The Relationship between the Structures of Personality Inventory for the Diagnostic and Statistical Manual, Fifth Edition (PID-5) and Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF).

Objective: The Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PID-5), is a trait-based measure of pathological personality designed to assess Criterion B of an alternative diagnostic system for personality disorders (PDs). In this study, we aimed to evaluate the relations among the PID-5 and the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF); a commonly used self-report instrument with a hierarchical structure. Method : We examined the joint structure of the PID-5 scales along with levels of the MMPI-2-RF hierarchy to understand whether conceptually expected structures tend to be loaded with each other. Data were collected from 536 participants from the general population of Iran. Results: Findings of Pearson's correlation analyses exhibited the generally expected patterns between the two mentioned measures on most scales, with some divergences. Similarly, although applying a set of joint exploratory structural equation modeling (ESEM) exhibited some factor loadings for PID-5 facets within the hierarchical framework of MMPI-2-RF scales that were different to what was theoretically expected, both measures were generally loaded in a conceptually expected way, indicating that they have a similar dimensional structure. Conclusion: Our findings provide support for adequate convergence of maladaptive personality traits and psychopathology structures, as well as for utilizing MMPI-2-RF to measure personality psychopathology from a dimensional perspective. The implications of these results are discussed by the authors.

Evaluation of Inflammatory Markers in Patients with Depressed Episodes in Major Depressive Disorder and Bipolar Disorder before and after Treatment.

Depression is one of the current dilemmas in both developed and developing societies. Studies show that the severity of psychiatric symptoms is directly related to the degree of inflammation caused by cytokines secreted by the immune system. Hence, evaluating serum cytokine levels in patients with depression can help to understand the pathogenesis of the disease and make the best therapeutic decisions. The present study investigated the levels of inflammatory cytokines, tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), and interleukin-6 (IL-6) in patients with major depression or bipolar disorder during depressive episodes (BDDE) before and after a 6-month pharmaceutical intervention. Patients referring to 3 clinics were recruited for the study. The diagnosis of major depression or bipolar disorder in a depressive phase was made according to the Diagnostic and Statistical Manual of Mental Disorders -5(DSM-5) criteria. There was a significant difference in depression levels between the pre-intervention and 6-month follow-up in both groups. After 6 months, IL-1 and IL-6 levels in the bipolar disorder group had decreased while TNF-α levels had increased. There was also a significant difference between pre-intervention and follow-up levels of IL-1.  Serum levels of IL-1 and IL-6 decreased significantly in both groups after the 6-month follow-up, and symptom improvement was observed. TNF-α levels, on the other hand, decreased in the major depression group but increased in the bipolar disorder group. Considering that inflammation is a major outcome of depression, treatment strategies to reduce inflammation could be a practical approach to improving psychiatric symptoms.

Healthcare System Responsiveness in Covid-19: An Experience from Capital City of I.R of Iran.

Background: As a public health emergency, coronavirus disease 2019 (Covid-19) is a threat to our future; therefore, appropriate health system responsiveness (HSR), as an important criterion, is of crucial importance. This study aimed to evaluate the different dimensions of responsiveness of healthcare centers, both public and private, providing COVID-19 services in Tehran. Methods: Following a cross-sectional design, this study was conducted in Tehran (the capital city of I.R. Iran) from May to November 2020. Data were collected using the World Health Organization (WHO) questionnaire on responsiveness. Two hundred questionnaires were filled out through face-to-face or phone call interviews in two public and private hospitals (100 in each) providing Covid-19 services. Participants were selected using the convenience sampling technique among all those who received Covid-19 services during the past six months in the city of Tehran. Results: The mean age of participants was 45.9 ± 15.9 and 51.5% were female. On an average, 52.6% of the respondents evaluated at least one dimension of responsiveness as appropriate and/or strongly appropriate. Communication obtained the highest score (58.2%), followed by confidentiality (56.5%), dignity (56%), and prompt attention (52%). Meanwhile, autonomy and choice were evaluated as poor (moderate, weak, and strongly weak) by 63.5 and 52.5% of respondents. There was no significant association between the type of healthcare center (i.e., public or private) and responsiveness (p-value = 0.896). However, there was a significant difference between gender (p-value = 0.036) and education level (p-value = 0.014) with responsiveness. According to the respondents, prompt attention and choice were the most and least important dimensions, respectively. Conclusions: Evaluation of HSR in the era of COVID-19 not only provides a tool for qualitative assessment of services but also plays an important role in providing feedback to policymakers to adopt effective policies.

