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Objective: Acceptance-based behavior therapy (ABBT) is a new psychotherapy for generalized anxiety disorder (GAD). The current study intended to compare severity of symptoms, worry and quality of life of GAD female patients between ABBT and control. Methods: This study was a randomized clinical trial. The sample included 18 women with GAD referred to psychiatrists in Isfahan, Iran. Patients were assigned in 2 groups randomly (ABBT and control group without any psychotherapy). Both groups received medication. The intervention in ABBT group was conducted based on Roemer & Orsillo's manual for Acceptance-based Behavior Therapy for GAD. 12 therapeutic sessions administered in Shariati psychiatric clinic of Isfahan. The instruments included the GAD-7 Inventory, Penn State Worry Questionnaire (PSWQ) and Short Form Health Survey -12 revised Version (SF-12V2). The data were analyzed using the Multivariate Analysis of Variance (MANCOVA). Results: Overall, clients receiving ABBT compared to control group reported a significantly decrease in severity of GAD symptoms, and improve in quality of life at post- treatment state. They reported decrease in severity of worry but it was not statistically significant compared to control group. Conclusion : ABBT was effective in alleviating symptoms of GAD.

Background: Some personality traits and coping styles could be as risk factors in stressful situations. This study aimed to investigate the association of personality traits and coping styles according to the stress level. Meterials and Methods: This cross-sectional study was performed in 2011. A total of 4628 individuals over 20 years were selected by random sampling from nonacademic employees that working in 50 different centers across Isfahan province. Data were collected using 12-item General Health Questionnaire (GHQ-12), Big Five Personality Inventory Short Form and coping strategies scale, and individuals were divided into high and low-stress groups in term of GHQ-12. To analyze the data, a binary logistic regression analysis was conducted. Results: Mean age of participants was 36.3 ± 7.91 years and 56.26% (2604) of them were female. Neuroticism with adjusting covariates of demographic characteristics and the rest of personality traits was a risk factor for stress level with odds ratios (OR) OR:1.24; but other personality traits were protective. Also, active coping styles were protective factors for OR of stress level with adjusting covariates of demographic characteristics and the rest of coping styles, and positive reinterpretation and growth was the most effective of coping style with OR:0.84. Conclusion: Some personality traits are associated with passive copings and cause high-stress level. So, it could be concluded that improve and strengthen effective coping strategies in individual with maladaptive traits should be considered as a crucial component of prevention and control programs of stress.

BACKGROUND: The aim was to translate and develop a patient competence (PC) questionnaire in the context of cardiology and test its validity and reliability. METHODS: In total, 148 cardiac patients who have inclusion criteria of the study were completed cardiac PC (CPC) questionnaire. Hospital Anxiety and Depression Scale and self-administered instrument European quality of life 5-dimensions were used to further validate the CPC questionnaire. The CPC was translated according to the recommended methodology for translating questionnaires, and psychometric properties including internal consistency, factor analysis, discriminant validity, construct validity, and concurrent criterion validity were tested. RESULTS: Five domains in problem-focused task including search for information, self-regulation, being assertive, independent decision-making, and looking for social services, and three domains in emotion-focused task including stress management, confronting the threat, and avoidance were obtained by factor analysis. The standardized Cronbach’s α of all domains were statistically significant (P < 0.001) and internal consistency for all domains was acceptable. Significant intercorrelations of CPC domains also indicated good criterion validity. As there were no cross-loadings, the domains have demonstrated good construct validity and discriminant validity. CONCLUSION: The results of this study show that the Persian version of the CPC is a reliable and valid questionnaire. Although further improvement of this measure is clearly required, it suggests being a potential basis for investigating the determinants and health effects of CPC. &nbsp

Objective: There are many studies indicating the role of psychological factors in the pathogenesis of cardiovascular disorders. Type D as a new personality construct has been proposed by Denollet, characterized by the joint global traits including negative affectivity and social inhibition. The purpose of this study was to examine the link between type D personality and hyperlipidemia in patients with myocardial infarction (MI). Materials and Methods: One hundred and seventy-six consecutive patients admitted to the cardiac care unit (CCU) wards of nine hospitals in Isfahan, Iran, following MI, were selected based on the inclusive and exclusive criteria. The patients completed demographic questionnaire and Type D Personality Scale (DS14). Their medical data were obtained from medical records. Chi-squared test, Student's t-test, and multivariate logistic regression were used to analyze the data. Results: Of the 176 subjects, 63 patients (35.8%) were type D. In univariate analysis, hyperlipidemia was the only significant variable (56% vs. 40%, P = 0.041) found to be associated with type D. Also, by multivariable logistic regression analysis, hyperlipidemia [Odds Ratio (OR) 0.374; 95% confidence interval (CI) 0.175–0.796] was the only independently significant variable found to be linked with type D personality. No other statistically significant differences were found between the two groups on demographic and medical factors characteristics. Conclusion: The type D personality was associated with hyperlipidemia. Thus, personality factors may make people vulnerable to metabolic syndromes.

