[Psychiatric intensive care unit [PICU]/ new plan]

The goal of hospitalization of a mentally ill person is providing safety for him [her] and others. Especially if he [she] wanted to harm himself [herself]. Usual wards cannot provide adequately for the treatment needs of all psychiatric patients. Structuring of the environment to bring about behavioral changes and to improve the psychological health and functioning of individuals is necessary. The main aim of this research is introduction of Psychiatric Intensive Care Unit [PICU] to controlling emergency state in hospitalized psychiatric patients. Psychiatric intensive care units [PICUs] were designed to create a safe and controlled environment for the management of acutely disturbed psychiatric patients on a short-term basis, with high staffing levels and a limited number of beds. In general, severely psychotic patients exhibiting poor impulse control and who were violent, suicidal, catatonic patients and those who were at nutritional risk due to their mental illness were admitted to psychiatric intensive care units. Many differences exist between these wards and usual sections. Nurses are able to provide a higher level of support and supervision. Nurses and other clinical staff spend therapeutic time directly with service users. No visitors are allowed on a ward during this time and no meetings take place. Threats of violence and self-harm [suicide] were the most significant factors associated with PICU admission. The unit provides a thorough medical, psychiatric and psychosocial assessment, as well as risk assessment for suicide or other violence. Further studies are required to examine the nature and operation of PICUs in other secure psychiatric settings. The PICU is now a well established part of many adult mental health provisions. Besides, our suggestion is opening such wards in psychiatrics hospital in Iran

[ frequency of Suicidal-thinking in NEZAJA personnel in Tehran at 2004-5 year]

Background: self mutilation carrying out underlying other psychiatric disease and disorder. The studies have shown about 4% of hospital patient have history of tissue scission. This study was planning to detect risk factor and etiology of self mutilation in army 506 hospital patients by 2005-6 y

Materials and Methods: this description case series study was done on 150 person of refry outpatient and hospitalized patients. After examination of them with hospital psychologist and confirmation of this diagnosis from malinjury and suicide, complete of check list was done by interview

Results: the most of patients affected of borderline personality disorder [74%] and then antisocial personality disorder [8%]. The average of period that traversed was 11.3+/-4 month and most of them do that in upper limb [93.3%] and last self mutilation signs [85.1%]. The mean of last self mutilation number in was 9 and the patients with 2 stairs were the most frequent. The mean of wound depth was 9.8+/-18.4 length 91.2+/-183, number 17.16+/-32.4

Conclusion: the most of patients have history of self mutilation and they are predictable in probability o self mutilation

[Review of drug treatments for nightmare in combat- related post-traumatic stress disorder]

Background: In Iran-Iraq war, many militants and civilians injured in body and soul aspects. Posttraumatic stress disorder [PTSD] is one of the psychiatery disorder who suffer it. Studies have shown the 80% percent of veterans who suffer from psychiatery disorder have PTSD. It means that PTSD is a prevalent, often chronic, significantly disabling illness in them. Sleep disturbance and freqnent nightmares are core symptoms of PTSD especially in combat veterans

Materials and Methods: This study is a review article. We gather articles in Internet by search engines snch as google and yahoo and we used Medical data bases such as: Pubmed and Iranmedex by keywords: PTSD, Post- traumatic stress disorder and nightmane

Results: In our stady we found traumatic- related nightmares in Posttraumatic stress disorder [PTSD] response to pharmatologic treatment. In a review article study We evaluated the efficacy of drugs that use for nightmare in PTSD. Drug such as Prazosin [alpha- 1 adrenerg: antagonist], Clonidin [alpha-2 receptor Agonist] , Propranolol [Beta- receptor Antagonist] Trazodone, Nefazodone, Cyproheptadine [5HT2- Blockers] are efficacious

Conclusion: Regards to frequent articles and researches in Iran and ont of country, Prazosin and Nefazodore are more efficacious in treatment for nightmare in combat- related Post- traumatic stress disorder

[Evaluation of frequencies of the Personality disorders [Axis II] in soldiers who evade the draft]

Mental disorders represent an important source of morbidity among military personnel and are a commen reason for early separation from the military, and the most frequency of premature elimination from the army was personality disorder. The goal of this study is evaluation of prevalence of personality disorder in soldiers separated from military service. In this study 102 awoles and 105 soldiers referred to the clinic of 506 Army hospital, evaluated by clinical interviews on the basis of DSM-4 criteria.The results were then analyzed by statistical software of SPSS 13. In this study, the frequencies of personality disorders in awols 73 percent and in the soldiers referred to clinic22 percent [p value 0/00].The frequencies of the most personality disorders [hysterionice, borderline, and antisocial] in awols are respectively 29, 18, and 23 percent and in soldiers referred to clinic are 16/2, 3/8, and 1 percent which there was a significant difference between two groups [p value in borderline 0/02, hysterionic 0/00, and antisocial 0/00]. The frequencies of personality disorders in awols were more common than community and soldiers which referred to clinic of hospital. Other trails are neede to determine relationship between the Personality disorders [Axis II] and separation from military service

[ prevalence of PTSD in conscript and official staff of earth force in Tehran during 2005-6]

Background: PTSD[Post Traumatic Stress Disorder] was happened in who was put in fearing or helplessness situation against the danger occurrence and effort to avoidance it. This symptom may was began after event and affected all of the person's life. This study was design to determine of PTSD prevalence in conscript and official staff of NEZAJA in Tehran by 2005-6

Materials and methods: this cross sectional study was done on 355 conscript and official staff of NEZAJA Garrison. Clustered stratified sampling was done to select the samples. PTSD was diagnosed on DSM-IV-TR criteria by psychologists. The obtained data was analyzed using SPSS11.5

