Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 8 1 2013 03 15 1 6 Seyed Ali Ahmadi Abhari Department of Psychiatry and Psychiatry Research Center, Tehran University of Medical Sciences, Tehran, Iran. Majid Sadeghi Department of Psychiatry and Psychiatry Research Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Mehdi Samimi Ardestani Behavioral Sciences Research Center Shahid Beheshti University of Medical Sciences Yousef Semnani Behavioral Sciences Research Center Shahid Beheshti University of Medical Sciences Gholamreza Mirsepassi Department of Psychiatry and Psychiatry Research Center, Tehran University of Medical Sciences Seyed Saeed Sadr Behavioral Sciences Research Center Shahid Beheshti University of Medical Sciences Atefe Kamaloo Department of Psychiatry and Psychiatry Research Center, Tehran University of Medical Sciences Morvarid Ahadi Department of Psychiatry and Psychiatry Research Center, Tehran University of Medical Sciences Behin Pourmirza Sanofi Medical Departments Elham Mir Sanofi Medical Departments 2015 10 14 Objective: Bipolar spectrum disorders may often go undiagnosed or unrecognized. The aim of this study was to determine the proportion of bipolar disorder symptoms in Iranian patients with a major depressive episode. Methods: 313 patients with a current DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders 4th ed. Text rev.) diagnosed with a major depressive episode entered this cross-sectional study. Thirty two items revised Hypomania/ mania Symptoms Checklist (HCL-32) was used to determine the frequency of bipolar episodes. Results: Considerable proportion of patients (53.9%) previously diagnosed as major depressive disorder fulfilled the criteria for bipolar disorder by Bipolarity Specifier. The Bipolarity Specifier additionally identified significant association for manic / hypomanic states during antidepressants therapy (p<0.0003) and current mixed mood symptoms (p<0.0001). Conclusion: Bipolar symptoms meeting the criteria for bipolar disorders in depressed patients who have not been previously diagnosed with bipolar disorder are frequent. Current DSM criteria may not be sufficient to diagnose more subtle or atypical forms of bipolar disorders. https://ijps.tums.ac.ir/index.php/ijps/article/view/210 https://ijps.tums.ac.ir/index.php/ijps/article/download/210/206

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 8 1 2013 03 15 7 13 Khodabakhsh Ahmadi Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. Shahriar Shahidi Departments of psychology, Shahid Beheshti University, Tehran, Iran. Vahid Nejati Departments of psychology, Shahid Beheshti University, Tehran, Iran. Gholamreza Karami Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran Mehdi Masoomi Bonyad Shahid Organization, Tehran, Iran, 2015 10 14 Objective: Quality of life measures can provide an important source of medical information for promoting the health status of chronically ill patients. The purpose of the present study was to evaluate health related quality of life in psychiatric veterans of the Iraq- Iran war of the 1980s. Methods: They were out patients diagnosed with various psychiatric symptoms. The present study used a cross sectional design, in which 971 psychiatric veterans were selected by Systematic-randomized sampling and evaluated using the SF36 questionnaire. Results: Findings revealed that veterans who suffered from one or more chronic conditions/illnesses reported significantly more bodily pain and significantly less vitality, mental and general health compared to those veterans without chronic conditions. Moreover, specific aspects of poor quality of life were more salient in specific chronic conditions/illnesses than others. Conclusion: Based on these findings, chronic conditions, especially respiratory problems, can https://ijps.tums.ac.ir/index.php/ijps/article/view/208 https://ijps.tums.ac.ir/index.php/ijps/article/download/208/204