Background: High psychiatric disorders frequency, especially mood disorders, among patients with skin diseases has been proved. Skin diseases can reduce the self-esteem and more suicidal thought and commitment have been reported among these patients. The aim of this study was to evaluate the psychological profile of patients with skin diseases. Methods: In this cross-sectional study, 250 patients with skin lesions aged from 16 to 60 years were submitted to survey by random convenience sampling. General health questionnaire-28 (GHQ-28) and Hospital anxiety depression scale (HADS) were used for measuring psychological profile. Data were analyzed using Mann-Whitney, chi-square, independent-t, Kruskal-Wallis and Spearman correlation tests. Findings: Psychiatric disorders prevalence, based on GHQ-28, was 60%. Social function disorder, anxiety and insomnia, somatic symptoms and depression had the higher average rank and frequency, respectively. HADS screening showed 27.6% of prevalence for psychological profile problems and 27.87% for anxiety and depression subscales. Sex and age had no significant correlation to the psychological profile of patients. On the other hand, the marriage status and body location of skin lesions were statistically correlated to psychological profile. Conclusion: This study confirms the correlation between impaired psychological profile and skin lesions. With regards to high amount of outpatient refer to dermatology clinics, psychological consideration of dermatologic outpatients for preventive and probable therapeutic measurements is recommended.

Background: Due to the excessive and pathologic effects of depression and anxiety, it is important to identify the role of protective factors, such as effective coping and social support. This study examined the associations between perceived social support and coping styles with depression and anxiety levels. Materials and Methods: This cross sectional study was part of the Study on the Epidemiology of Psychological, Alimentary Health and Nutrition project. A total 4658 individuals aged ≥20 years was selected by cluster random sampling. Subjects completed questionnaires, which were used to describe perceived social support, coping styles, depression and anxiety. t-test, Chi-square test, pearson′s correlation and Logistic regression analysis were used in data analyses. Results: The results of Logistic regression analysis showed after adjusting demographic characteristics for odd ratio of anxiety, active copings such as positive re-interpretation and growth with odds ratios; 95% confidence interval: 0.82 (0.76, 0.89), problem engagement (0.92 [0.87, 0.97]), acceptance (0.82 [0.74, 0.92]) and also among perceived social supports, family (0.77 [0.71, 0.84]) and others (0.84 [0.76, 0.91]) were protective. In addition to, for odd ratio of depression, active copings such as positive re-interpretation and growth (0.74 [0.69, 0.79]), problem engagement (0.89 [0.86, 0.93]), and support seeking (0.96 [0.93, 0.99]) and all of social support types (family [0.75 (0.70, 0.80)], friends [0.90 (0.85, 0.95)] and others [0.80 (0.75, 0.86)]) were protective. Avoidance was risk factor for both of anxiety (1.19 [1.12, 1.27]) and depression (1.22 [1.16, 1.29]). Conclusion: This study shows active coping styles and perceived social supports particularly positive re-interpretation and family social support are protective factors for depression and anxiety.

System-level design decisions such as HW/SW partitioning, target architecture selection and scheduler selection are some of the main concerns of current complex system-on-chip (SOC) designs. In this paper, a novel window-based heuristic is proposed that addresses the issue of design space exploration in applications that have a data flow characteristic. The objective in this paper is to partition the application into HW and SW components such that the execution time of the application is minimized while simultaneously satisfying the hard area constraints of the HW units. In this algorithm, the search space is divided into smaller intervals, referred to as windows. For each window the full search is performed to find the optimum partitioning and scheduling solution for that specific window. Moreover, in this paper a novel indexing mechanism is presented for identifying the nodes in the task graph. The proposed index specifies not only the relation of each node with respect to the other nodes in the graph, but also its position in the task graph. With the help of the proposed windowing and indexing techniques, the time required for partitioning is reduced significantly. Simulation results indicate that the proposed algorithm improves the search time by 74% compared to conventional optimization heuristics namely Genetic Algorithm (GA), Simulated Annealing (SA) and Tabu Search (TS), while providing comparable results in terms of the overall execution time of the partitioned system.

