Efficacy of Rivastigmine Augmentation on Positive and Negative Symptoms, General Psychopathology, and Quality of Life in Patients with Chronic Schizophrenia: A Randomized Controlled Trial.

The study aimed to assess Rivastigmine augmentation on positive and negative symptoms (PNSs), general psychopathology, and quality of life in patients with chronic Schizophrenia. A double-blind, parallel-design, randomized, placebo-controlled trial of 60 schizophrenia patients was conducted. Intervention group received rivastigmine 3 mg/day + Treatment as Usual (TAU) and the control group: TAU + placebo. Negative and positive symptoms, general psychopathology; and quality of life were measured using Positive and Negative Symptom Scale (PANSS) and Manchester Short Assessment of Quality of Life (MANSA). T-test, ANOVA, and the general univariate linear model tests were used for the analyses. Out of 60 participants, 52 (86.6%) were male. At baseline, no significant relationship was found for demographic and clinical characteristics between intervention and control groups. Between-group analysis indicated that all outcome measures PNSs, general psychopathology symptoms, and QoL score in rivastigmine group was significantly improved (p = 0.001). According to within-group analysis, a significant association was found between Rivastigmine and placebo groups in PNSs (p < 0.05). Rivastigmine augmentation improved PNSs and psychopathology in schizophrenia patients. However, no significant association found for improving the life quality after 8 weeks treatment.

Analysing the behaviour change of brain regions of methamphetamine abusers using electroencephalogram signals: Hope to design a decision support system.

Long-term use of methamphetamine (meth) causes cognitive and neuropsychological impairments. Analysing the impact of this substance on the human brain can aid prevention and treatment efforts. In this study, the electroencephalogram (EEG) signals of meth abusers in the abstinence period and healthy subjects were recorded during eyes-closed and eyes-opened states to distinguish the brain regions that meth can significantly influence. In addition, a decision support system (DSS) was introduced as a complementary method to recognize substance users accompanied by biochemical tests. According to these goals, the recorded EEG signals were pre-processed and decomposed into frequency bands using the discrete wavelet transform (DWT) method. For each frequency band, energy, KS entropy, Higuchi and Katz fractal dimensions of signals were calculated. Then, statistical analysis was applied to select features whose channels contain a p-value less than 0.05. These features between two groups were compared, and the location of channels containing more features was specified as discriminative brain areas. Due to evaluating the performance of features and distinguishing the two groups in each frequency band, features were fed into a k-nearest neighbour (KNN), support vector machine (SVM), multilayer perceptron neural networks (MLP) and linear discriminant analysis (LDA) classifiers. The results indicated that prolonged consumption of meth has a considerable impact on the brain areas responsible for working memory, motor function, attention, visual interpretation, and speech processing. Furthermore, the best classification accuracy, almost 95.8%, was attained in the gamma band during the eyes-closed state.

A meta-analysis of systematic reviews and meta-analyses to evaluate the psychological consequences of COVID-19.

BACKGROUND: Several meta-analysis studies have been reported in the literature on the incidence of psychopathological conditions resulting from the COVID-19 pandemic. This investigation aims to compile and analyze the findings of previously published meta-analysis research, as shown by the present meta-analysis of previous meta-analysis studies. METHODS: The PubMed and Scopus databases were searched from 1 January 2019 to 30 May 2022. The procedure was carried out according to the PRISMA flow chart and the qualities of the identified studies were analyzed using AMSTAR 2. Heterogeneities and risk of bias were assessed using the Meta-MUMS tool. The corresponding results, forest and funnel plots of the psychological consequences of COVID-19 were synthesized. RESULTS: Eleven meta-analysis studies were included. Random-effects meta-analysis of anxiety and depression showed (ER = 0.318 p-value < 0.001, ER = 0.295 p-value < 0.001) high heterogeneities (I2 = 99.70%, I2 = 99.75) between studies. Random-effects meta-analyses of sleep difficulties and insomnia were shown (ER = 0.347 p-value < 0.001, ER = 0.265, p-value < 0.001) along with heterogeneities (I2 = 99.89, I2 = 99.64). According to the random meta-analysis of post-traumatic stress syndrome (PTSS) and post-traumatic stress disorder (PTSD) (ER = 0.246, p-value = 0.001, ER = 0.223 p-value < 0.001) with heterogeneities (I2 = 99.75, I2 = 99.17). Random-effects meta-analyses of somatic and fear symptoms have been shown (ER = 0.16 p-value < 0.001, ER = 0.41, p-value = 0.089) with high heterogeneities (I2 = 99.62, I2 = 98.63). Random-effects meta-analysis of obsessive-compulsive symptoms and distress (ER = 0.297 p-value = 0.103; ER = 0.428, p-value = 0.013) with high heterogeneity, as I2 = 99.38%. Subgroup analysis of all symptoms and Egger's tests for detecting publication bias were also assessed. CONCLUSION: The data from the current meta-analysis showed different psychological disorders of COVID-19 during the pandemic. Clinicians should be aware of the prevalence with which COVID-19-infected patients experience emotional distress, anxiety, fatigue, and PTSD. About half of the included systematic reviews (SRs)/meta-analyses (MAs) suffered from poorer methodological quality and increased risk of bias, reducing confidence in the findings. There must be more SRs/MAs and high-quality clinical trials conducted to confirm these findings.

