Body Image Concern Inventory (BICI) for identifying patients with BDD seeking rhinoplasty: using a Persian (Farsi) version.

BACKGROUND: Dissatisfaction with appearance is most pronounced in rhinoplasty patients compared to candidates for other aesthetic procedures. We aimed to test and introduce the Body Image Concern Inventory (BICI) as a self-report screening tool for identifying body dysmorphic disorder (BDD) among patients seeking rhinoplasty. METHODS: The surgeon completed a two-point defect severity scale in which a score of 1 represented no defect or one defect and a score of 2 represented more than one defect. Each of the 117 subjects with a score of 1 answered a questionnaire that was designed to obtain demographic data and completed the Persian version of the BICI. The psychiatrist, considering the patient's demographic data and blind to the BICI score, interviewed him/her using a semistructured diagnostic tool for BDD based on DSM-IV. RESULTS: The validity of the Persian version of the BICI was calculated at 85%. The reliability of the Persian BICI items was tested and Cronbach's alpha was 0.90. The results of ROC analysis for the ideal cutoff point of the Persian BICI, based on the Youden index method and optimum sensitivity and specificity, revealed that the ideal cutoff point for positive or negative criterion of that questionnaire's result may be the total score of 42 (sensitivity, 93.5%; specificity, 80.8%) The diagnostic accuracy of the Persian BICI in comparison with the gold standard (psychiatric interview), according to the area under the ROC curve (AUC), was 91.4% (95% CI = 86-97%, P < 0.0001). The agreement of the results of the Persian BICI questionnaire with the psychiatric interview for diagnosis of BDD, according to kappa index, was 61.7% (P < 0.001), and the odds ratio (OR) of being diagnosed with BDD in a psychiatric interview for those with overall scores ≥42 for the Persian BICI was 47.7 (95% CI = 43-52). CONCLUSION: The results of the present study emphasize the high rate of BDD (12.2%) in subjects seeking rhinoplasty. The BICI appears to be an internally consistent and valid brief multiple-choice instrument for assessing dysmorphic concern. To our knowledge, this is the first time that this measure has ever been used for identifying BDD patients in a rhinoplasty setting; it is also the first time that ROC analysis has been used for calculating and analyzing the results of BICI. Our study suggests that rhinoplasty surgeons could rely on the scores of the BICI to identify subjects with probable BDD among their consultants with no or one slight defect.

Evaluation of psychological resistance to insulin treatment in type II diabetic patients.

AIMS: Various studies have demonstrated that the majority of the factors affecting the reluctance of individuals to insulin injections are rooted in psychological factors. Present study aimed to determine relationships between main causes of refusal to insulin injection in diabetic patients and factors such as age, gender, and educational degree of patients. MATERIAL & METHODS: This was a descriptive study which was conducted on diabetic patients (n = 505) who need insulin therapy. The data were collected with a questionnaire in following steps. First, the most important causes of patients' reluctance, in the patients' opinion, to insulin therapy were determined using the data of the previous studies. In the second step, the patients were asked to express their opinion on each of these factors and the recorded responses were analyzed. RESULTS: The results of the study showed that fear of ampoules, fear of pain caused by insulin and the embarrassment of patients from injections in public significantly depended on the gender of the patients, so that these factors were much lower in men than women. In addition, these factors in the patients with higher degrees of education led to lower level of refusal to insulin injections. Another factor influencing the reluctance to insulin injections was the forming of a sense of addiction due to daily insulin injections, which was significantly lower among the patients with higher education, but did not have a significant relationship with sex of the patients. In this regard, another factor was fear of hypoglycemia and insulin side effects, which did not have a significant relationship with gender and educational degree. In addition, there was no significant relationship between the patient's age and any of the factors effective in patients' reluctance to insulin injections. CONCLUSION: Psychological factors seem to be effective in the emergence of the sense of reluctance to insulin injections. Therefore, not only patients but also the entire society need to receive training and appropriate services to improve their attitude to this issue with a psychological approach and help to solve this problem.

Mental Health and Latent Toxoplasmosis: Comparison of Individuals with and without Anti-Toxoplasma Antibodies.

AIM: There is evidence to suggest that the protozoan Toxoplasma gondii affects the mental health of people who are infected with it. The aim of the present study was to examine the relationship between T. gondii and mental health. METHODS: A total of 200 students (87 men and 113 women) of Jundishapur University of Medical Sciences (Ahvaz, Iran) were tested for the presence of anti-Toxoplasma antibodies and completed the General Health Questionnaire (see Appendix 1, available at: http://www.longwoods.com/content/24938) and a demographic form. Data were analyzed using independent samples t-test, chi-square test and Fisher's exact test. RESULTS: Infected women had significantly lower scores in somatic symptoms (p = 0.04), anxiety/insomnia (p = 0.006) and depression (p = 0.04) compared with non-infected women. Difference in social dysfunction was not significant (p > 0.05). There were no significant differences in somatic symptoms, anxiety/insomnia, depression and social dysfunction between infected and non-infected men (all p > 0.05). CONCLUSION: Our findings indicate that latent toxoplasmosis can affect some components of mental health just in women.