Evaluating the Effects of Experiencing Virtual Reality Simulation of Psychosis on Mental Illness Stigma, Empathy, and Knowledge in Medical Students.

Objectives: Applying technologies such as virtual reality (VR) in education has gained popularity especially in comprehending abstract and subjective phenomena. Previous studies have shown that applying a virtual reality simulation of psychosis (VRSP) is useful in increasing knowledge and empathy toward patients. Here, the efficacy of using VRSP in altering stigma, empathy and knowledge as well as side effects have been assessed in medical students in comparison with the routine education (visiting the patients). Method: After attending one session of lecture about positive psychotic symptoms, medical students were allocated to two groups: experiencing one session of VRSP or visiting patients under supervision as routine practice in the ward. Before and after the first session and after the second one, questionnaires of knowledge, empathy and stigma were filled by students. Finally, the results were compared in two groups. Results: Both interventions were effective in reducing stigma as well as increasing knowledge and empathy toward patients with psychotic experiences. VRSP could significantly reduce stigma and increase knowledge and empathy compared with the traditional visiting patients under supervision. The side effects were minimal and ameliorated right after the experience. Conclusion: VRSP is an effective tool in decreasing stigma and increasing empathy and knowledge of the students and can be incorporated in psychiatric education with minimal side effects.

Assessing DSM-5 Section II Personality Disorders Using the MMPI-2-RF in an Iranian Community Sample.

The aim of the current study was to examine the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008) scales in assessing Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM-5) Section II Personality Disorder (PD) symptoms. For this purpose, we first tested the cross-cultural factorial and criterion validity of MMPI-2-RF scales. We used a sample of 536 (327 women and 209 men) community individuals in Tehran, Iran. DSM-5 Section II PD criterion counts were assessed using the Structured Clinical Interview for DSM-5-Screening Personality Questionnaire. Exploratory structural equation modelling analyses revealed that the models reported by Ben-Porath and Tellegen generally fitted the data well. Criterion validity of the MMPI-2-RF scales as well as MMPI-2-RF PDs spectra scales were analyzed with respect to their correlations with DSM-5 Section II PDs, indicating results generally consistent with expectations. Results based on Poisson or Negative binomial regression models indicated that a set of MMPI-2-RF scale hypotheses were supported, with several exceptions that are discussed in detail. These findings have implications for applicability of the MMPI-2-RF across Iranian population.

Health services coverage: Physical access to rehabilitation facilities in Tehran compare with the country.

OBJECTIVE: According to the World Health Organization, estimates about 1,800,000 people lived with disability in Tehran. Against there is little evidence of physical access to rehabilitation facilities in Tehran. This study is aimed to assess the physical access to physical rehabilitation facilities in Tehran and compare it with the country. METHODS: This is a cross-sectional study conducted since January to April 2017. We used a master facilities list of rehabilitation facility that developed in Iran to collect the information. The samples of this study included all existing physical rehabilitation centers in Tehran province. Data analysis was done using the SPSSr version 21.0 (SPSS Inc., Chicago, IL). RESULTS: The results showed that rehabilitation facilities existed at different levels, including inpatient (10.51), outpatient (224.28), community based (36.72), and long-term care (4.96)/1,000,000 populations. Rehabilitation services are provided by rehabilitation professional including: Physical medicine and rehabilitation specialists (8.7), physiotherapists (132.89), occupational therapists (57.4), speech therapists (42.11), and audiologists (48.84) (in 1,000,000 populations). CONCLUSION: Tehran needs to increase the physical access to rehabilitation facilities and compared with country was disproportionate physical access to facilities in most cases. It is necessary to establish an interdisciplinary referral system between different rehabilitation providers.

Development and psychometric properties of the physical rehabilitation services acceptability questionnaire.

