18 1735-4315 Iran University of Medical Sciences and Health Services 240 Psychiatry and Psychology Psychiatrist Manpower in Iran: A Planning Evidence Ardalan A. Shahmohammadi D. 1 7 2002 8 1 4 13 01 11 2007 Abstract The purpose of human resources planning in the health services system is to account for a sufficient number of efficient manpower in all the needed professions, who are appropriately distributed in terms of geographical, gender, and organizational parameters. Any inadequacies in such planning will lead to lack of coordination between supply and demand. Planning for psychiatrist manpower follows the same rule. The changes in social, cultural, and economic conditions, followed by an increase in the intensity of mental disorders more than ever before calls for extended implementation of mental health programs and careful attention to proper human resources planning, which plays a governing key role in the success of such programs. The purpose of this article is to examine the various aspects of human resources planning in Iran. In this regard, it presents an assessment of the present conditions of manpower in Iran, a critique of reviews implemented in this area, a survey of the number of psychiatrists and its ratio to the population as compared to other countries, and the significant factors affecting the need for psychiatrists. Finally, appropriate suggestions are provided with regard to the lack of an existing integrated planning system, and the lack or inadequacy of the data required for future policy making in the country’s mental health and treatment system.  
241 Psychiatry and Psychology Epidemiology of Depression and Sexual Abuse among Street Children Ahmad Khaniha H. R. Turkman Nejad Sh. Hussaini Moghaddam M. M. 1 7 2002 8 1 14 20 01 11 2007 AbstractObjectives: This study reviews the prevalence of present as well as prior history of sexual abuse and depression among the street children of South Tehran. Method: Using K-SADS, 87 street children as the subjects of the study from District 12 of Tehran were screened for depression. The prevalence of their experience of sexual abuse was assessed through clinical interviews. The average age of the subjects was 11 years. 56 children (64%) were boys and 31 children (36%) were girls. Findings: The results showed that 26 girls (86.7%) and 27 boys (48.2%) were diagnosed with depression. Significant co-relations were indicated between depression and the following variables: fathers’ history of imprisonment, fathers’ unemployment, and family income provided by someone other than the father. The findings also demonstrated that 18 subjects (20.9%) had been victims of sexual abuse in 55.5% of the cases, the abuse was committed by a stranger. No significant co-relations were found between sexual abuse with depression, drug abuse, cigarette smoking, or other variables under study. Results: The high prevalence of depression and sexual abuse among homeless children demands serious attention from both governmental and non-governmental organizations in provision of protection and education for these children. Special attention invested in this stratum of the society is quite indispensable in the eradication of venereal diseases and the prevention of the spread of AIDS.  242 Psychiatry and Psychology Factors Contributing to Illicit Substance Dependence among Treatment Seeking Addicts in Tabriz Ghoreishizadeh S. M. A. Torabi K. 1 7 2002 8 1 21 28 01 11 2007 AbstractObjectives:This study examined the leading factors causing drug abuse initiation and further continuation and relapse of illicit drug use by treatment seeking addicts in Tabriz Self-Referred Welfare Center. Method: Among those referring to the Center, 200 male addicts were randomly selected as the subjects of the study. The necessary information was collected through semi-structured psychiatric clinical interviews and a questionnaire on epidemiology as well as etiology of substance dependence. Findings: The findings demonstrated that the highest number of subjects (46%) fell in the 25 to 34-age range group 65% possessed education below high school diploma and 78% were married. The most common substance used was opium (80%). As for the causation of substance abuse, the most common responses were in the following categories: peer pressure and interaction with unsuitable cohorts (28%), Enjoyment and recreational use (26%), Physical discomfort and pain relief (19%), Psychological pressures and life stressors (13%). The factors contributing to the maintenance and continuation of drug abuse were found in the categories of Feelings of dependence (20%), Inability to tolerate withdrawal symptoms (28%), Euphoric effects (15.5%), Elimination of anxiety and stress (12.5%), Self confidence (11%), Concentration, thinking and working capacity (13%). The factors leading to relapse after some periods of abstinence included Mental stress ensuing from withdrawal (45%), Banishment by the family (10%), Peer pressure (22%), Feeling of loneliness and social ostracism (8.5%), Unemployment (6%), and Depression (8.5%). Results: This study demonstrated that various biological, psychological, and social factors contribute to different levels of illicit substance dependence.   