BACKGROUND: Schizophrenic patients who receive antipsychotic drugs may be highly prone to metabolic disorders such as weight gain, dyslipidemia, and insulin resistance. The objective of the present study was to compare the effect of atypical and conventional antipsychotics on lipid profile. METHODS: 128 schizophrenic patients were enrolled into the study. Patients were divided into two groups. One group had received one type of atypical antipsychotic drug, and, the other, one type of conventional antipsychotic drug. They were considered as atypical and conventional groups. Moreover, both groups had not used any other antipsychotic drugs during the past year. Demographic data and food frequency questionnaire were completed by the participants. Serum triglyceride, total cholesterol (TC), high-density lipoprotein and low-density lipoprotein (LDL) cholesterols, and apolipoprotein A and B (Apo B) were tested by blood sample drawing after 12 hours of fasting through the antecubital vein. Student’s t-test was used to compare atypical and conventional groups. RESULTS: There was no significant difference in age, gender, duration of illness, period of drug consumption, and age at onset of illness in the two groups. Patients in the atypical group used clozapine and risperidone (46.9%) more than olanzapine. In the conventional group 81.3% of patients used phenothiazines. Comparison between lipid profile in the conventional and atypical groups showed a significantly higher mean in TC (P = 0.01), LDL (P = 0.03), and Apo B (P = 0.01) in conventional group than the atypical group. CONCLUSION: In schizophrenic patients, the level of lipid profile had been increased in both atypical and conventional antipsychotic users, especially conventional users, so the effect of antipsychotic drugs should be investigated periodically. Keywords: Atypical Antipsychotic, Conventional Antipsychotic, Lipid Profile

Background: Patients with schizophrenia receiving antipsychotic drugs are highly at risk of metabolic disorders such as weight gain, dyslipidemia, and insulin resistance. This study was designed to compare the effect of atypical and conventional antipsychotics on lipid profile. Methods: 128 patients with schizophrenia were divided in two groups. One of the groups received one type of atypical antipsychotic drugs while the other got one type of conventional ones. None of the groups had used any other antipsychotic drugs during the past year. Demographic data and food frequency questionnaire were completed by each participant. Serum triglyceride, total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterols, and apolipoprotein A and B (Apo A and B) were recorded. Student’s t test was used for statistical analysis. Findings: The two groups were similar in age, gender, duration of illness, period of drug consumption, and age at onset of illness. Patients in the atypical group used clozapine and risperidone (46.9%) more than olanzapine; while in the conventional group, 81.3% of patients used phenothiazines. Our data showed a significantly higher mean in TC (P = 0.01), LDL (P = 0.03), and Apo B (P = 0.01) in conventional group. Conclusion: In patients with schizophrenia, lipid profile was higher in both atypical and conventional antipsychotic users, especially in conventional drug users.

Background: Proper management of depression in elderly population would improve the outcome of the disease and reduce its related disability and mortality. Use of memantine with minimal side effects and drug interaction seems reasonable in the elderly but its antidepressant activity is controversial. The aim of the current research is to investigate the effects of add-on memantine during citalopram therapy in elderly patients with depression, in Isfahan. Materials and Methods: In this double-blind, placebo controlled trial study; elderly patients aged more than 60 years who were recently diagnosed with depression, were enrolled. The selected patients were randomlysplit into two groups, viz. intervention and placebo groups. The intervention was memantine (20 mg daily) or identical placebo plus citalopram for 8 weeks. The severity of depression and quality of life was evaluated using Geriatric Depression Scale (GDS-15), Hamilton Rating Scale for depression (HRSD) and World Health Organization Quality of Life WHOQOL-BREF respectively. The mentioned scores were evaluated at baseline, 4 weeks and 8 weeks, after initiating the trial in two studied groups and compared with each other. Results: 28 and 29 patients were studied in the intervention and placebo groups, respectively. Score of GDS-15, HRSD and WHO-QOL-BREF scales at baseline, 4 weeks and 8 weeks, after initiating trial did not change significantly after use of memantine (P > 0.05). There was no significant difference in mean +/- SD of GDS-15, HRSD and WHO-QOL-BREF scales among intervention and placebo groups (P > 0.05). Conclusion: The outcome of this clinical trial did not support the antidepressant effect of add-on memantine in elderly patients with depression receiving citalopram. It is recommended to design further studies considering the limitations of the current study mentioned herein and the effect of memantine with other anti-depressant agents.