Background: Access to rehabilitation services is considered to be a right for all people. One of the most important indicators for access to rehabilitation services is an individual's general acceptance of rehabilitation. This tool was designed based on relevant studies and experiences of rehabilitation specialists to design a questionnaire to specifically measure patient acceptability of physical rehabilitation services. Methods: In this study, an exploratory sequential mixed methods design was used. The first phase included a review of the literature and analysis of relevant studies, focus group discussions, and qualitative content analysis. In the second phase, construct validity was assessed by exploratory and confirmatory factor analysis. Also, convergent and divergent validity were measured. Reliability was evaluated by internal consistency (Cronbach's alpha and McDonald's Omega) and construct reliability. Statistical procedures were calculated by SPSS-AMOS24 and JASP0.9.2 software. Results: A total of 200 questionnaires were completed by members of Iranian Disability Campaign. Three factors and 25 items were identified according to results of the first phase of this study. In the second phase, face validity was confirmed. To assess the content validity ratio, 9 items, with the mean of content validity ratio (CVR) < 0.49, were deleted, while the content validity index (CVI) < 0.79 was revised. The kappa coefficient < 0.6 was fair and scale content validity index (SCVI) under 0.9 was considered appropriate. Results of exploratory factor analysis showed that 48% of the variance of the acceptability of physical rehabilitation services was based on patients' satisfaction, ethical behavior, and patient centered services. Confirmatory factor analysis confirmed the suitability of the final model. Convergent and divergent validity and reliability of the measure, the Physical Rehabilitation Services Acceptability questionnaire was fulfilled. Conclusion: Findings indicated that the proposed constructs that promoted the Acceptability of Physical Rehabilitation Services Questionnaire had good validity and reliability in participants with physical disabilities.

Introduction of a Community-Based Participatory Model for Women's Mental Health Promotion in Iran: A-Z.

BACKGROUND: To address the disproportionate burden of poor mental health among women, we present a community based participatory research (CBPR) model used to develop a women's mental health promotion program for Iranian women. METHODS: This is a multi-phase interventional study using a CBPR approach among married women age 18-65 living in Tehran. First, participants described the process of women's mental health. Subsequent steps involved participatory needs assessment, priority setting, intervention design, and evaluation. Finally, a conceptual model of women's mental health promotion was developed. RESULTS: "Seeking comfort" emerged as the core process in women's mental health. To promote mental health, women prioritized training on coping mechanisms to deal with stress. Women receiving this training used more problem-based coping methods and reported a higher quality of life than the comparison group. CONCLUSIONS: The resulting conceptual model illustrates the utility of using a CBPR approach to develop women's mental health promotion programs.

Social Determinants of Positive Mental Health in Iranian Society: A Qualitative Approach.

BACKGROUND: Based on the World Health Organization definition, mental health is the absence of mental disorders and presence of positive mental health (PMH). As the social determinants of mental disorders and PMH are not the same in different cultures and in order to promote community mental health, social determinants of PMH should be identified, which is the aim of this study. METHODS: This was a qualitative study conducted in Tehran. Data were collected through eight focus group discussions with the general population aged between 30 and 60 years and ten semi-structured interviews with mental health professionals from Tehran. Data were analyzed through directional content analysis using Dedoose software. RESULTS: Fifty-one lay people and ten mental health professionals participated in this study. The process of content analysis resulted in two main themes: (a) structural determinants of PMH which consist of socioeconomic and political context and socioeconomic position and (b) intermediary determinants of PMH which consist of working condition, living condition, family factors, lifestyle, psychosocial factors, and health system. CONCLUSIONS: Improvement of living conditions, with emphasis on working conditions as one of the intermediary social determinants, will play an important role in promoting PMH.

Priorities of positive mental health promotion in the Iranian community: a qualitative study.

BACKGROUND: Positive Mental Health (PMH) enables people to cope with the common stresses of life and adversity to achieve their full potential and humanity. In many communities, promoting PMH via prioritized interventions has been considered as a key component of public health policies to optimize mental well-being. OBJECTIVE: To set the priorities of interventional programs of Iranian PMH promotion according to the World Health Organization (WHO) Priority Public Health Condition (PPHC) analytical framework. METHODS: This qualitative study was implemented in 2017 in Tehran, Iran and had two main phases. In a qualitative needs-assessment phase, needs of the community's PMH were collected through eight focus group discussions with a general population aged 30 to 60 years-old. In a priority-setting phase, the priorities of PMH were extracted through an expert panel consisting of mental health professionals and policy makers. Data gathering was implemented based on purposeful sampling according to inclusion criteria. Data were analyzed based on directional content analysis using Dedoose software version 7.6.6. RESULTS: Fifty-one people and ten mental health professionals and policymakers participated in this study. The process of data analyzing, categorized PMH needs in 4 main categories, 15 subcategories and 46 codes. The four categories were financial security, social security, healthy lifestyle and promoting psychological factors. In the expert panel, first, the indicators of PMH priority setting were determined and then based on the priority public health condition analytical framework of the World Health Organization, the most important of PMH priority in each level was indicated as "creating job positions" in socioeconomic level, "providing proper working conditions" in differential exposure, "promoting practical life skills training" in the differential vulnerability, "easy and affordable access to mental health services" in differential healthcare outcome. CONCLUSION: Appropriate policymaking and regulation at national level regarding employment, promoting working conditions, and reducing unemployment, promote community PMH as well as expanding accessible and affordable mental health services in the national healthcare system and empowering the community through providing practical life skill courses.