243 Psychiatry and Psychology Demographic Features of Opium Dependent Patients with Successful Withdrawal Attempts at RUMS Outpatient Clinic Sayyadi Anari A. R. Esmaili A. Nazer M. Khaleghi E. 1 7 2002 8 1 29 38 01 11 2007 AbstractObjectives: The purpose of the study was to examine the role of individual and social factors in continuation of treatment as well as relapse for opium dependent patients. Method: 920 upload dependent patients admitted to the self-referring clinic at the Rafsanjan University of Medical Sciences (RUMS) were selected through random sampling as the subjects of the survey. In an ad hoc study, the subjects were monitored through a six-month follow up period. The data were collected through an demographic questionnaire. Findings: The results indicated 28.7% of the subjects had successful opium withdrawal, but 15.7% of them relapsed in less than 6 months, and only 119 subjects (12.9%) remained clean at the 6- month follow-up screening. In addition, there were significant differences found between the successful withdrawal group, unsuccessful withdrawal group, and the relapsed group across the following parameters: age, employment, marital status, ownership of a place of residence, type of opium, the usage route, daily dosage, initiation age, experience with other drugs, prior experiences with injection and abstinence. Results: Successful treatment cannot be judged with reference to a single variable rather, there are a number of intervening factors that determine the prognosis of treatment, of which the addict’s personal and social characteristics constitute only a part.   244 Psychiatry and Psychology Forgiveness Treatment with an Emphasis on Islamic Perspective: A Case Study Khodayari Fard M. Ghobari Bonab B. Faghihi A. N. Vahdat Torbati Sh. 1 7 2002 8 1 39 48 01 11 2007 Abstract Objectives: The present article examines the application of “forgiveness” with an emphasis on Islamic perspective as a treatment method to improve interpersonal relationships and to enhance problem-solving skills in the resolution of difficulties and internal conflicts such as resentfulness toward others in particular. Method: The study was conducted as a library research and a testimonial report of two case studies in which the spoken treatment had been used. Findings: The findings demonstrated that by using this method, the resentful subjects were able to gradually replace their negative thoughts and feelings toward others with positive ones. Results: Forgiveness treatment-method is effective in reconciliation of the feelings, thoughts, and behaviors of the resentful it improves relationships with others. This method seems to be more effective for those who have stronger religious inclinations.   245 Psychiatry and Psychology Prevalence of Personality Disorders among the Hospitalized Patients at an Educational-Treatment Center in Kermanshah Shakeri J. Sadeghi Kh. 1 7 2002 8 1 49 56 01 11 2007 Abstract Objectives: The purpose of the present study was to examine the comorbidity of personality disorders with mental disorders that are focus of clinical attention. Method: 203 hospitalized patients (124 male and 79 female) at the psychiatric ward of Farabi Educational-Treatment Center in Kermanshah were selected from an available sample as the subjects of the study. A symptom check list was used to review the patients' psychiatric symptoms based on DSM- IV diagnostic criteria. Findings:  67.5% of subjects were found to suffer from co-existing personality disorders. Some of the most common dually diagnosed disorders were as follow: schizoid personality disorder with schizophrenia (25.8%), paranoid personality disorder with psychosis (48.3%), narcissistic personality disorder with bipolar (38%), borderline personality disorder with major depression (61.2%), and antisocial personality disorder with drug- dependency (29.5%). Moreover, personality disorders were found to be more prevalent among the following groups of subjects: women, literate, younger, unemployed, third born or younger children of the family, patients whose parents were relatives, patients with personal or family history of psychiatric disorders, and subjects in higher socio-economic classes.    246 Psychiatry and Psychology Prevalence of Diabetes Mellitus in Hospitalized Patients with Bipolar Disorder Firouzabadi A. Momeni T. 1 7 2002 8 1 57 60 01 11 2007 Abstract Objectives: The study was implemented to investigate the prevalence of Diabetes Mellitus in the hospitalized patients suffering from bipolar disorder in Shiraz. Method: The subjects were 384 bipolar patients (192 female and 192 male) hospitalized in the psychiatric wards of Ibne’Sina and Hafez hospitals in Shiraz. The subjects' age range was between 13 to 85 years their history of diabetes was evaluated and then compared with the general population in terms of prevalence of the disorder. Findings: 7 females and 9 males were diagnosed with diabetes, of whom only one was diagnosed with type II diabetes. The prevalence of diabetes among the population under study was 4.2%, which was significantly different from that of the general population. Results: The study implies that the comorbidity of the two disorders might be due to genetic inheritance, a cause-effect relationship, the presence of a shared disorder involving specific brain areas, or the effect of the medication.  