18 1735-4315 Iran University of Medical Sciences and Health Services 1507 Psychiatry and Psychology Meta-analysis of the Effectiveness of Cognitive-Behavior Interventions Aghaie Elham b Abedi Ahmad c Jamali Paghale Somaye d b Isfahan University c Isfahan University d Isfahan University 1 7 2012 18 1 3 12 09 07 2012 Objectives: The aim of the Current meta-analysis was to determine the effectiveness of cognitive-behavior treatments in reducing test anxiety.  Method: Totally 23 studies with accepted methodology were selected and meta-analysis was done on them. The data were gathered using meta-analysis check list. The effect size of each study was calculated separately. Results: The study findings showed that the rate of effect size of cognitive-behavior treatment on reducing test anxiety was 2.66 (p≥0.001) which according to Cohen’s table was high. Conclusion: Cognitive-behavior interventions are suitable treatments for test anxiety.
1508 Psychiatry and Psychology Axis I Psychopathology during the First Four Mounts After Traumatic Brain Injury Rezaei Sajad e Salehi Iraj f Moosavi Heshmatollah g Yousefzaeh Shahrokh h e Guilan University f Guilan University g Guilan University of Medical Sciences h Guilan University of Medical Sciences 1 7 2012 18 1 13 28 09 07 2012 Objectives: The aim of this research was to examine ‎the dimensions of axis I disorders during the first four months after ‎Traumatic Brain Injury (TBI) and mental states after TBI. Method: Overall, 238 patients (43 females and 195 males) with TBI, in a descriptive-longitudinal study, were selected by consecutive sampling procedure and each of them undergone medical ‎examinations. After 4 months of follow-up, 65.1% (155 cases) of the patients referred ‎to a psychiatrist to determine the nature of their mental disorder due to ‎TBI, using a structured clinical interview, based on the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) ‎. Results: The results showed that 75.5% (117 cases) of the patients had post-injury mental disorders ‎secondary to TBI‎. Of these, 88 patients (75.2%) showed the comorbidity of mental disorders. However, the most common mental disorders due to TBI included personality change (58.6%), mood disorders (32.3%), anxiety disorders (20%), sleep disorders (19.3%), chronic amnesia (12.9%) and somatoform disorders (1.3%). Delirium, eating and psychotic disorders due to TBI, ‎each ‎up to 0.64%, were also diagnosed‎. Conclusion: The high frequency of mental disorders is evident in the acute phase after TBI, along with many novel cases of personality changes, mood and anxiety disorders. Therefore ‎‎TBI patients must be monitored and evaluated at least in a 4-‎month period after the trauma to reduce the risk of mental ‎disorders incident. 1509 Psychiatry and Psychology Clinical Characteristics and Diagnostic Stability of Bipolar Disorder in Children and Adolescents Habibi Nastaran i Shahrivar Zahra j Sharifi Vandad k Mahmoudi Gharaee Javad l Tabatabaee Maryam m Zarrabie Mojgan n i Tehran University of Medical Sciences j Tehran University of Medical Sciences k Tehran University of Medical Sciences l Tehran University of Medical Sciences m Tehran University of Medical Sciences n Tehran University of Medical Sciences 1 7 2012 18 1 29 39 09 07 2012 Objectives: The aim of this study was to evaluate the clinical characteristics and diagnostic stability of children and adolescents with bipolar disorder. Method: In this prospective study, 257 subjects with bipolar disorder who were consecutively admitted to Roozbeh Hospital (Tehran, Iran) were enrolled. Demographic characteristics, diagnosis, treatment, comorbid disorders and mood and psychotic symptoms were extracted from the patients’ admission files and the information questionnaire, which had been filled in the admission time by the patients. In the further assessment, diagnostic evaluation was done using the Schedule for Affective Disorders and Schizophrenia for School-aged  children present and lifetime version (K-SADS-PL), for the patients under 18, and the Schedule for Affective Disorders and Schizophrenia (SADS) for the patients older than 18. Severity of the symptoms in the acute phase of mood disorder was evaluated by the Young Mania Rating Scale (Y-MRS) in manic phase and Beck Depression Inventory (BDI) for patients older than 16 or Children Depression Inventory (CDI) for the patients under 16 in depressive phase. Also, current and past levels of functioning were evaluated by the Global Assessment of Functioning (GAF) scale for patients older than 18 and the Child Global Assessment Scale (CGAS) for the patients under 18. Results: The most common symptom, irritability, was accompanied by elated mood in most cases. 