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Amin-Esmaeili M, Rahimi-Movaghar A, Sharifi V, Hajebi A, Radgoodarzi R, Mojtabai R, Hefazi M, Motevalian A. Epidemiology of illicit drug use disorders in Iran: prevalence, correlates, comorbidity and service utilization results from the Iranian Mental Health Survey. Addiction 2016; 111:1836-47. [PMID: 27177849 DOI: 10.1111/add.13453] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 02/03/2016] [Accepted: 05/09/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND AIMS Drug abuse is a significant social and public health problem in Iran. The present study aimed to provide prevalence estimates and information on correlates of illicit drug use disorder and opioid dependence, as well as service use for these disorders in Iran. DESIGN, SETTING AND PARTICIPANTS This report is based on the Iranian household Mental Health Survey (IranMHS) conducted in 2011. A three-stage probability sampling was employed. Face-to-face interviews by trained psychologists were carried out with a nationally representative sample of 7841 individuals (3366 men and 4475 women) aged 15-64 years. MEASUREMENTS The Composite International Diagnostic Interview and questionnaires for socio-demographic correlates and service use. FINDINGS The prevalence of 12-month use disorders for any illicit drug according to DSM-IV and DSM-5 criteria were 2.09% [95% confidence interval (CI) = 1.70-2.47%] and 2.44% (95% CI = 2.03-2.85%), respectively. Opioid use disorders, and opium in particular, were the most common use disorder. The odds of drug use disorders were greater in men than in women, in previously married participants than in currently or never married participants, and in participants with lower socio-economic status than in those with higher socio-economic status (all P-values <0.05). Approximately half of those with drug use disorders and 40% with opioid dependence had a 12-month unmet need for treatment. Self-help groups were the most common type of service used, followed by obtaining medication from pharmacies directly and outpatient treatment services. CONCLUSIONS Opioid use disorders are the most common type of drug use disorders in Iran, setting Iran apart from many other countries. Patterns of service use suggest a large unmet need for drug use disorder treatment in Iran.
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Sharifi V, Eaton WW, Wu LT, Roth KB, Burchett BM, Mojtabai R. Psychotic experiences and risk of death in the general population: 24-27 year follow-up of the Epidemiologic Catchment Area study. Br J Psychiatry 2015; 207:30-6. [PMID: 25953893 PMCID: PMC4486819 DOI: 10.1192/bjp.bp.113.143198] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 11/24/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND Psychotic experiences are common in the general population and are associated with adverse psychiatric and social outcomes, even in the absence of a psychotic disorder. AIMS To examine the association between psychotic experiences and mortality over a 24-27 year period. METHOD We used data on 15 049 adult participants from four sites of the Epidemiologic Catchment Area baseline survey in the USA in the early 1980s, linked to the National Death Index and other sources of vital status up until 2007. Psychotic experiences were assessed by the Diagnostic Interview Schedule. RESULTS Lifetime psychotic experiences at baseline (n = 855; weighted prevalence, 5.5%) were significantly associated with all-cause mortality at follow-up after adjustment for sociodemographic characteristics and psychiatric diagnoses, including schizophrenia spectrum disorders (P<0.05). Baseline psychotic experiences were associated with over 5 years' shorter median survival time. Among the underlying causes of death, suicide had a particularly high hazard ratio (9.16, 95% CI 3.19-26.29). CONCLUSIONS Future research needs to explore the association of psychotic experiences with physical health and lifestyle factors that may mediate the relationship of psychotic experiences with mortality.
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research-article |
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Sharifi V, Assadi SM, Mohammadi MR, Amini H, Kaviani H, Semnani Y, Shabani A, Shahrivar Z, Davari-Ashtiani R, Shooshtari MH, Seddigh A, Jalali M. A Persian translation of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: psychometric properties. Compr Psychiatry 2009; 50:86-91. [PMID: 19059520 DOI: 10.1016/j.comppsych.2008.04.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Revised: 03/26/2008] [Accepted: 04/10/2008] [Indexed: 01/23/2023] Open
Abstract
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.
