Violence against professionals has been long documented as a source of stress and post traumatic stress. Interestingly, whereas the effects of violence directed at medical staff have been studied extensively, the frequency of exposure and effects on other practitioners of the helping professions has been scarcely studied.

To present the scope of the problem, frequency, and the moderating role of trust on the levels of PTSD experienced by the exposed practitioners.

A sample of 645 practitioners in social services in Israel. The instrument included the Client Violence Questionnaire, PTSD and related somatic symptoms.

80% of the practitioners were victimized in at least one form of violence over the last 3 months including verbal abuse, threats, vandalism, and/or physical violence. Positive association was found between each type of abuse and PTSD reactions. Interestingly, trust among team members has shaped the relationships between exposure to violence and PTSD reactions (moderating variable). Higher levels of trust were associated with lesser exposure on the one hand, yet higher levels of trust were also associated with higher correlation between exposure and PTSD.

Trust in team seems to serve a dual function. On the one hand, it serves as a buffer, reducing the odds for exposure to violence. On the other hand it increases the negative effects of exposure - when such occurs. In other words, trust in team may be associated with higher trust in clients, a factor that reduces the anticipation of violence, and thus increases its negative effect.

Modified Early Warning Scores (MEWS) are now commonly used for the assessment of unwell patients in general hospitals. It can be used to quickly identify the deteriorating patients who need urgent intervention. The use of MEWS has been shown to be effective in reducing mortality and morbidity of patients who deteriorate slowly. Its use in mental health has not been thoroughly studied.

Standard MEWS form was reproduced and customized for using in psychiatric wards. A survey was conducted on level of confidence of Chiltern unit's nursing staff before and after introducing the MEWS form.

They were asked to make a decision about management of two standard case studies and rate their level of self confidence from 1 to 5 before and after using the form.

10 nursing staff band 5 and 6 took part in this study with wide range of experience from 6 months to 20 years (Average 9.7 years).

The average level of confidence before introducing MEWS was 3.65± 0.66 and rose to 4.6±0.5 afterward. The improvement in the level of confidence was statistically significant (P = 0.002).

The validity of decisions made by nursing staff about two cases rose from 45% before using the form to 100% afterward. The improvement in the validity of decision making after introduction of MEWS system was also statistically significant (P< 0.0001).

Our study suggests promising potentials for improvement in patients’ safety and confidence of nursing staff by introducing MEWS system to in-patient psychiatric wards.

There are complicated relations between child's psychiatric problems secondary to epilepsy, maternal stress and parenting style.

The aim of the present research is to study psychological and behavioral characteristics in children with epilepsy, study maternal stress associated with parenting these children, and parenting styles of these mothers.

Children aged 3 to 7 years old with an established diagnosis of epilepsy for at least 1 year without other neurological disorders or mental retardation and their mothers were selected from child neurology clinics in Mashhad, Iran. Eligible participants were 30 epileptic children. Control group of 30 healthy children from Mashhad kindergartens were matched with epileptic children in terms of age and sex. Strengths & Difficulties Questionnaires (SDQ), Parenting Stress Index (PSI), Parenting Style Questionnaire (PSQ) and a demographic questionnaire were used for data collection.

Mothers of children with epilepsy had higher levels of parenting stress (in both parent and child domains) compared to the other group (P < 0.001). Parents with epileptic children scored higher on permissive and authoritarian parenting scales. However, the score was lower for authoritative parenting style in comparison with the scores of the control group. In general, these differences did not reach a significant level (P>0.05). Children with epilepsy had significantly higher scores than normal children in terms of emotional symptoms, conduct problems, hyperactivity and hence, the total difficulty score (P< 0.05).

Educational and psychological programs aimed at enhancing adjustment of parents with their children's epilepsy are greatly needed.

ADHD is one of the most common neuro-psychiatric disorders in children Methyl Phenidate is the most frequent medication prescribed for this disorder. Bupropion is suggested as an alternative medication for treatment.

This research aims to compare the efficacy and safety of Bupropion and Methyl Phenidate(Ritaline) in children with ADHD.

This research was a double blind clinical trial and was approved by the Ethics Committee of Mashhad University of Medical SciencesForty children with ADHD, aged 6 to 12, from consecutive referrals to child psychiatric clinic of Ebn-e-Sina hospital were selected and randomly divided into two categories,treatment with Methyl Phenidate and Bupropion. Evaluations were carried out based on ADHD Rating Scale (by teacher and parent) and Clinical Global Scale (by clinician) at the beginning of the study, 4 and 8 weeks through the study. Adverse effects were checked at 4 and 8 weeks time as well. Data were analyzed by SPSS11.5.

Methyl-phenidate and Bupropion were both significantly effective in reduction of ADHD symptoms of children based on parents and teachers ratings in 8 weeks treatment (P< 0.001). The therapeutic response, in parents’ views, was better in Methyl -phenidate group than Bupropion (p=0.014).