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 8 1 2013 03 15 14 9 Seyed Mehdi Saberi Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran. Ardeshir Sheikhazadi Department of Forensic Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mazaher Ghorbani Department of Forensic Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Zaynab Nasri Nasrabadi Department of Forensic Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran AND Department of Pediatrics, Children's Medical Center, Pediatric Center of Excellence, Tehran University Of Medical Sciences, Tehran, Iran . Ali Pasha Meysamie Department Of Community Medicine, Tehran University Of Medical Sciences, Tehran Iran. Sayed Mahdi Marashi Department of Forensic Medicine, School of Medicine,, Tehran University Of Medical Sciences, 16 Azar Avenue Tehran, Iran. This research was supported by funding from Tehran University of medical science. 2015 10 14 Objective: In many jurisdictions, psychiatric problems are intended for commutation. Therefore, a forensic psychiatrist has an important role in detection of malingering. While several studies evaluate diagnostic tests, it is less known what symptoms are more likely to be imitated by malingerers. Method: In a prospective study 45 malingerers, who were diagnosed according to interviews by two forensic psychiatrists, from defendants with a judicial order for evaluation of mental status and criminal responsibility during a period of eighteen months were examined in legal medicine center of Tehran. Participants were assessed in another interview to determine symptoms. Dichotomous symptoms in felony and misdemeanor groups were analyzed using fisher’s exact test. The level of statistical significance was set at P<0.05. Results: Thirty-eight malingerers were charged with misdemeanors and seven with felonies. Behavioral symptoms were most frequently faked by 35 participants (77.8%). Participants charged with criminal accusation had a significantly lower mean age (P=0.032) and a higher level of education (P=0.008) than other non-criminal defendants. A statistically significant increase in memory function problems was demonstrated in the misdemeanor group (P=0.040). With regard to dual symptom imitation, statistically significant correlations were observed between thought content and perceptual symptoms (P=0.048) for felonies and mood & affect and thought process symptoms (P=0.034), mood & affect and behavioral symptoms (P=0.000) and cognitive function and behavioral symptoms (P=0.039) for misdemeanors. In general, many simulators attempted to mimic simple symptoms of behavioral disorders. Probably felony offenses need less accurate programming; therefore, their rates are higher in older, less educated participants. Conclusion: This study demonstrated that differences between presenting symptoms among different offenses may not be useful in  detection of malingering,; however, unusual dual symptom imitations may be useful, particularly when standard tests are not performed. https://ijps.tums.ac.ir/index.php/ijps/article/view/206 https://ijps.tums.ac.ir/index.php/ijps/article/download/206/202

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 8 1 2013 03 15 20 7 Hadi Zarafshan BAVAR Iranian Autism Center, Tehran, Iran. Mohammad Reza Mohammadi Tehran Universities of Medical Science, Psychiatry & Psychology Research Center, Tehran, Iran. Fatemeh Ahmadi Institutes of Health and Society, Newcastle University, Newcastle, UK. Akram Arsalani Special Education Office of Tehran 2015 10 14 Objective: Teachers often experience burnout and challenges during their active career. Different studies have shown that those directly involved with teaching children with special needs are more subject to burnout. Due to advance screening tools, more children with autism are now diagnosed and involved in special education. The aim of the present study was to investigate the professional burnout in teachers of children with autism compared to teachers of other children with special needs . Methods: Casual Comparative study design was used for this research. Three self-reported measures (Maslach Burnout Inventory, Job Descriptive Index, and General Health Questionnaire) were distributed; clustered sampling selection was conducted to select participants. Ninety three female teachers (32 teachers of children with autism, 30 teachers in schools for deaf and 31 for teachers of children with mental retardation) from 12 schools located in 4 districts of Tehran were selected. Pearson’s and Spearman’s correlation statistical tests, analysis of variances and regression were used to analyze the results. Results: Results of the current study revealed a significant difference in criterion validity between the three groups of teachers The three groups were different in terms of general health (p=0.010), emotional exhaustion (p=0.005) and depersonalization (p<0.001); however considering other variables no significant differences were observed. Comparison between groups showed that the average scores of teachers of children with autism were significantly higher than teachers of deaf and hard of hearing and mentally retarded children in general health, fatigue, and depersonalization variables. No significant differences were observed in average scores of teachers for mentally retarded and deaf children. Conclusions: Female teachers’ of children with autism are experiencing significantly higher levels of burnout and general mental health problems compared to teachers of children with other disabilities requiring special education. https://ijps.tums.ac.ir/index.php/ijps/article/view/204 https://ijps.tums.ac.ir/index.php/ijps/article/download/204/200