73.2% of the patients had at least one comorbid disorder and the most common comorbid disorder was Attention Deficit Hyperactivity Disorder (44.2%). Diagnostic stability in all periods of illness was higher than 80%. Conclusion: This study supports the high diagnostic stability of bipolar disorder in both children and adolescents. 1510 Psychiatry and Psychology Effectiveness of Cognitive - Behavioral Group Therapy and Exposure Therapy on Interpretation Bias and Fear of Negative Evaluation in Social Anxiety Disorder Dadashzadeh Hosein o Yazdandoost Rokhsare p Gharraee Banafsheh Asgharnejad farid Aliasghar o Tabriz University of Medical Sciences p Tehran University of Medical Sciences Tehran University of Medical Sciences Tehran University of Medical Sciences 1 7 2012 18 1 40 51 09 07 2012 Objectives: The purpose of this study was to compare the effectiveness of cognitive-behavioral group therapy and exposure therapy on the reduction of interpretation bias and fear of negative evaluation in social anxiety disorder. Method: In a pre-posttest experimental design with control group, 24 students studying at B.Sc. level in the Health School of Iran University of Medical Sciences with the diagnosis of social anxiety disorder were selected by convenience sampling. Then, all of the subjects were randomly allocated into three groups (cognitive-behavioral group therapy, exposure therapy, and waiting list control group). Twelve sessions of cognitive-behavioral group therapy and exposure therapy were carried out according to a standard manual of therapy, and the waiting list control group did not receive any treatment. Data were gathered through administration of Social Phobia Inventory (SPIN), Interpretation Questionnaire- Revised, and Brief Fear of Negative Evaluation Scale (BFNE-S). Univariate analysis of covariance was used for data analysis. Results: The cognitive-behavioral group therapy comparing to the exposure therapy (p<0.01) and the waiting list control group (p<0.001) significantly led to the reduction of interpretation bias in the socially anxious subjects. It was also found that exposure therapy alone did not significantly reduce interpretation bias in the social anxiety patients and showed no difference with the waiting list control group. On the other hand, both  cognitive-behavioral group therapy and exposure therapy in comparison with the waiting list control group significantly reduced fear of negative evaluation (p<0.001 & p<0.001 respectively), but there was no significant difference between these groups themselves. Conclusion: Both cognitive- behavioral group therapy and exposure therapy, reduced fear of negative evaluation in social anxiety disorder. On the other hand, the cognitive-behavioral group therapy also reduced interpretation bias, but the exposure therapy could not do so.   1520 Psychiatry and Psychology Standardization of the Neuropsychological Test of NEPSY on 3-4 Years Old Children Abedi Ahmad Malekpour Mokhtar Oraizi Hamidreza Faramarzi Salar Jamali Paghale Somayeh Isfahan University Isfahan University Isfahan University Isfahan University Isfahan University 1 7 2012 18 1 52 60 15 07 2012 Objectives: The current study aimed to standardize the neuropsychological test of NEPSY on 3-4 years old children. Method: Statistical population of the study was 3-4 years old children in Isfahan city (Iran). The research sample consisted of 400 kindergarten children who were selected randomly with multiple-stage sampling method. The research instrument was the neuropsychological test of NEPSY. The data were analyzed using descriptive method for factor analysis and determining the validity and reliability. Results: The results of factor analysis gave the following five factors: executive functions/attention, language, sensory motor functions, visuo-spatial processing, and memory and learning. Totally, 51.13% of variance was explained. The reliability coefficient for the above factors was obtained as 0.64, 0.71, 0.78, 0.67 and 0.85, respectively (P<0.001). Conclusion:  NEPSY test can be an appropriate and valid instrument for early diagnosing neuropsychological deficits in 3-4 years old children. 