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Validation Study |
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4
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Sharifi V, Amin-Esmaeili M, Hajebi A, Motevalian A, Radgoodarzi R, Hefazi M, Rahimi-Movaghar A. Twelve-month prevalence and correlates of psychiatric disorders in Iran: the Iranian Mental Health Survey, 2011. ARCHIVES OF IRANIAN MEDICINE 2015; 18:76-84. [PMID: 25644794 DOI: 015182/aim.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
IMPORTANCE No national information is available on the epidemiology of psychiatric disorders in Iran for the last decade. OBJECTIVES To estimate the 12-month prevalence of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) psychiatric disorders in Iranian population, and to investigate the severity and correlates of psychiatric disorders. DESIGN, SETTING AND PARTICIPANTS The Iranian Mental Health Survey (IranMHS) was a nationally representative face-to-face household survey with a multistage, cluster sampling design that was carried out in 2011. A total of 7886 community dwelling residents aged 15-64 were recruited. MAIN OUTCOME MEASURES 12-month diagnoses of DSM-IV psychiatric disorders including mood, anxiety, and substance use disorders were assessed using a validated Persian translation of the Composite International Diagnostic Interview (CIDI; version 2.1). The Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) was administered by a psychiatrist on subjects screened positive for the presence of a psychotic disorder. The severity of psychiatric disorders was determined using criteria that included markers for disability, particular diagnoses and suicide attempts. RESULTS The response rate was 86.2%. The 12-month weighted prevalence of "any psychiatric disorder" was 23.6% [95% confidence interval (CI): 22.4-24.8] with 26.5% of women and 20.8% of men having one or more psychiatric disorders. The most common category of psychiatric disorders was any anxiety disorder (15.6%) and the most prevalent particular disorder was major depressive disorder (12.7%), followed by generalized anxiety disorder (5.2%) and obsessive-compulsive disorder (5.1%). A 12-month psychotic disorder was observed in 0.5% of the population (95% CI: 0.33-0.66). Almost two-thirds (63.8%) of individuals with a mental disorder had moderate or serious illness. Unemployment, being widowed/divorced and urban living were associated with a greater likelihood of 12-month disorders; while, higher socioeconomic status and having a university degree were associated with a lower likelihood. CONCLUSION The high prevalence of psychiatric disorders, particularly major depression, merits further attention in the country's mental health policy and program planning.
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Research Support, Non-U.S. Gov't |
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49 |
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Sharifi M, Sorkin R, Sharifi V, Lakier JB. Inadvertent malposition of a transvenous-inserted pacing lead in the left ventricular chamber. Am J Cardiol 1995; 76:92-5. [PMID: 7793416 DOI: 10.1016/s0002-9149(99)80812-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In conclusion, we propose the following approach to prevent and manage lead malposition in the left ventricle: A 12-lead electrocardiogram in the paced mode and an anterior and lateral chest view should be thoroughly inspected shortly after pacemaker implantation. A definitive diagnosis of malposition can be established with these tests. Development of any neurologic symptoms should be attributed to the malpositioned lead until proved otherwise. In such patients, serious consideration should be given to transcatheter or surgical lead extraction after a period of anticoagulation. If this is not possible, chronic anticoagulation with warfarin must be initiated, achieving an international normalized ratio of > or = 2.5. Antiplatelet therapy alone may not confer adequate protection against future cerebral events. Furthermore, most patients with neurologic manifestations do not have echocardiographic evidence of thrombus on the lead. Conversely, presence of thrombus is highly associated with neurologic symptoms. Any intraarterial lead must be removed due to inevitable complications. Patients who have remained completely asymptomatic for > or = 3 years may be followed carefully with no therapy. For asymptomatic patients diagnosed before this time period, we recommend empiric therapy with antiplatelet agents or low-dose warfarin (international normalized ratio 1.5-2) with careful observation for symptoms.
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Review |
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45 |
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Hajebi A, Motevalian SA, Rahimi-Movaghar A, Sharifi V, Amin-Esmaeili M, Radgoodarzi R, Hefazi M. Major anxiety disorders in Iran: prevalence, sociodemographic correlates and service utilization. BMC Psychiatry 2018; 18:261. [PMID: 30126386 PMCID: PMC6102821 DOI: 10.1186/s12888-018-1828-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 07/24/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND It has been shown in the past two decades that anxiety disorders are the most common mental disorders in general population across the world. This study sought to assess the prevalence of major anxiety disorders, their sociodemographic correlates and mental health service utilization as part of the Iranian Mental Health Survey (IranMHS). METHODS A national household face-to-face survey was carried out on a representative sample of Iranian adults from January to June 2011 using Composite International Diagnostic Interview (CIDI 2.1). A total of 7886 subjects between 15 and 64 years who can understand Persian language were included. The 12-month prevalence of anxiety disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), their socio-demographic correlates, health service use and days out of role were measured in this study. RESULTS The 12-month prevalence of anxiety disorders (not including specific phobias) was 15.6%. The prevalence was 12.0% in males and 19.4% in females. The three most prevalent anxiety disorders were generalized anxiety disorder (5.2%), obsessive-compulsive disorder (5.1%) and social phobia (3.2%), respectively. Factors found to be significantly associated with anxiety disorders were: female gender (OR = 1.16, 95% CI: 1.09-1.23), middle (OR = 1.23, 95%CI: 1.01-1.50) or low (OR = 1.66, 95%CI: 1.31-2.10) socioeconomic status, unemployment (OR = 1.98, 95%CI: 1.49-2.62), and urban residence (OR = 1.31, 95%CI: 1.10-1.57). Comorbidity with non-anxiety disorders significantly increased service utilization. In all subgroups, service utilization was higher among females while the number of days out of role was higher among males. CONCLUSIONS Anxiety disorders are common conditions with a higher prevalence among the female gender, unemployed individuals, and people with low socioeconomic conditions living in urban areas. Comorbidity of anxiety disorders with other psychological disorders aggravates the disability and significantly increases the number of days out of role.