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 8 1 2013 03 15 28 36 Azam Baheiraei Department of Reproductive Health, Tehran University of Medical Sciences, Tehran, Iran ; Centers for Community-Based Participatory Research, Tehran University of Medical Sciences, Tehran, Iran. Elham Khoori Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Fazlollah Ahmadi Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran, Abbas Rahimi Foroushani Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Fazlollah Ghofranipour Department of Health Education, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran Robert M Weiler Department of Health Education & Behaviour, University of Florida, Florida, USA. 2015 10 14 Objective: It is important to consider the health concerns of adolescents before developing and implementing public health promotion or health education curriculum programs aimed at ameliorating priority health problems experienced by adolescents. The aim of this study was to test the psychometric properties of the original Adolescent Health Concern Inventory (AHCI) for use with an Iranian population. Methods: This was a methodological study in which 50 adolescents with age range of 14-18 years were selected using convenience sampling. The translation and cultural adaptation process of The AHCI followed recognized and established guidelines. The face and content validity was established by analyzing feedback solicited from teenagers and professionals with expertise in health, sociology and psychology. Reliability was examined using test-retest and Cronbach's alpha for internal consistency reliability. Kappa and McNemar tests were used to examine test-retest reliability for each item. Results: Minor cultural differences were identified and resolved during the translation process and determining the validity of the checklist. Results from Kappa and McNemar tests indicate a high degree of test-retest reliability. Internal consistency reliability as measured by Cronbach's alpha for the subscales were between 0.68 and 0.87 with total instrument reliability of 0.96 indicating considerable overall reliability. Conclusion: The Persian version of the AHCI appears valid and reliable. Hence, it can be used for filling a gap in identifying the adolescents' health concerns in the research and community settings and school health education programs in Iran to design appropriate interventions. https://ijps.tums.ac.ir/index.php/ijps/article/view/202 https://ijps.tums.ac.ir/index.php/ijps/article/download/202/198

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 8 1 2013 03 15 37 43 Homayoun Amini Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran ; Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ali-Akbar Nejatisafa Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran AND Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran Saeed Shoar Development Association of Clinical Studies, Tehran University of Medical Sciences, Tehran, Iran Hosein Kaviani Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran AND Departments of Psychology, University of Bedfordshire, Luton, UK Mehdi Samimi-Ardestani Departments of Psychiatry, Imam Hosein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Amir Shabani Departments of Psychiatry, Mental Health Research Center, Tehran University of Medical Sciences, Tehran, Iran Sara Esmaeili Development Association of Clinical Studies, Tehran University of Medical Sciences, Tehran, Iran Yasaman Moghaddam School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2015 10 14 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. https://ijps.tums.ac.ir/index.php/ijps/article/view/200 https://ijps.tums.ac.ir/index.php/ijps/article/download/200/196

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 8 1 2013 03 15 44 50 Mohammad Reza Mohammadi Tehran University of Medical Sciences, Department of Psychiatry, Tehran, Iran ; Psychiatry and Clinical Psychology Research Center. Abufazel Hosseininasab MSc. Allameh Tabatabaei University Department of Psychology Address: Tehran, Allameh Tabatabaei University, Faculty of psychology Ahmad Borjali Allameh Tabatabaei University, Department of Psychology, Tehran, Iran. Amir Ali Mazandarani Tarbiat Modares University, Department of Psychology, Tehran, Iran 2015 10 14 Objective: The aim of this study was to examine reality testing in schizophrenic children and compare it with normal children using minus responses subcomponent in ego impairment index of the Rorschach test. Methods: In a descriptive design, 20 accidentally sampled children, including 10 schizophrenic and 10 normal children, were recruited in to two groups and were compared in terms of reality testing subcomponent of Ego Impairment Index (EII). After initial interview, the Rorschach inkblot test was administered on the two groups, and Distorted Quality responses (FQ-) were calculated. The results were then analyzed by independent ttest and Cohen’s d for effect size . Results: The result of independent t-test revealed that the mean of minus responses in schizophrenic children was significantly higher than that of normal children. In addition, the usefulness of the Rorschach ego impairment index (EII) in evaluating reality testing in schizophrenic children was confirmed. In addition, it was found that defect in reality testing is one of the prominent characteristics of schizophrenic children . Conclusion: The higher minus responses in schizophrenic children indicate that schizophrenic children have weaker functioning in reality testing compared with normal children. https://ijps.tums.ac.ir/index.php/ijps/article/view/198 https://ijps.tums.ac.ir/index.php/ijps/article/download/198/194