Results: age average of conscript and official staff of NEZAJA was 20.68 years old and the average mean duration of their employment was 24 month. Prevalence of PTSD disorder in Conscript and official staff of NEZAJA was 14.9%. The most common cause of the PTSD was motor accident[30.2%], explosion[9.4%]. The patients had more age and mean time of employment. [P<0.05]

Conclusion: prevalence of PTSD disorder in Conscript and official staff of NEZAJA was 14.9%. It is advised to reduce conscription period time, enhance safety standard and increase professional education

[ relative risk of smoking in conscripted soldier in Tehran NEZAJA Garrison since 2005-6]

Background: nicotine dependency appears very quickly and strongly affected by environments condition. Smoking caused secondary death by immionosystem debilitation. Almost 25. 6% of high school student in Tehran have smoking experience. The men who are in hard condition of battle was dependent on nicotine 2 more time. This study was done to determine Relative Risk [RR] of smoking in conscripted soldier in Tehran since 2005-6

Materials and Methods: this descriptive cross sectional study was done on 385 conscript of NEZAJA Garrison. Clustered stratified sampling was done to select the samples from 3 tehran NEZAJA Garrison. The diagnose of disease based on DSM-IV-TR criteria by psychologist interview and diagnosis. The diagnosis based on self report of NEZAJA conscript

Results: most of the conscript of NEZAJA have primery education[42. 1%], rural[50. 9%] and 14. 3% of them were smoker 22. 1% of them have history of smoking. [87. 3%] of them had been smoker in selective service. The most incidence of smoking addiction was occur before selective service period[22%] and [13%] in period of selective service. Sectional prevalence in selective service period[7%] is less than before selective service period [14.3%]. The prevalence of smoking was less before selective service period[22.1%] and[19.5%] in selective service period [RR=2. 02]. There is increase in prevalence of smoking about 7. 3% in selective service period

Conclusion: this study on the conscripts of NEZAJA garrison showed the service in army despite of prescription and limitation of Tehran garrison based on smoking forbiddance, there is an increase in smoking addiction

[Comparison of early maladaptive schemas between personality disorder [cluster B] and normal subjects]

Background: the aim of this study is compartion of early maladaptive schemas between patients with personality disorders [cluster B]and normal subjects

Materials and Methods: in this research participants were fifty patient soldiers with personality disorders [cluster B]according to diagnosis psychiatric group and sixty health individuals [according to general health inventory scores].Both of them complited young schema questionnaire

Results: there was significant difference between normal and patient subjects in 12 schema of 15 schema in this questionnaire.In abandonment,unrelenting standards and self-sacrific there was not significant difference

Conclusion: cognitive elements especially schema have important role in vulnerability to the mental disorders

[ study of the frequencies of the psychiatry disorders [AXIS I] in soldiers who evade the draft]

Background: mental disorders represent an important source of morbidity among U.S.military personnel and are a commen reason for early separation from the military, and theThe purpose of this study is evaluation of prevalenceOf psychiatry disorders[axis I] in soldier of separation from military a service

Materials and Methods: in a descriptive-cross sectional study 102 awoles and 105 soldiers referred to the clinic of 506 Army hospital, evaluated by clinical interviews on the basis of DSM-4-TR criteria. The results were then analyzed by statistical soft ware of SPSS

Results: in this study, the frequencies of psychiatry disorders in awols respectively major depression disorder 27.27%, cyclotymia 25.97%, dysthymia25.97%, bipolar mood disorder [1] 7.79%, bipolar mood disorder [2]6.49%, adjusyment disorder 6.49% and in the soldiers referred to clinic are respectively 47.5%, 12.5%, 13.75%, 15%, 6.49% and 7.5%

Conclusion: the frequencies of major depression disorder and adjustment disorder in soldiers of referred to clinic of hospital were more than awols, but cyclotymia, dysthymia, bipolar mood disorders wre more common than soldiers which referred to clinic of hospital

[ prevalence of mood disorder in conscript and fficial staff of NEZAJA in Tehran by 2005-6]

Background: human being's mood can be high, low or normal. Our fillings are under control of us but in mood disorders this control is damaged. The prevalence of that in life time is 2-25%. This study was design to determine the prevalence of mood disorder in conscript and official staff of NEZAJA and its attributed risk factors in Tehran within 2005-2006

Materials and Methods: this cross sectional study was done on 385 conscript and official staff of NEZAJA Garrison. Clustered stratified sampling was done to select the samples. The diagnose of disease was based on DSM IV [Diagnostic and Statistic manual of Mental Disorder] criteria and documented by psychologist interview

Results: 12.7% of samples had mood disorder. The patients with mood disorder had more contributory psychiatric diseases. The prevalence of depression was higher in younger patients and those had fiancée. However, ranks and servitude have no significance relation with mood disorder [P<0.05]

Conclusions: servitude have no significance relation with mood disorder

[ frequency of Suicidal-thinking in NEZAJA personnel in Tehran at 2004-5 year]

Background: suicide is the self naughting. Army suicide have special condition because of catastrophic effect on their family and military environment. This study proceeds the frequency of Suicidal-thinking in NEZAJA personnel in Tehran within 2005-2006

Materials and Methods: this cross sectional study was done on 321 conscript and official staff of NEZAJA Garrison. Clustered stratified sampling was done to select the samples. The diagnose of disease based on DSM-IV-TR criteria. At first 3 garrisons were selected and sampling on population proportion of them on verbal interview was done

Results: 15.3% of samples had suicidal thinking and 1.9% of them mention to suicide history. The frequency of suicidal thinking in conscript [19.8%] and who psychiatric disease history [84.2%] was more. There is no significant difference between different education level of military personnel

Conclusions: suicidal thinking in conscript of NEZAJA Garrison and those having underling psychiatric disease was more. The result of this study was compatible whit previous study