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research-article |
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43 |
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Gilbert P, Ryu C, Sharifi V, Swithenbank J. Tar reduction in pyrolysis vapours from biomass over a hot char bed. BIORESOURCE TECHNOLOGY 2009; 100:6045-6051. [PMID: 19604685 DOI: 10.1016/j.biortech.2009.06.041] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Revised: 06/11/2009] [Accepted: 06/12/2009] [Indexed: 05/28/2023]
Abstract
The behaviour of pyrolysis vapours over char was investigated in order to maximise tar conversion for the development of a new fixed bed gasifier. Wood samples were decomposed at a typical pyrolysis temperature (500 degrees C) and the pyrolysis vapours were then passed directly through a tar cracking zone in a tubular reactor. The product yields and properties of the condensable phases and non-condensable gases were studied for different bed lengths of char (0-450 mm), temperatures (500-800 degrees C), particle sizes (10 and 15 mm) and nitrogen purge rates (1.84-14.70 mm/s). The carbon in the condensable phases showed about 66% reduction by a 300 mm long char section at 800 degrees C, compared to that for pyrolysis at 500 degrees C. The amount of heavy condensable phase decreased with increasing temperature from about 18.4 wt% of the biomass input at 500 degrees C to 8.0 wt% at 800 degrees C, forming CO, H(2) and other light molecules. The main mode of tar conversion was found to be in the vapour phase when compared to the results without the presence of char. The composition of the heavy condensable phase was simplified into much fewer secondary and tertiary tar components at 800 degrees C. Additional measures were required to maximise the heterogeneous effect of char for tar reduction.
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Amin-Esmaeili M, Rahimi-Movaghar A, Sharifi V, Hajebi A, Mojtabai R, Radgoodarzi R, Hefazi M, Motevalian A. Alcohol use disorders in Iran: Prevalence, symptoms, correlates, and comorbidity. Drug Alcohol Depend 2017; 176:48-54. [PMID: 28514696 DOI: 10.1016/j.drugalcdep.2017.02.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 02/04/2017] [Accepted: 02/18/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND For nearly four decades, alcohol production and consumption has been banned in the Islamic country of Iran. However, little is known about the extent of alcohol use and associated problems in the country. The paper aims to present findings on the 12-month prevalence, symptoms, severity, correlates, and comorbidity of alcohol use disorders in the Iranian population. METHODS This report is based on the 2011 Iranian household Mental Health survey (IranMHS), a nationally representative face-to-face household survey with a multi-stage, cluster sampling design. A total of 7840 individuals aged 15-64 responded to the alcohol section. We assessed 12-month alcohol use disorders according to DSM-IV and DSM-5 criteria and harmful use according to the ICD-10 criteria. RESULTS Weighted prevalence of using alcohol at least once in the past 12 months was 5.7%. The prevalence of 12-month alcohol use disorders was 1% according to DSM-IV criteria and 1.3% according to DSM-5. Harmful use was reported in 0.6%. Alcohol use disorders were markedly more common in men than women with an odds ratio (OR) of 13.3. It was also more prevalent in never-married versus married individuals (OR=2.5) and in those living in urban versus rural areas (OR=2.4). Among those with alcohol use disorders, 46.3% had a concurrent mood or anxiety disorder. Aggressive behaviors and injuries were more likely in those with alcohol use disorders. CONCLUSION Although Iran has a low level of alcohol use, its adverse consequences including use disorders, aggression, and injuries are moderately common and raise serious public health concerns.