Background: Delirium is a dangerous neuro-psychiatric syndrome. Intensive Care Delirium Screening Checklist (ICDSC) is a suitable tool for diagnosis of this disease. This tool has not been translated and validated into Persian language until now. The goal of this study was to determine the reliability and validity of Persian version of this tool in detection of delirium in intensive care units (ICU). Methods: This study is a psychometric study of the Persian version. All samples were selected from hospitalized patients in ICU and nurses in Al-Zahra hospital, Isfahan, Iran, in 2015. In each case, after 30 minutes of making diagnoses based on Diagnostic and Statistical Manual of Mental Disorders-Forth Version-Text Revision (DSM-IV-TR) criteria by a psychiatrist, a nurse makes her diagnoses by using ICDSC without knowing the psychiatrist’ idea. Then all cases of delirium diagnosis according to the tool were compared with delirium diagnosis by psychiatrist and psychometric properties of tool were assessed. Findings: After doing forward and backward translation, the face validity was confirmed. The mean of content validity index (CVI) in relevancy, clarity and simplicity were 0.83, 0.81, and 0.86 respectively. The construct validity based on factor analysis outputs were above 0.5 for all items. In criterion validity measurement, the cut point of five for Persian version of ICDSC is founded. In this cut point the sensitivity and specificity of the tool was calculated 80% and 93%, respectively. The positive predictive value and negative predictive value in this cut off was calculated 92% and 88%, respectively. The correlation between an equivalent criteria with this tool for delirium screening was 0.74 (P = 0.001). Internal Consistency for the tool based on Cronbach’s alpha was 0.83 and the correlation between two split half of the tool for delirium screening was 0.72. Conclusion: The Persian version of ICDSC has a high validity and reliability for delirium screening. This tool in cut point of five can differentiate delirium from normal case with high positive and negative predictive value.

Limited evidence is available regarding mutual interactions between psychological factors and tooth loss. This study aimed to investigate the association between these two issues.In this 2011 cross-sectional study we obtained data from 4,585 adults who had completed information in 20 counties across Isfahan province, Iran, regarding tooth loss and psychological factors (depression, anxiety and stress level). To analyse the data ANOVA and multiple ordinal regression were applied.After adjusting socio demographic factors, the association between depression (OR 1.23; 95% CI = 1.01,1.49), anxiety (OR 1.19; 95% CI = 1.03,1.38), and high stress level (OR 95% CI = 1.19; 1.01,1.39) remained significant.We confirm the interaction between psychological factors and tooth loss, but recommend further studies on a national Iranian population.

Background: Patient`s illness perception is formed base on patient`s beliefs and perceived information about their condition and it may influence the individual’s mental health and how the patient deal with the medical condition. The aim of this study was to determine the relationship between illness perception and symptom severity in patients with irritable bowel syndrome (IBS). Methods: In a cross-sectional study, 160 consecutive IBS patients, referred to the gastrointestinal and psychosomatic clinics at khorshid hospital in Isfahan, were selected. The patients completed illness perception questionnaires and the IBS Symptom Severity Scoring System (IBS-SSS). Data was analyzed by pearson correlation and multi variant regression models. Finding: A relationship between illness perception and symptom severity in patients with IBS was observed (R = 0.546, P = 0.001). The results showed that 39% of variation in symptom severity is predicted by variation in illness perception components (R = 0.63, R Squer = 0.39). Rregression model showed that only the identity and emotion components of illness perception can predict symptom severity variation (P = 0.04). However, there is no relationship between other subscales of illness perception and symptom severity. Conclusion: This study showed that there is a relationship between illness perception and symptom severity. So the interventions based on illness perception is proposed for managing symptom severity in IBS. Keywords: Illness perception, Symptom severity, Irritable bowel syndrome, Psychological factors.

Background: Mental and physiological responses to the repeated use of drugs are called dependency. Opioid bowel dysfunction (OBD) is common side effect associated with opium. OBD has many manifestations such as abdominal pain, abdominal cramping, bloating and gastroesophageal reflux but is known commonly by constipation. Narcotic bowel syndrome (NBS) is a subset of OBD characterized by recurrent and chronic abdominal pain getting worse by continuing or increasing doses of opium. Due to ever increasing incidence of consumption of narcotics drugs and also expanded spread of gastrointestinal disorders in people of society and due to lack of precise studies in such cases in Iran, research in this field seemed vital. Methods: In this cross-sectional study, among all methadone maintenance therapy (MMT) clinics in Isfahan, Iran, 4 centers were selected by easy non-probability sampling method in 2012 fall. A questionnaire was distributed among the opioid consumers. The questionnaire contained demographic information sucs as age, sex, occupation, and duration of drug use, drug type, duration of MMT, gastrointestinal symptoms and the severity of the symptoms. Findings: From 192 completed and collected questionnaires, 184 were acceptable. The most common gastrointestinal symptoms in patients were constipation, abdominal pain, belching and bad taste in the mouth, respectively. The severity of symptoms and extent of methadone use in patients were assessed and gastrointestinal symptoms were not associated significantly with methadone dose of patients. Conclusion: In this study, the prevalence of gastrointestinal symptoms among patients in addiction clinics was assessed and the most common digestive complaint of these patients was constipation. Severity of constipation and other gastrointestinal symptoms were unrelated with amount of methadone use and the type and amount of prior drug use.