1511 Psychiatry and Psychology Trends of Psychiatric Consultation in Rasoul Akram Hospital Ghanbari Jolfaee Atefeh Nasr Esfahani Mehdi Tehran University of Medical Sciences Tehran University of Medical Sciences 1 7 2012 18 1 61 66 09 07 2012 Objectives: The present study aimed to assess the characteristics of psychiatric consultations and their changes over a 3-year period in Rasoul Akram Hospital, (Tehran, Iran). Method: The consultations’ characteristics of various hospital wards were retrospectively evaluated since 2007 to 2010 and some characteristics like gender, the reason of consultation request, the requesting ward for consultation, request and consultation date and psychiatric diagnosis were recorded. The data were analyzed using c2 and matched-paired t-test. Results: During the study period, for 1.09% of the inpatients, a psychiatric consultation was requested. Most of the referrals were from internal medicine department. Current psychiatric symptoms (55%) and unexplained physical symptoms (16%) were the most prevalent reasons for referral and major depressive disorder (27.7%), delirium (11.8%) and substance dependency (10.2%) were the most common psychiatric diagnoses. There were no significant differences between the two time periods (2007 and 2010) based on the total number of consultations, gender of  patients, the requesting ward for consultation and lag time. Although the rate of referrals from some departments such as neurology had significant difference (p<0.05), the reason for consultations were not different between the two periods (p≥0.05). The rate of substance dependency in 2010 was more than 2007 (p=0.001). Conclusion: Further such studies are necessary for monitoring up the changes of consultations’ patterns. 1512 Psychiatry and Psychology Reliability, Validity and Factor Analysis of Cohen-Mansfield Agitation Inventory (CMAI) Zare Maryam shayeghian Zeinab Birashk Behrooz Afkham Ebrahimi Azizeh Tehran University of Medical sciences Tarbiat Modarres University, Tehran University of Medical sciences Tehran University of Medical sciences 1 7 2012 18 1 67 73 09 07 2012 Objectives: In order to investigate the effectiveness of pharmacological and non-pharmacological treatment methods for decreasing agitation in diseases like dementia, a proper scale like Cohen-Mansfield Agitation Inventory (CMAI) is needed. The aim of the present study was to evaluate the psychometric properties of the CMAI. Method: The sample consisted of 100 caregivers of patients with Alzheimer's disease that responded to the CMAI. Results: The inter-rater reliability of the inventory was investigated by the assessment of other observer. After two weeks, the main observer filled the CMAI for the same patients again. The reliability of the inventory was investigated by test-retest, alpha Cronbach and split-half methods that were 0.99, 0.92 and 0.82 respectively. The validity of the questionnaire was investigated by convergent validity, inter-rater agreement across items and exploratory factor analysis. The results from factor analysis of the CMAI using varimax rotation method yielded 4 factors labeled: 1- Aggressive Behaviors, 2- Non-Aggressive Behaviors, 3- Verbal Aggression, and 4- Hiding Behaviors, which explained 72.77% of the total variance. Convergent validity was confirmed by computing a correlation coefficient between the subscales together and with total scale, which was significant between 0.43 and 0.90 (p<0.01). Conclusion: Regarding the results, it could be said that this inventory can be a valid and reliable scale to evaluate the agitation in patients with Alzheimer's disease. 1513 Psychiatry and Psychology Reliability and Validity of the Sexual Self-Efficacy Scale-Erectile Functioning Rajabi Gholamreza Dastan Nasir Shahbazi Masoud Shahid Chamran University Shahid Chamran University Shahid Chamran University 1 7 2012 18 1 74 82 09 07 2012 Objectives: The purpose of the present study was to examine the reliability and validity of the Sexual Self-Efficacy Scale-Erectile Functioning (SSES-E) among university students. Method: 115 married male students of Shahid Beheshti University, Tehran, Iran, were selected voluntarily, and completed the SSES-E. Results: The alpha chronbakh coefficient was calculated as α= 0.95 and for the five factors extracted, it was 0.82 to 0.91. Also, exploratory factor analysis using varimax rotation and with eagenvalues more than one, extracted five factors (having intercourse without fear or anxiety, keeping an erection during the intercourse, get a sexual encounter, reach to orgasm, and re-sexual desire) which explained 74.04% of the items variances. There was significant correlation between total score and five extracted factors. Furthermore, there was high sexual self-efficacy among 20 males and low sexual self-efficacy among 17 males. Conclusion: The clinical psychologists and family councelors can use and benefit the  SSES-E to identify the male clients with erectile difficulties for training and treatment activities in clinical and counceling settings.