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Amini H, Alaghband-rad J, Omid A, Sharifi V, Davari-Ashtiani R, Momeni F, Aminipour Z. Diagnostic stability in patients with first-episode psychosis. Australas Psychiatry 2005; 13:388-92. [PMID: 16403137 DOI: 10.1080/j.1440-1665.2005.02199.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine the short-term stability of Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) and International Classification of Diseases (10th revision; ICD-10) diagnoses in a group of patients with first-episode psychosis. METHOD Sixty patients with first-episode psychosis admitted consecutively to Roozbeh Hospital, Tehran, were sampled; their illnesses could not be attributed to any medical or substance-induced conditions. Patients were assessed at the time of discharge from the hospital, and at 3, 6 and 12 month intervals following admission. At each visit, two psychiatrists made consensus DSM-IV and ICD-10 diagnoses, based on all available information. Stability was discerned as the consistency between diagnoses at the time of discharge and at 12 month follow up. RESULTS Forty-eight patients completed follow up. Affective psychotic disorders and schizophrenia in both classification systems were highly stable. In addition, all patients with DSM-IV brief psychotic disorder and ICD-10 acute and transient psychotic disorders remained the same at follow up. CONCLUSIONS Affective psychoses and schizophrenia, in line with previous findings, remained stable. Diagnoses of brief psychoses were highly stable as well; this could reflect a non-relapsing course of acute brief psychoses, especially in developing countries.
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Hajebi A, Motevalian A, Amin-Esmaeili M, Hefazi M, Radgoodarzi R, Rahimi-Movaghar A, Sharifi V. Telephone versus face-to-face administration of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, for diagnosis of psychotic disorders. Compr Psychiatry 2012; 53:579-583. [PMID: 21820651 DOI: 10.1016/j.comppsych.2011.06.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Revised: 05/31/2011] [Accepted: 06/07/2011] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE The current study aims to compare telephone vs face-to-face administration of the version of Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (SCID) for diagnosis of "any psychotic disorder" in a clinical population in Iran. METHOD The sample consisted of 72 subjects from 2 psychiatric outpatient services in Tehran, Iran. The subjects were interviewed using face-to-face SCID for the purpose of diagnosing psychotic disorders. A second independent telephone SCID was administered to the entire sample within 5 to 10 days, and the lifetime and 12-month diagnoses were compared. RESULTS The positive likelihood ratio of telephone-administered SCID for diagnosis of "any lifetime psychotic disorder" was 5.1 when compared with the face-to-face SCID. The value for the primary psychotic disorders in the past 12 months was lower (2.3). CONCLUSIONS The data indicate that telephone administration of the SCID is an acceptable method to differentiate between subjects with lifetime psychotic disorders and those who have had no psychotic disorders and provides a less resource-demanding alternative to face-to-face assessments.
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Comparative Study |
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29 |
11
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Hajebi A, Motevalian A, Amin‐Esmaeili M, Rahimi‐Movaghar A, Sharifi V, Hoseini L, Shadloo B, Mojtabai R. Adaptation and validation of short scales for assessment of psychological distress in Iran: The Persian K10 and K6. Int J Methods Psychiatr Res 2018; 27:e1726. [PMID: 29888523 PMCID: PMC6877187 DOI: 10.1002/mpr.1726] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 04/14/2018] [Accepted: 04/19/2018] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES The aims of the study were to translate into Persian and culturally adapt the Kessler Psychological Distress Scales, K10 and K6, and to assess their reliability and validity. METHOD The sample was recruited from primary health care (PHC) settings by quota nonprobability sampling, stratified by sex and age. Validity was assessed against the Composite International Diagnostic Interview (v2.1). The psychometric properties of K6 and K10 were also compared with the 12-item General Health Questionnaire (GHQ-12). RESULTS A total of 818 participants completed the questionnaire. Cronbach's alpha were 0.92 and 0.87 for K6 and K10, respectively. Optimal cutoff scores for detecting any mood or anxiety disorder in the past 30 days were 15 for K10 and 10 for K6. At these cutoff points, the measures had sensitivities of 0.77 and 0.73, specificities of 0.74 and 0.78, and positive predictive values of 0.48 and 0.52, respectively. Psychometric properties of K10 and K6 were similar to GHQ-12. CONCLUSION Persian K10 and K6 have acceptable psychometric properties as screening instruments for common mental health conditions. Given its brevity and similar psychometric properties to the longer instruments, the Persian K6 appears to be a suitable scale for use in PHC settings and, possibly, epidemiologic studies in Iran.