Investigation of Mental Health in Patients with Medically Unexplained Physical Symptoms .

OBJECTIVE: Medically unexplained symptoms are physical symptoms, which cannot be explained by organic causes. This study aimed to investigate mental health in patients with medically unexplained physical symptoms. METHOD: One hundred outpatients who were admitted to the Electro Diagnosis Clinic of Imam Khomeini hospital, Ahvaz/Iran, participated in this study. Data were collected using physical examination, paraclinical examinations, and SCL-90-R, and analyzed through multivariate analysis of variance (MANOVA), Chi-square test and Fisher's exact test. RESULTS: The findings revealed significant differences between clients with medically explained and unexplained symptoms in obsessive compulsive and somatization (p<0.05). Differences in depression, anxiety, phobia, psychosis, aggression and paranoia were not significant (p>0.05). CONCLUSION: The present study suggested an association between some psychological problems and somatic symptoms. Therefore, screening for psychological impairments can improve clinical outcomes. .

Effect of Cognitive Behavior Group Therapy on Parenting Stress in Mothers of Children With Autism.

BACKGROUND: Due to the various problems of children with autism, their families and especially their mothers become exposed to stress. OBJECTIVES: This study aimed to evaluate the effect of cognitive behavior group therapy on parenting stress of mothers of children with autism. MATERIALS AND METHODS: The sample of this research consisted of sixteen mothers of children with autism. The measurement tools were the Abidin Parenting Stress questionnaire and a demographic questionnaire. The samples participated in seven sessions of cognitive behavior group therapy. The data were analyzed using the repeated measures test. RESULTS: The findings indicated significant differences between scores of pretest and posttest considering parenting stress (P = 0.03) and subscales of parenting distress (P = 0.01), yet there weren't significant differences in the other subscales (P > 0.05). CONCLUSIONS: Cognitive behavior group therapy could be an important part of interventions used to decrease parenting stress of mothers of children with autism.

Investigation of anti-Toxocara and anti-toxoplasma antibodies in patients with schizophrenia disorder.

Objective. The aim of the present study was to examine the relationship between Toxoplasma gondii and Toxocara spp. infections in patients with schizophrenia disorder. Method. A total of 100 patients with schizophrenia disorder and 95 healthy individuals participated in the study. Participants were tested for the presence of anti-T. gondii and anti-Toxocara spp. antibodies by ELISA and Western blotting. Data were analyzed using Chi-square test and Fisher 9 s exact test. Results. There were no differences in T. gondii IgG seroprevalence between patients with schizophrenia and healthy individuals (P = 0.1), but there were differences in seroprevalence between males and females with schizophrenia (P = 0.009). In contrast, Toxocara spp. IgG seroprevalence was greater in patients with schizophrenia disorder than in healthy individuals (P = 0.02), but there were no differences in seroprevalence between men and women with schizophrenia (P = 0.5). Finally, there were no differences in seroprevalence of T. gondii or Toxocara spp. IgG among different subtypes of schizophrenia, various age groups, residential area, or clinical course of treatment (P > 0.05). Conclusion. The present study suggests that patients with schizophrenia disorder are at elevated risk of Toxocara spp. infection. Moreover, contamination with T. gondii is a risk factor for schizophrenia in women.

Toxoplasma gondii Exposure and the Risk of Schizophrenia.

BACKGROUND: Schizophrenia is a major psychiatric disorder with a deeply destructive pathophysiology. There are evidences to indicate that infectious agents such as Toxoplasma gondii may play some roles in etiology of the disorder. OBJECTIVES: The current study aimed to determine the association between T. gondii exposure and the risk of schizophrenia. MATERIALS AND METHODS: T. gondii IgG antibodies of 100 patients with schizophrenia as well as 200 healthy volunteers were assessed. The subjects also completed demographic questionnaires. Data was analyzed using the chi-square and Fisher exact tests. RESULTS: The analyses confirmed the significant differences between healthy women and ones with schizophrenia (P = 0.001) as well as between males and females with schizophrenia (P = 0.009) in IgG positivity. CONCLUSIONS: The present study supported the contamination with T. gondii as a risk factor for schizophrenia just in women.