Positive Mental Health from the perspective of Iranian society: A qualitative study.

Background: According to the World Health Organization, mental health relates, not only to the absence of mental disorder, but also to Positive Mental Health. Studies have shown that promoting positive mental health, not only reduces the prevalence and incidence of mental disorders, but also affects the process of treatment and reduces related burden. However, this concept has different interpretations in different cultures, and in many societies, mental health is still considered the absence of mental illness. Thus, the present study was conducted to provide an in-depth understanding of Iranian adults` perspective towards the concept of positive mental health. Materials and Methods: In the present qualitative study, eight focus group discussions (6 to 8 adults in each session) were held consisting of 30 to 60 year-old men and women from Tehran. Data were analyzed in "DeDoose" qualitative software using content analysis. Results: According to the data obtained, participants found no difference between positive mental health and mental health, mostly equating it to the absence of mental disorders and having positive energy, peace in and satisfaction with life. According to the results, positive mental health has four domains of emotional/psychological, spiritual, social, and life skills. Conclusion: Understanding an individual's positive mental health concepts culturally and providing appropriate community based programs can significantly promote the mental health of the community.

RIT2 Polymorphisms: Is There a Differential Association?

Neurological disorders include a wide variety of mostly multifactorial diseases related to the development, survival, and function of the neuron cells. Single-nucleotide polymorphisms (SNPs) have been extensively studied in neurological disorders, and in a number of instances have been reproducibly linked to disease as risk factors. The RIT2 gene has been recently shown to be associated with a number of neurological disorders, such as Parkinson's disease (PD) and autism. In the study reported here, we investigated the association of the rs12456492 and rs16976358 SNPs of the RIT2 gene with PD, essential tremor (ET), autism, schizophrenia (SCZ), and bipolar disorder (BPD; total of 2290 patients), and 1000 controls, by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Significant association was observed between rs12456492 and two disorders, PD and ET, whereas rs16976358 was found to be associated with autism, SCZ, and BPD. Our findings are indicative of differential association between the RIT2 SNPs and different neurological disorders.

Current status of health index in Tehran: A multidimensional approach.

Background: Health is an essential component of human rights and the rights are interdependent, indivisible, and correlated. The present study aimed at codifying a multidimensional health index according to multistage index development and describing the status of this index in 22 municipal districts of Tehran. Methods: This study was conducted using the data collected in the second round of Urban HEART Project of Tehran (2012-2013). The sample size was 34 700. To develop a multidimensional health index (MDHI), the nine steps of the Organization for Economic Cooperation and Development (OECD) were followed, from codifying theoretical framework to introducing the index. Results: According to the constructed MDHI, the districts no. 13, 10, 17, 1, 3, 4, and 22 had the best status and the district no. 8 the worst status. With respect to physical health, the districts no. 13, 17, 1, 3, 10, and 18 had the best status and the district no. 8 the worst. Concerning mental health, the districts no. 3, 6, 1, and 10 had the best status and the districts no. 8 and 12 the worst status. With respect to social health, the districts no. 10, 22, and 21 had the best status and the districts no. 6, 7, 12, and 14 the worst status. The analysis of sensitivity indicated that the MDHI was more sensitive towards physical health. Based on the mean, minimum, and maximum scores on each indicator of the questionnaires, the physical, mental, social, and MDHI status of Tehran residents (2012-2013) was high-medium, medium, low-medium, and high-medium, respectively. Conclusion: The right to health should be widely investigated, as it is a primary principle needed for sustainable development, which can be accomplished when the attitudes of different organizations towards the health construct are multidimensional rather than unidimensional.

National survey of availability of physical rehabilitation services in Iran: A mixed methods study.