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Validation Study |
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12
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Sharifi V, Kermani-Ranjbar T, Amini H, Alaghband-rad J, Salesian N, Seddigh A. Duration of untreated psychosis and pathways to care in patients with first-episode psychosis in Iran. Early Interv Psychiatry 2009; 3:131-136. [PMID: 21352186 DOI: 10.1111/j.1751-7893.2009.00119.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
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.
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Mojtabai R, Cullen B, Everett A, Nugent KL, Sawa A, Sharifi V, Takayanagi Y, Toroney JS, Eaton WW. Reasons for not seeking general medical care among individuals with serious mental illness. Psychiatr Serv 2014; 65:818-21. [PMID: 24733659 DOI: 10.1176/appi.ps.201300348] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The study compared delays in seeking general medical care among adults with serious mental illness and a general population sample. Associations of delays with health status and use of emergency department services among individuals with serious mental illness were also assessed. METHODS Data for 271 persons with serious mental illness (clinic sample) and 40,016 participants in the National Health Interview Survey (NHIS sample) were compared. RESULTS Fifty-three percent of the clinic sample and 13% of the NHIS sample reported delays, most because of difficulties accessing services. In the clinic sample, delays were associated with receipt of routine care at a public clinic, rather than a physician's office; more severe depressive symptoms; and functional difficulties. Delays were also associated with poorer health status and use of emergency department services. CONCLUSIONS Integration of services as envisioned in the Affordable Care Act and targeted case management may reduce delays among individuals with serious mental illness.
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Alaghband-Rad J, Boroumand M, Amini H, Sharifi V, Omid A, Davari-Ashtiani R, Seddigh A, Momeni F, Aminipour Z. Non-affective Acute Remitting Psychosis: a preliminary report from Iran. Acta Psychiatr Scand 2006; 113:96-101. [PMID: 16423160 DOI: 10.1111/j.1600-0447.2005.00658.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the concept of 'Non-affective Acute Remitting Psychosis' (NARP) in a group of patients with first episode psychosis in Iran. METHOD This is a 24-month follow-up study of 54 patients with first-episode psychosis admitted consecutively to a psychiatric hospital in Tehran, Iran. At the end of follow-up, consensus judgments were made on fulfillment of the NARP criteria as well as illness course and treatment. NARP was defined as a psychotic illness with acute onset (developed within 1 week), short duration (remission within 6 months), and the absence of prominent mood symptoms. RESULTS Of 49 patients who completed the follow-up, 15 (30.6%) had NARP, accounting for 60% of non-affective psychoses. Ten patients with NARP remained relapse free, four had a very short-lived relapse, and only one developed a chronic illness. Throughout the follow-up, patients with NARP received fewer months of treatment than did patients with other non-affective psychoses. CONCLUSION The high proportion of NARP among patients with first episode psychosis, and the favorable course is in keeping with previous studies in developing countries.
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Anderson S, Kadirkamanathan V, Chipperfield A, Sharifi V, Swithenbank J. Multi-objective optimization of operational variables in a waste incineration plant. Comput Chem Eng 2005. [DOI: 10.1016/j.compchemeng.2004.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Masoomi M, Hosseinikolbadi S, Saeed F, Sharifi V, Jalali Nadoushan AH, Shoib S. Stigma as a barrier to suicide prevention efforts in Iran. Front Public Health 2023; 10:1026451. [PMID: 36699938 PMCID: PMC9868841 DOI: 10.3389/fpubh.2022.1026451] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/06/2022] [Indexed: 01/12/2023] Open
Abstract
Suicide and suicide attempt affect a considerable part of the general population, and in spite of their prevalence, the stigma associated with suicide remains an unsolved problem surrounding this important public health problem, especially in lower-income countries such as Iran. Evidence shows that help-seeking from formal mental health services for suicidal people is low in countries like Iran. Previous studies on Iranian survivors of suicide attempts have shown that these people experience fear of stigma due to labels such as loss of faith in God, having forms of severe mental illnesses ("madness"), and being involved in unaccepted sexual relationships. The associated stigma prevents them from seeking appropriate health and social services. Although both self-stigma and public stigma contribute to an unwillingness to seek mental health care and suicide prevention efforts in Iran, public stigma may be of greater consequence, significantly impeding an individual's likelihood of accessing care for their suicidal thoughts or attempts. In such circumstances, many people with suicidal thoughts miss out on social and formal support programs offered by social and healthcare providers. In this perspective article, focusing on the public stigma regarding suicide in Iranian society, we address the challenges and barriers to seeking suicide prevention efforts in Iran and discuss culturally appropriate strategies to improve the current situation.