Results showed that Bupropion was an effective in ADHD treatment but its effect based on the parent's report was less than Methyl-phenidate.

Many researchers have emphasized the importance of teaching stress management and self-care skills to medical students as they are vulnerable to develop psychological health problems.

To explore potential effects of a 4-hour stress management intervention on medical students’ psychological health.

To determine changes of psychological distress symptoms between the intervention and control groups.

A randomized controlled trial study was conducted in a medical school. Out of 500 medical students who were randomly invited to participate in this study, 171 medical students consented. They were randomly assigned into the study groups. Their psychological distress symptoms were measured by the DASS-21 at five different intervals. The Repeated Measure ANCOVA was performed to determine the effects of intervention.

A total of 153 medical students (intervention = 73 and control = 80) completed this study. There was a significant reduction of the symptoms among the intervention group at different intervals (p = 0.007). The intervention group experienced significantly lower psychological distress symptoms than the control group (p = 0.011). The effect size was -0.43, indicating the symptoms were significantly improved by 43% of a standard deviation as a result of the intervention. The effects were sustained for duration of 32 weeks post intervention.

The results support the effectiveness of the brief intervention to improve psychological health of medical students. It is a promising intervention to be adopted by medical schools as it consumes minimal amount of time, money and man power as well as simple to be implemented.

Pathologic changes in neuronal plasticity and apoptosis are important factors influencing alterations in synaptic transmission and impaired cognitive function, characteristic features of schizophrenia. Brain derived neurotrophic factor (BDNF), complexin-2, and annexin A-5 are known as members of regulatory pathways responsible for maintenance of neuronal plasticity and apoptosis.

The study was focused on assessment of possible association of functional single nucleotide polymorphisms (SNPs) and expression levels of BDNF, complexin-2, and annexin A-5 with schizophrenia.

For this purpose we investigated functional polymorphisms and plasma levels of these proteins in schizophreniaaffected neuroleptic-treated and neuroleptic-free patients and healthy controls.

DNA samples were genotyped by polymerase chain reaction with sequence-specific primers. Plasma levels of BDNF, complexin-2, and annexin A-5 were measured with an enzyme-linked immunosorbent assay. The significance of differences between allele and phenotype frequencies in study groups was determined using Pearson's χ2 test. For evaluation of intergroup differences in the levels of BDNF, complexin-2, and annexin A-5, both parametric and non-parametric statistics were used. The assessment of correlation between the measured parameters within each group was also performed. P-values less than 0.05 were considered significant.

In patients with schizophrenia, as compared to controls, the carriers of mutant alleles of the functional polymorphisms of BDNF, complexin-2, and annexin A-5 genes were overrepresented, and the blood levels of these proteins were altered.

Functional polymorphisms of genes encoding BDNF, complexin-2, and annexin A-5 proteins are associated with schizophrenia resulting in altered expression levels of these proteins upon this disorder.

Family functioning is one of the most important factors in psychiatric treatment. The purpose of this study was to compare the family functioning between patients with psychotic and non psychotic disorders in Shahrekord, Iran.

This analytical discriptive study was performed on family members of 200 patients with schizophrenia(psychotic), mood and anxiety disorders(nonpsychotic). The data was collected through interview by using the family assessment device (FAD). Quantative analysis of data was undertaken by using T students.

The mean of the total score of FAD in family members of psychotic and nonpsychotic patients was 2.55 ± .31 and 2.34 ± .25 respectively, and FAD in non psychotic patients was significantly better than psychotic patients in all dimensions of FAD.

The present study highlights that the family functioning among caregivers of patients with Psychotic and non psychotic disorders were unhealthy in all of the domains of the family functioning.

Aggressive behavior is a critical issue for psychiatric services, because of the adverse impact on patients and staff, and management of this behavior is difficult. This study was done by aim of determination of nurses’ problem in management of aggressive behavior in psychiatric wards.

This descriptive analytic study was done in 41 nurses who worked in Hajar and Sina Psychiatric ward in 2011. Sampling method was census. Data was gathered by self-making questionnaire include two parts: nurses’ demographic data and aggression management problem in three domains: personal, physical, and organizational factors. Data was analyzed by SPSS software 18, and means and frequency and analytical statistic exams such as Mann-Whitney and chi square were used.

The average of aggression episode was 4.44±3.3 time and in 51.25% occurred in all work shifts. 82.9% of aggression episode was mix verbal and physical aggression. The most aggressive patients suffer from schizophrenia and they had 30 till 40 years old. The most frequent problem in management of aggressive patients was related to personal problem specially fear about physical conflict with patients and physical restriction side effects. There was no significant relationship between age, sex, work shift and ward with aggression frequency (P>0.05),but there was significant difference between two hospital in physical environment (P= 0.003) and personal problems (P=0.011).