BACKGROUND: The prevalence of disability in Iran has increased due to ageing of the population and the presence of chronic diseases. However, little is known about the availability of rehabilitation services in Iran. OBJECTIVE: To study the availability of physical rehabilitation services in Iran. METHODS: This was a mixed method study. In the first phase, a qualitative design was conducted for designing an instrument with focus groups based on Service Availability and Readiness Assessment (SARA) instrument (developed by World Health Organization). Content analysis was used for data analysis. Then, in the second phase, a cross-sectional study was performed to collect the data with census method in Iran. This study was formed from June to October 2015, and samples consisted of all governmental, public non-governmental and private facilities established for rehabilitation centers affiliated with the Ministry of Health and Medical Education, Ministry of Labor, Cooperative and Social Welfare and the Iranian Red Crescent Society. Data analyses were performed using SPSS software (version 16). Descriptive statistical analysis (percentage and frequency) were calculated for quantitative data. RESULTS: In the first phase, the content analysis of qualitative data identified a Master Facilities List (MFL) of rehabilitation services and service providers in Iran. Results of the second phase showed that the rate of inpatient, outpatient, community-based and long-term care centers per 1,000,000 populations in Iran were 1.68, 89.24, 66.21 and 3.6, respectively. Also, that the rate of rehabilitation professionals including physical medicine and rehabilitation specialists, physiotherapists, occupational therapists, speech therapists, and audiologists were 3.90, 64.65, 22.09, 22.83 and 24.18 per 1,000,000 populations, respectively. CONCLUSION: There is a need to increase the availability of rehabilitation services and to promote rehabilitation referrals by using an interdisciplinary team approach.

Psychosocial factors in pregnancy and birthweight: Path analysis.

AIM: Birthweight is known to be affected by several factors. In the present study a relationship model of psychological and economic determinants of birthweight was designed and tested. METHODS: This prospective study involved 400 pregnant women in four districts of Tehran, Iran. The subjects were selected through a multistage sampling method. Seven questionnaires (socioeconomic status; Holmes and Rahe Stress Scale; Perceived Stress Scale; 21-item Depression, Anxiety, and Stress Scale [DASS-21]; perceived social support; pregnancy-related anxiety scale; and domestic violence questionnaire) were used to assess participant psychosocial and economic conditions. In order to collect post-partum information about the mother and the infant, the women were followed up until delivery. Data were analyzed using SPSS-16 and Lisrel-8.8. RESULTS: Based on the obtained path diagram, the greatest adverse effects on birthweight were exerted directly by DASS-21 score (B = -0.14) and indirectly by stressful life events (B = -0.037). Among variables that affected birthweight in both paths, socioeconomic status and perceived stress had the strongest overall effects on birthweight (B = 0.203 and -0.1024, respectively). CONCLUSION: According to the path analysis model, psychosocial and economic factors can directly/indirectly affect birthweight.

A Comparative Study of Nurses as Case Manager and Telephone Follow-up on Clinical Outcomes of Patients with Severe Mental Illness.

BACKGROUND: Providing community-based mental health services is crucial and is an agreed plan between the Iranian Mental Health Office and the Regional Committee for the Eastern Mediterranean (affiliated with WHO). The aim of this study was to determine the effectiveness of home-visit clinical case-management services on the hospitalization rate and other clinical outcomes in patients with severe mental illness. METHODS: A total of 182 patients were randomly allocated into three groups, namely, home-visit (n=60), telephone follow-up (n=61) and as-usual care (n=61) groups. Trained nurses as clinical case-managers provided home-visit services and the telephone follow-up tasks. Hospitalization rate as a measure of recurrence, as well as burden, knowledge, general health condition of caregivers with positive/negative symptoms, satisfaction, quality of life, and social skills of the consumers were assessed as the main and secondary outcomes, respectively. RESULTS: Most clinical variables were improved in both intervention groups compared with the control group. During the one year follow-up, the rate of rehospitalization for the telephone follow-up and as-usual groups were respectively 1.5 and 2.5 times higher than the home-visit group. CONCLUSION: Trained clinical case-managers are capable of providing continuous care services to patients with severe mental illness. The telephone follow-up services could also have beneficiary outcome for the consumers, their caregivers, and the health system network.

A genetic variant in CAMKK2 gene is possibly associated with increased risk of bipolar disorder.

A recent large-scale study have reported that rs1063843, a single nucleotide polymorphism located in the CAMKK2 gene is highly associated with schizophrenia in European and Han Chinese populations. Increasing evidences show that schizophrenia and bipolar disorder have some common genetic variance. Here, we evaluated the association of this variant with schizophrenia and bipolar disorder in Iranian population. Genomic DNA was extracted from peripheral blood of 500 schizophrenic patients, 500 bipolar patients and 500 normal controls and all were genotyped for the rs1063843 using a PCR-RFLP method. The allele frequency of rs1063843 was significantly different in both schizophrenia and bipolar patients comparing to control group. For the first time, we showed that rs1063843 is highly associated with bipolar disorder, although more replication studies are needed to confirm our findings. Our results also support the findings of previous studies suggesting a significant association between rs1063843 and schizophrenia.