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brief-report |
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Rezayat F, Mohammadi E, Fallahi-Khoshknab M, Sharifi V. Experience and the meaning of stigma in patients with schizophrenia spectrum disorders and their families: A qualitative study. Jpn J Nurs Sci 2019; 16:62-70. [PMID: 29749105 DOI: 10.1111/jjns.12212] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 03/11/2018] [Indexed: 02/03/2023]
Abstract
AIM This study aimed to explore the experiences of stigma in patients with schizophrenia spectrum disorders and their families. METHODS This qualitative content analysis study was carried out in 2016-2017 in a psychiatric hospital in Tehran, Iran. A total of 16 patients with schizophrenia spectrum disorders and their families were chosen purposefully. In order to collect the data, unstructured interviews were conducted. For the data analysis, an inductive content analysis approach was used. RESULTS The data analysis led to the formation of two categories, "being socially rejected" and "being oppressed by others," and nine subcategories. In being socially rejected, others do not have a desire to communicate and start or continue cohabitation with the patients and their families and stay at a distance from them with fear. In being oppressed by others, persons behave aggressively with the patients and their families, violate their rights, and humiliate and ridicule them with their incorrect judgment. CONCLUSIONS Patients with schizophrenia spectrum disorders and their families have the unpleasant and upsetting experiences of stigma. This problem imposes pressures and extreme difficulties on them, besides the difficulties related to the nature and the symptoms of the disorder. The findings reveals the need to develop strategies to help patients and their families effectively encounter stigma.
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Hajebi A, Amini H, Kashani L, Sharifi V. Twelve-month course and outcome of methamphetamine-induced psychosis compared with first episode primary psychotic disorders. Early Interv Psychiatry 2018; 12:928-934. [PMID: 27991722 DOI: 10.1111/eip.12404] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/20/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND To assess the clinical course and outcome of patients with methamphetamine-induced psychosis in comparison with patients with primary psychotic disorders. METHODS This prospective study was conducted on patients with methamphetamine-induced psychosis, and 2 groups of primary psychotic disorders: affective psychosis and non-affective psychosis admitted to 2 psychiatric hospitals in Tehran, Iran, with a first episode of a psychotic illness. A total of 165 subjects (55 in each group) were selected using convenience sampling. They were assessed at the time of admission, discharge and 6 and 12 months after discharge using the Positive and Negative Syndrome Scale, the Young Mania Rating Scale and the Global Assessment of Functioning Scale. The frequency of readmissions and suicide attempts were also assessed. RESULTS Significant differences were found in the trend of changes of symptoms and functioning among the 3 groups. At all-time points, the severity of negative psychotic symptoms and dysfunction in the non-affective psychosis group were greater than those in affective or methamphetamine-induced psychosis groups, with latter 2 having similar profiles. However, the course of positive symptoms in methamphetamine-induced psychosis was more similar to non-affective psychosis. Number of suicide attempts and readmissions were non-significantly higher in methamphetamine-induced psychosis than in the other groups. CONCLUSION Methamphetamine-induced psychosis does not have a satisfactory course and in some cases symptoms may remain even after many months of follow-up. Rate of certain outcomes such as re-hospitalization is also considerably high. It is a challenge for the health-care system that requires evidence-based interventions.
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Amin-Esmaeili M, Motevalian A, Rahimi-Movaghar A, Hajebi A, Sharifi V, Mojtabai R, Gudarzi SS. Bipolar features in major depressive disorder: Results from the Iranian mental health survey (IranMHS). J Affect Disord 2018; 241:319-324. [PMID: 30142591 DOI: 10.1016/j.jad.2018.08.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/11/2018] [Accepted: 08/07/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Past research suggests that individuals suffering from depressive disorders with bipolar features might have different clinical outcomes resembling bipolar disorders. The objectives of this study are to determine the prevalence of bipolar features among individuals meeting the criteria for 12-month major depressive disorder (MDD) in the Iranian population and to examine the demographic and clinical characteristics associated with these features. METHODS Data were drawn from the Iranian Mental Health Survey (IranMHS), a representative household survey of the Iranian population aged 15-64 years. The study sample consisted of all individuals with a 12-month MDD (n = 1014) ascertained by the Composite International Diagnostic Interview (CIDI 2.1) without a lifetime history of bipolar I or II disorders. Mood Disorder Questionnaire (MDQ) was used to screen for the lifetime history of bipolar features among participants with MDD. RESULTS Among participants meeting the 12-month MDD criteria, 22.1% (95% CI: 19.6-24.7) had a lifetime history of bipolar features. Compared with those without these features, participants with bipolar features had higher odds of endorsing suicidal ideations and suicide attempts, comorbid anxiety and substance use disorders, severe impairment, history of psychotic symptoms, some features of atypical depression and fewer depressive symptoms. Associations with comorbid anxiety disorders [Odds Ratio (OR) = 1.43; 95% confidence interval (CI): 1.00-2.03] and history of psychotic symptoms (OR = 2.63 95% CI: 1.81-3.81) persisted in multivariable models. LIMITATION Relying on self-reports of lifetime bipolar symptoms which is open to recall bias, and cross-sectional study design which limits interpretation of outcome and course of MDD are two major limitations of this study. CONCLUSION The presence of bipolar features is associated with a distinct demographic and clinical profile in MDD. Identifying these cases would enhance the homogeneity of the depressive disorder phenotype in general population surveys. Identifying MDD patients with these features has potential clinical implications.