Results of this study revealed that nurses who work in psychiatry ward have some problem in management of aggressive patient's especially in personal and physical environment domain, and attention of managers is necessary.

Évaluer l’impact (efficacité) de cinq modalités différentes composant les soins hospitaliers de l’anorexie mentale (AM) sur l’état de santé global (physique, psychique, cognitif, nutritionnel et social) des sujets, et à moyen terme (12 mois) sur le maintien ou le dépassement des acquis de l’hospitalisation.

(1) Déterminer, à partir d’une méthodologie relevant de l’épidémiologie clinique, les facteurs liés aux échappements de la prise en charge hospitalière, et à la durée (coût) de l’hospitalisation. (2) Développer des projets ancillaires sur cet échantillon homogène de gravité importante.

Étude prospective naturalistique multicentrique (11 centres spécialisés français). Nous avons initialement réalisé la description détaillée des modalités de prises en charge dans chaque centre à l’aide d’une grille d’évaluation ; puis 242 patients consécutivement admis ont été évalués les 2 premières semaines de leur hospitalisation, les 2 semaines précédant leur sortie et 12 mois après la sortie. Le critère principal d’efficacité pour l’objectif principal est le score de l’état clinique global de Morgan et Russell. Les critères secondaires sont : l’IMC, l’état somatique, l’état psychique, les symptômes alimentaires et l’adaptation sociale.

L’étude est en cours de finalisation. La base de données est en cours d’exploitation, elle a permis : la validation d’une technique de mesure de la composition corporelle facile d’utilisation pour les sujets anorexiques ; l’étude des liens entre état nutritionnel, paramètres biologiques et état psychologique ou somatique (ostéopénie) ; la caractérisation des facteurs prédictifs des ruptures de soins permettant d’envisager des aménagements thérapeutiques. Elle a contribué à un échange et un partenariat intense entre les grands centres spécialisés de prise en charge des troubles des conduites alimentaires, et a permis de développer un réseau de collaboration entre chercheurs et cliniciens sur le plan national et international dans le domaine de l’AM.

Psychiatric morbidity and concomittant alcohol use are associated with poor outcomes among substance dependent individuals.

To investigate the prevalence of psychiatric morbidity and alcohol use among the inmates and their psychosocial correlates.

Cross-sectional study involving 201 inmates age 18 years and above with written consent who currently seeking treatment on volunteer basis under the government run rehabilitation centre in sunagi Besi, Kuala Lumpur. The study was conducted in December 2011 with approval from the Ethic committee board from the university hospital. The psychiatric morbidity measured by MINI Neuropsychiatric Inventory (MINI ver 5.0) and alcohol use measured by AUDIT.

The current prevalence of anxiety and depression are 27.9% and 39.8% respectively. The lifetime prevalence for depression is 21.9%. We also found that lifetime and current prevalence of alcohol use are 77% and 37% respectively. Univariate analysis showed significant association between psychiatric morbidity and alcohol use among this group of inmates (Odd ratio=1.9, P< 0.05) and educational status(Odd ratio =, p< 0.05). However, no significance association found between alcohol use with age, gender, ethnicity, marital status, religion and methadone treatment status. 73.1% of inmates also receiving methadone maintenance therapy during the study take place. Mean dose of methadone is 52.2mg daily (minimum 25mg daily, maximum 119mg daily).

There is high prevalence of psychiatric morbidity and alcohol use among the inmates seeking treatment in government run rehabilitation centre on top of receiving methadone treatment. Therefore, this centre need specialised care to cater the dual diagnosis group clients.

The objective of this study was to assess the nonpsychotic psychiatric disorders of stoma patients in Iran.

The only study that evaluated stoma patients in Iran indicated that postoperative problems, especially psychosocial ones, have a rather high frequency in comparison with other reports, but since no standardized questionnaire was applied for the evaluation of psychosocial problems and their severity, further studies were needed.

In this cross-sectional study, patients referred to the Iranian Ostomy Association from 2005 to 2006 filled the 28-item General Health Questionnaire (GHQ) in Farsi as a screening instrument to identify cases of nonpsychotic psychiatric morbidity.

A total of 155 patients participated in the study, of whom 79 (51%) were female and 76 (49%) were male. Fifty-five percent of the patients (n=86) had psychiatric problems. The females’ mean GHQ score was significantly higher than that of males (P=.001). Psychiatric disorder was significantly more frequent among patients with the following specifications: educational level of high school or lower (P=.001), mucosal hemorrhage of the ostomy (P=.03), stomal stenosis (P=.012), and history of psychiatric drug consumption (P=.000). GHQ score decreased as stoma age increased (P=.032; r=−.177).

Similar to other complications, psychiatric problems are prevalent in Iranian stoma patients. Our findings highlight the need for special support.