Clinical outcomes and cost effectiveness of two aftercare models provided by general physicians and nurses to patients with severe mental illness.

BACKGROUND: Implementing community-based psychiatric services is one of the priorities of the WHO/EMRO mental health programs. This study presents an aftercare service, as a community based-service, for patients with severe mental illness (SMIs). METHODS: In this randomized controlled clinical trial design, 176 patients, who attended selective hospitals with SMI, were allocated into three groups: clinical case managers provided by general practitioners, nurses and the control group (usual treatment). The clients and their caregivers received monthly home visits (education and treatment supervision). The effectiveness of the intervention was measured by indicators of psychopathology such as scores of YOUNG, caregivers' knowledge and satisfaction with the services. Health-related quality of life (SF-36) was considered as the primary outcome variable. Data were collected at baseline and at 12 months follow-up. Direct and indirect medical costs were obtained through a periodic completion of questionnaires and interviews by caregivers. Cost effectiveness ratio was estimated as cost per QALY gained in each group. SPSS 16.0 was used in this survey and statistical methods were chi-square, ANOVA, Scheffe as post-Hoc test and paired sample t-test with 95% confidence interval and 0.05 significance level. RESULTS: The results of our study revealed that the score of YOUNG, caregivers' knowledge and satisfaction with service were improved in both intervention groups after 12 months. Improvement in health-related quality of life was observed in the general practitioner and nurse group. The incremental cost effectiveness ratio was 5740807 IRR and 5048459 IRR per QALYs gained in the general practitioner and nurse groups, respectively. CONCLUSION: The model of aftercare services provided by trained nurses is the most cost- effective and feasible model for Iran's socio-economic conditions with low resource allocations.

The Epidemiology of Suicide Behaviors among the Countries of the Eastern Mediterranean Region of WHO: a Systematic Review.

This systematic review aimed to help better to understand the epidemiology of suicidal behaviors among Eastern Mediterranean Region (EMR) countries. The PubMed, EMR medex, Scopus, PsychInfo, ISI, and IMEMR were searched with no language limitation for papers on the epidemiology of suicidal behaviors in the general population, published up to August 2013. A total of 13 articles were reviewed. The incidence (per 100.000) of committed suicide ranged from 0.55 to 5.4. The lifelong prevalence of attempted suicide, suicidal plan and thoughts were 0.72-4.2%, 6.2-6.7%, and 2.9-14.1%, respectively. The figures for suicide are higher than those officially reported. Suicide behaviors' statistics is susceptible to underestimation presumably due to the socio-cultural, religious and legal barriers, not to mention the lack of well-organized registries and methodologically sound community-based surveys.

The therapeutic effectiveness of risperidone on negative symptoms of schizophrenia in comparison with haloperidol: a randomized clinical trial.

INTRODUCTION: A number of research studies have shown that the new generation of neuroleptic medications can more effectively contribute to treating negative symptoms of schizophrenia compared with the first generation by influence cognitive functioning. The present study examined the therapeutic effectiveness of manufactured Risperidone and Haloperidol in Iran on treating the negative symptoms of schizophrenia. METHODS: This randomized clinical trial (RCT) study examined 100 hospitalized patients who met DSM-IV. TR criteria for schizophrenia were sampled at Razi psychiatric hospital in Tehran, Iran. After two weeks of stopping neuroleptic medications, the patients were randomly assigned into two groups, Risperidone and Haloperidol group. During 8 weeks of the study, baseline and weekly assessments were performed by completing brief psychiatric report scale (BPRS). RESULTS: Both Risperidone and Haloperidol were effective in treating the negative symptoms of schizophrenia and improvements in both groups were initiated in the second week of treatment. The most prominent response rate was the second week in Haloperidol group and the eighth week in Risperidone group but this difference was not statistically significant. DISCUSSION: Prescribing Risperidone or Haloperidol for treating negative symptoms of schizophrenia can be influenced by other criteria including side effects, previous treatment histories of patients and their families and a patient's or physician' preference in prescribing a medication. Studies in other countries show that Haloperidol has better therapeutic effects in treating the negative symptoms of schizophrenia in comparison with Risperidone. Further studies on the therapeutic effectiveness of Risperidone and Haloperidol are suggested.