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Sharifi V, Bakhshaie J, Hatmi Z, Faghih-Nasiri L, Sadeghianmehr Z, Mirkia S, Darbooy S, Effatpanah M, Mirsharifa SM. Self-reported psychotic symptoms in the general population: correlates in an Iranian urban area. Psychopathology 2012; 45:374-80. [PMID: 22854278 PMCID: PMC11939829 DOI: 10.1159/000337749] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 02/25/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Psychosis exists in the community as a continuum of severity. Here, we examine the correlates of self-reported psychotic symptoms in an urban catchment area of Iran. SAMPLING AND METHODS Two thousand one hundred and fifty-eight participants (age 18-65 years) residing in southern Tehran (the capital city of Iran) were interviewed using the psychoticism and paranoia dimensions of the Symptom Checklist-90-Revised (SCL-90-R) to assess the severity of psychotic symptoms. Other dimensions of the SCL-90-R assessing nonpsychotic symptoms and a sociodemographic questionnaire were also used. Paykel's Interview for Recent Life Events was used to assess stressful life events. RESULTS Independent associations were observed between younger age, female gender, stressful life events and dimensions of depression, anxiety, hostility, obsessive-compulsive symptoms and interpersonal sensitivity and psychoticism. Independent associations were also observed for marital problems, unemployment, stressful life events and dimensions of depression, anxiety, hostility, interpersonal sensitivity and phobic anxiety with paranoid ideation. There was also a trend toward an association between higher educational levels and the severity of psychotic symptoms, particularly paranoid ideation. CONCLUSIONS Most of the previously accepted correlations for psychotic symptoms in the community were replicated. An unexpected association between paranoia and female gender, and a trend toward higher rates of psychotic symptoms in more educated participants, were in contrast with the studies in developed settings. The insufficient coverage of psychosis-relevant questions from the SCL-90-R for the entire psychotic diagnostic spectrum should be considered a limitation.
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Faghihi T, Jahed A, Mahmoudi-Gharaei J, Sharifi V, Akhondzadeh S, Ghaeli P. Role of Omega-3 fatty acids in preventing metabolic disturbances in patients on olanzapine plus either sodium valproate or lithium: a randomized double-blind placebo-controlled trial. ACTA ACUST UNITED AC 2012; 20:43. [PMID: 23351198 PMCID: PMC3555734 DOI: 10.1186/2008-2231-20-43] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 07/10/2012] [Indexed: 11/10/2022]
Abstract
Background Metabolic and cardiovascular side effects have been noted with the use of second generation antipsychotics (SGAs) and mood stabilizers. Since Omega-3 fatty acids have been known to prevent some cardiovascular risks, this preliminary study was designed to evaluate the cardiovascular benefits of omega-3 when added to the combinations of olanzapine with mood stabilizers. Methods This study was a randomized, double-blind, placebo-controlled, within-subject trial in adult psychiatric patients who were receiving olanzapine combined with lithium (Li) or valproate sodium (VPA). Omega-3 as fish oil with less than 1 g/day of EPA/DHA or its placebo was added to patients’ olanzapine and mood stabilizer regimens for 6 weeks. Metabolic parameters including anthropometric variables, lipid profile, metabolic syndrome indices, C-reactive protein, fibrinogen and lipoprotein (a) [(Lp) (a)] were assessed for participants. Results Forty one participants completed this study; 20 patients received omega-3 and 21 patients received placebo, added to their regimen of SGA and mood stabilizer. Omega-3 addition did not modulate anthropometric, metabolic syndrome and lipid parameter changes in 6 weeks. However, fibrinogen levels significantly decreased, Lp (a) did not increase and non-high-density lipoprotein cholesterol (non-HDL-C) did not go beyond its target level after omega-3 supplementation. Additionally, a significant inter-group effect was noted for Lp(a). Conclusions This study suggests that use of short-term omega-3 supplementation added to a combined regimen of olanzapine and mood stabilizer may have a small modulating effect on some cardiovascular risk factors. Trials in longer periods of time and with larger number of patients are needed to further evaluate the effects of omega-3 supplements on preventing cardiovascular risk factors. This trial is registered at irct.ir and its Identifier is as following: IRCT138712231764N1