247 Psychiatry and Psychology Optional Bias toward Guilt Feeling Signs in the Course of Information Processing in Obsessive-Compulsive Patients` Naziri Gh. Birashk B. 1 7 2002 8 1 61 69 01 11 2007 Abstract Objectives: The present study was designed to examine the bias toward signs related to guilt feeling in the course of information processing in obsessive-compulsive patients. Method: Within the framework of a quasi-experimental design, 20 obsessive-compulsive patients through a Stroop Test were compared with 20 depressed and 20 normal subjects. Findings: The findings of the study demonstrated that the obsessive-compulsive patients took more time to read guilt related color-signs the depressed subjects too showed the same delay when compared to the normal group. No significant difference in lapsed time was noted among the three groups in relation to the signs lacking emotional load. Results: The results verify previous research findings concerning obsessive-compulsive disorder, which emphasize the role of guilt feeling as a foregrounding, exposing, or maintaining factor in this disorder. The clinical advices derived from the results of this research are to take notice of this symptom in the cognitive treatment of obsessive patients and attempting to reduce it.   248 Psychiatry and Psychology Knowledge and Attitude of Nurses Regarding ECT among Staff at a Psychiatric Hospital Mehrabian S. Mohammad Alizadeh S. Bahrampour M. R. 1 7 2002 8 1 70 75 01 11 2007 Abstract Objectives: Although widely used in treatment of some mental illnesses, electro-convulsive therapy (ECT) still receives negative reactions, even from medical and nursing communities. The purpose of the present study was to determine the knowledge and attitude of the nursing staff at Shahid Beheshti Psychiatric Hospital in Kerman toward ECT, and their method of care for patients under ECT treatment. Method: 80 staff members of the spoken hospital were the subjects of the study. Reviewed by an aid of a questionnaire developed by the researcher, the staff’s method of care was observed before, during, and after 80 consecutively conducted ECTs. Findings: The results demonstrated that most subjects were female (78.7%), married (73.8%), under 31 years of age (46.3%), and held a B.A. (or higher) degrees (51.3%). The subjects collectively responded correctly to 47.8% of the questions 67.3% was reached on the attitude test score. A comparative analysis of the attitude scores based on demographic features, showed a statistically significant difference in terms of age, sex, and working experience, so that staff members who were older and had more working experience obtained lower attitude scores. Results: The nurses’ limited knowledge of ECT and their slightly negative attitude toward it calls for ECT education for nurses.  249 Psychiatry and Psychology The Impact of Pharmacological Treatment on Personality Disorders of Obsessive-Compulsive Patients Dadfar M. Malakouti K. Bolhari J. Mehrabi F. 1 7 2002 8 1 76 87 01 11 2007 AbstractObjectives: This study was designed to examine the changes in the diagnosis of personality disorders of obsessive-compulsive patients following a pharmacological treatment. Method: In a quasi-experimental design, 30 obsessive-compulsive patients (15 with and 15 without personality disorders) selected from an available sample, received pharmaceutical treatment for a period of three months. The tools used for this study included a demographic questionnaire, Hamilton Rating Depression Scale, Yale-Brown Obsessive-compulsive Scale, and MCMI-II. The subjects were matched in term of variables affecting treatment. The data were analyzed through a t-test, X2, Mann-Whitney and Wilcoxon statistical methods. Findings:  No significant difference was found in the number of personality disorders diagnosed before and after treatment in either group of obsessive-compulsive patients (with and without personality disorders). However, as a result of a personality trait comparison, a significant difference was indicated between the aforementioned groups before and after treatment. Results: Pharmaceutical treatment is more likely effective in bringing about changes in personality traits of obsessive-compulsive patients. Such an impact is either influential in alteration of the ways by which this illness is manifested or by affecting personality traits directly.  250 Psychiatry and Psychology Short Scientific Article Asgari M. A. 1 7 2002 8 1 89 89 01 11 2007 Short Scientific Article