one patients with a first episode of non-organic psychosis admitted to a university-affiliated psychiatric hospital in Iran were assessed for duration of untreated psychosis (DUP), pathways to care and mode of onset.

RESULTS

Median DUP was 11 weeks (mean = 52.3 weeks). Following the onset of psychosis, most patients were first seen by a psychiatrist (n = 23, 25.3%), a traditional healer (n = 21, 23.1%) or a general practitioner (n = 16, 17.6%). Most referrals to the psychiatric hospital were made by the family (n = 30, 33.1%), or health professionals (n = 29, 31.9%). Acute onset and rural place of residence were associated with shorter DUP in multivariate analysis.

CONCLUSIONS

Median DUP was not long in an inpatient sample with first-episode psychosis, which may be due to the preponderance of affective and acute psychoses in this sample and some help-seeking or service variables.

A Persian translation of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: psychometric properties

OBJECTIVE

The aim of this study is to assess the reliability and validity of a Persian translation of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders (SCID-I) through a multicenter study in a clinical population in Iran.

METHOD

The sample consisted of 299 subjects admitted to outpatient or inpatient services of 3 psychiatric centers in Tehran, Iran. The SCID was administered by trained interviewers. To study the test-retest reliability, a second independent SCID interview was administered to 104 of the entire sample within 3 to 7 days of the first interviews. For the assessment of validity, the SCID diagnoses were compared with the consensus clinical diagnoses made by 2 psychiatrists for all 299 patients.

RESULTS

Diagnostic agreements between test and retest SCID administration were fair to good for most diagnostic categories. Overall weighted kappa was 0.52 for current diagnoses and 0.55 for lifetime diagnoses. Specificity values for most psychiatric disorders were high (>0.85); the sensitivity values were somewhat lower.

CONCLUSIONS

The Persian translation of the SCID yields diagnoses with acceptable to good reliability and validity in a clinical population in Iran. This supports the cross-cultural use of the instrument.

Psychotic-like ideations among a group of young normal subjects in Iran

BACKGROUND

Recent studies show that self-reported psychotic-like experiences in general population samples are quite common and on a continuum with psychotic symptoms in clinical samples. However, most evidence comes from western settings and there is a dearth of research in developing countries. Examination of these experiences across different cultures adds to their validity.

AIMS

To assess psychotic-like ideations and its association with poor mental health in a group of young normal individuals in Iran.

METHODS

A total of 150 medical students with no history of a psychiatric disorder completed the Peters et al. Delusions Inventory (PDI-40) and the General Health Questionnaire (GHQ-28). Psychotic-like ideations were rated on the basis of their presence, as well as their levels of distress, preoccupation and conviction (PDI sub-scores).

RESULTS

On average, 9.4 psychotic-like ideations were reported by the subjects (range 0-28). More frequent psychotic-like ideations and higher distress and preoccupation associated with these ideations were correlated with poor mental health as assessed by the GHQ.

CONCLUSION

Frequency of psychotic-like ideation and its dimensions, as well as its association with poor mental health, were comparable to the studies on healthy subjects conducted in Europe.

Acute treatment response and its predictors in patients with first-episode psychosis in Iran

OBJECTIVE

The aim of this paper was to investigate the acute treatment response and its predictors in a sample of patients with first-episode psychosis admitted to a psychiatric hospital in Iran.

METHOD

A total of 163 patients with first-episode psychosis were treated with antipsychotics and other medications as prescribed by their treating psychiatrists. Sociodemographic and premorbid data at baseline and clinical data at both baseline and discharge (6+/-1 weeks after admission) were collected.

RESULTS

Patients showed a response rate of 71.4% for negative symptoms, 91.5% for positive symptoms and 67.5% for functioning. Those having a positive family history and less severe negative symptoms at baseline were less likely to respond in terms of negative symptoms. Higher premorbid and lower baseline functioning as well as acute onset were associated with the treatment response.

CONCLUSIONS

Acute treatment response of first-episode psychosis in a clinical sample of a developing country seems to be higher than that of developed countries. However, predictors of response are comparable.