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Sharifi V, Mojtabai R, Shahrivar Z, Alaghband-Rad J, Zarafshan H, Wissow L. Child and Adolescent Mental Health Care in Iran: Current Status and Future Directions. ARCHIVES OF IRANIAN MEDICINE 2016; 19:797-804. [PMID: 27845550 DOI: 0161911/aim.0010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The need for mental health care among children and adolescents in Iran, as in other low and middle income countries (LAMIC) remains mostly unmet. In this paper, we sought to provide an overview of the extent of unmet need and mental health services in Iran. We also aimed to propose approaches to address this gap. METHOD We reviewed the published epidemiologic studies of child and adolescent mental and behavioral health problems in Iran. We also examined the current status of child mental health services and the gaps between current needs and available services based on published literature that included papers published in scientific journals, as well as governmental and other administrative reports. The contextual issues relevant to child mental health care were also explored, as well as the possibilities to introduce new or scale up promising services. RESULTS Child and adolescent mental and behavioral health problems are highly prevalent in Iran. Different studies have estimated that 16.7% to 36.4% of children and adolescents suffer from one or more mental health problems. However, there is a serious scarcity of resources to meet this need. Available services are delivered by independent public organizations (e.g., Ministry of Health, Welfare Organization, and Ministry of Education) or private sector with inefficient communication and collaboration among them and no mandatory national mental health policy. Available specialized child and adolescent services are mostly confined to small inpatient units and university outpatient facilities in larger cities, and there is a scarce evidence for the effectiveness of the available services. CONCLUSIONS Expansion of primary care's role in timely detection and management of child and adolescent mental health problems, implementation of task-shifting and -sharing initiatives, as well as improved collaboration among responsible governmental and non-governmental sectors are some of the most promising future venues to improve mental health care for the Iranian youth.
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Amin-Esmaeili M, Motevalian A, Hajebi A, Sharifi V, Stockwell T, Rahimi-Movaghar A. Methods for calculation of per capita alcohol consumption in a Muslim majority country with a very low drinking level: Findings from the 2011 Iranian mental health survey. Drug Alcohol Rev 2018; 37:874-878. [PMID: 30027547 DOI: 10.1111/dar.12847] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 06/27/2018] [Accepted: 07/02/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS There is a paucity of data on volume of alcohol use from Muslim majority countries. We aimed to present estimation methods for alcohol consumption with the use of survey data for these societies and provide an estimation for age 15+ per capita consumption of pure alcohol for Iran. DESIGN AND METHODS The Iranian Mental Health Survey was a nationally representative household survey on individuals aged 15-64 years, with a multistage, cluster sampling design. We used the 'Last Week' method and 'Quantity-Frequency' methods for gathering data on alcohol consumption and combined these to provide more complete estimates. RESULTS The response rate was 85.7%. From the total of 7840 respondents, 5.7% and 1% reported past 12 months and past week alcohol use, respectively. The highest estimation for age 15+ per capita consumption of pure alcohol was yielded by the 'combination method' (0.108 L ethanol/person/year) followed by the Quantity-Frequency method (0.079 L). The 'Last Week' method provided the lowest estimate (0.059 L). DISCUSSION AND CONCLUSIONS Unlike in surveys of non-Muslim countries, frequency of drinking from recent recall (last week) was much lower than from recall of usual drinking in the last year. We conclude that 0.108 L (SE = 0.03) is the best survey-based estimate of age 15+ per capita consumption, which translates to about 5 750 000 L of national consumption per year in Iran. However, this method is still likely to under-estimate per capita consumption due to evidence of under-reporting in the survey.
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Cotton A, Finney K, Patchigolla K, Eatwell-Hall R, Oakey J, Swithenbank J, Sharifi V. Quantification of trace element emissions from low-carbon emission energy sources: (I) Ca-looping cycle for post-combustion CO2 capture and (II) fixed bed, air blown down-draft gasifier. Chem Eng Sci 2014. [DOI: 10.1016/j.ces.2013.11.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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