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 8 1 2013 03 15 51 4 Hannan Ebrahimi Medical Student, student research committee, Guilan University of Medical Sciences. Mohammad Ja'far Modabbernia Shafa Hospital, 15 Khordad Ave, Rasht, Iran Alieh Mohammadi Medical Student, student research committee, Guilan University of Medical Sciences Sina Khajeh Jahromi Medical Student, student research committee, Guilan University of Medical Sciences Misa Naghdipour General Practitioner, student research committee, Guilan University of Medical Sciences Hossein Ebrahimi Medical Student, student research committee, Guilan University of Medical Sciences 2015 10 14 Objective: Screening is one of the ways to combat Tuberculosis (TB) and should be mostly concentrated on groups showing some symptoms of the disease. Tuberculosis can be transferred from person to person in laboratories, prisons and psychiatry hospitals. The purpose of this study was to survey pulmonary TB in patients with schizophrenia in Rasht. Methods: In this descriptive-cross sectional, Two hundred fifty seven consecutive patients with chronic psychotic disorder hospitalized in psychotic hospitals underwent purified protein derivative (PPD) test. PPD test was done with the unit 5T which was injected subcutaneously on anterior surface and at the top of left forearm. The results of the test were interpreted by the pen technique method and based on transverse diameter of induration of about 48-72 hrs. Induration size due to hypersensitivity to PPD more than 10mm was considered positive. Patients with positive PPD test underwent complementary sputum smear.  Data were analyzed using chi- square and T test. Results: The mean age of patients was 45±10 years; 75.5% were male, 74.7% were single, 10.5% married, 7.8% divorced, and 68.1% were     smokers. These patients suffered from chronic psychotic disorder at the mean time of 15±7.9 years. In 74 patients (28%) positive PPD test were recorded, but active pulmonary TB was not found in complementary experiments of PPD sample. Based on data analysis, only age and gender showed a significant relationship with the results of the PPD test (P < 0.05). Conclusions:This study showed that patients with positive PPD test are much more than the normal population, but active pulmonary TB was not observed in our samples. Since these patients are in clinical and closed places, more programs for screening are required. https://ijps.tums.ac.ir/index.php/ijps/article/view/196 https://ijps.tums.ac.ir/index.php/ijps/article/download/196/192

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 8 1 2013 03 15 55 8 Hooshang Dadgar School of Rehabilitation.Tehran University of Medical Sciences (TUMS). Ahmad Reza Khatoonabadi School of Rehabilitation.Tehran University of Medical Sciences (TUMS). Jalal Bakhtiyari School of Rehabilitation.Semnan University of Medical Sciences (TUMS). 2015 10 14 Objective: While Parkinson’s disease (PD) has traditionally been defined by motor symptoms, many researches have indicated that mild cognitive impairment is common in non-demented PD patients. The purpose of this study was to compare verbal fluency performance in non-demented Parkinson’s disease patients with healthy controls . Method: In this cross-sectional study thirty non-demented Parkinson’s disease patients and 30 healthy controls, matched by age, gender and education, were compared on verbal fluency performance. Verbal fluency was studied with a Phonemic Fluency task using the letters F, A, and S, a semantic fluency task using the categories animals and fruits. The independent t-test was used for data analysis. Results: Overall, participants generated more words in the semantic fluency task than in the phonemic fluency task. Results revealed significant differences between patients and controls in semantic fluency task (p<.05). In addition, PD patients showed a significant reduction of correctly generated words in letter fluency task. The total number of words produced was also significantly lower in the PD group (p<.05). Conclusion: Verbal fluency disruption is implied in non-demented PD patients in association with incipient cognitive impairment . https://ijps.tums.ac.ir/index.php/ijps/article/view/194 https://ijps.tums.ac.ir/index.php/ijps/article/download/194/190

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 8 1 2013 03 15 59 60 Kamyar Mollazadeh-Moghaddam Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran AND National Drug and Poison Information Center, Deputy of Food and Drug, Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Milad Clinical Research Center, Milad Hospital, Tehran, Iran. Arsia Jamali Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Milad Clinical Research Center, Milad Hospital, Tehran, Iran. Fatemeh Adili-Aghdam Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran. Shahin Akhondzadeh Ph.D., FBPharmacolS. Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, South Kargar Street, Tehran 1333795914, Iran. 2015 10 14 Donepezil, a member of the acetylcholinesterase inhibitor family, is approved for management of cognitive impairments as well as behavioral complications in patients with neurodegenerative Alzheimer's disease. Generally, donepezil is regarded as a safe medication in patients with Alzheimer's disease although there have been reports of several minor adverse events including gastrointestinal disturbances. Herein we describe a patient with Alzheimer's disease who demonstrated delirious behavior upon treatment with donepezil. https://ijps.tums.ac.ir/index.php/ijps/article/view/192 https://ijps.tums.ac.ir/index.php/ijps/article/download/192/188