MicroRNAs and pro-inflammatory cytokines as candidate biomarkers for recent-onset psychosis.

BACKGROUND: Recent studies on the schizophrenia spectrum and other psychotic disorders showed that alternation of immune system components, particularly microRNAs (miRNAs) and pro-inflammatory compounds, plays a significant role in developing the illness. The study aimed to evaluate serum expression of the miRNA-26a, miRNA-106a, and miRNA-125b as genetic factors and serum levels of IL-6, IL-1ß, and TNF-α as pro-inflammatory factors in an IranianAzeri population. METHODS: Forty patients with recent-onset non-affective psychosis and 40 healthy people as a control group were involved. Expression levels of miRNAs and serum levels of the cytokines were measured using RT-qPCR and ELISA, respectively. T-test, receiver operating characteristics (ROC), and spearman correlation coefficient were carried out data analysis. RESULTS: Findings showed higher levels of IL-6, IL-1ß, TNF-α, miR-26a, and miR-106a in the plasma of the patients' group compared with the control. miRNA-26a showed a statistically significant higher level (p < .003) compared to the control group, with AUC = 0.84 (95% CI: 0.77 to 0.93, P < .001) and cut-off point = 0.17 in comparison to other miRNAs as mentioned above; in this regard, it might be a suggestive biomarker for schizophrenia in the early stage of the illness. Moreover, miRNAs' expression level was not substantially associated with the level of any measured cytokines above. CONCLUSIONS: miR-26a might be a suggestive biomarker for schizophrenia in the early stage of the illness. Given that the relationship between other miRNAs and cytokines is not yet well understood; accordingly, there are encouragement and support for continued research in this fascinating field.

Molecular Evaluation of Ex3 VNTR Polymorphism of the DRD4 Gene in Patients With Autism Spectrum Disorder.

Objective: Autism Spectrum Disorders (ASDs) are a group of neurodevelopmental disorders that affect social and communication skills. These diseases are characterized by severe communication and social skills disabilities and limited and repetitive activities. The prevalence of these disorders appears to be steadily increasing. It is proposed that the genes involved in the dopamine pathway may play an essential role in the development of autism. In this study, we investigated the possible association between Ex3 VNTR polymorphism of the DRD4 gene and autism spectrum disorders in the Iranian population. Materials & Methods: In this case-control study, 97 children with autism and 103 healthy individuals from a northwestern area of Iran as the case and control groups, respectively. After genomic xtraction from peripheral blood samples by the proteinase K method, the polymerase chain reaction (PCR) technique was used to determine the polymorphism genotypes. The data were then coded and analyzed using SPSS version 22 software. Results: The study results showed that the allele frequencies differed in the two groups, some of them being statistically significant. The most common allele in both the ASD and the control group was the 700 bp allele, and its frequency was significantly different in the two groups and was more common in the ASD group (p-value=0.0018). The other allele with a statistically different frequency was the 800 bp allele which was less frequent in the ASD group (p-value=0.0017). Conclusion: These results suggest a potential association between Ex3 VNTR polymorphism of the DRD4 gene and autism spectrum disorder in the Iranian population. This necessitates further studies for the evaluation of the DRD4 gene.

Assessment of Neuropsychiatric Indicators in Children and Adolescents With Primary Brain Tumors and Other Brain Space-Occupying Lesions Before and After Surgery.

Objectives: Cognitive abilities might be impaired due to brain lesions in children and adolescents. This study aimed to investigate neuropsychiatric indicators in children and adolescents with primary brain tumors and other brain space-occupying lesions (SOLs) before and after the surgical procedure. Materials & Methods: The current pre-post study was conducted on 81 patients with brain SOLs aged under 18 years hospitalized in the Neurosurgery Ward of Imam Reza university hospital, Tabriz, Iran, within 20 December 2016 to 20 December 2017. The patients with metastatic brain tumors were excluded. Before and after the surgical procedure, Digit Span forward and backward task (to assess working memory), Stroop Task and Trail Making Task A and B (to assess attention), and Rey-Osterrieth Complex Figure Test (ROCF) (to assess visuospatial memory) were carried out. Then, the scores of the tests were compared to standard values and postsurgical scores. Results: The most prevalent type of brain SOLs was medulloblastoma, and the most prevalent region of involvement was the posterior fossa. The scores of all tests after the surgery were significantly improved, compared to those before the surgery (P<0.05). In the assessment of Digit Span forward and backward task scores, there was no significant difference between the scores of patients before the surgery and standard values (P>0.05). Regarding the scores of various stages of the ROCF, the scores of the immediate recall stage were significantly low (P<0.05). Regarding Trail Making Task A and B and Stroop Task before the surgery, only Trail Making Task A and B scores were significantly increased (P<0.05). The scores of Trail Making Task A were significantly higher in patients with medulloblastoma and anatomically in left temporal tumors, which indicated greater damage to the attention field (P<0.05). In addition, in cerebellar tumors, the scores of the immediate recall stage of the ROCF were significantly lower than in other brain tumors or SOLs (P<0.05). Conclusion: The visuospatial memory and attention of preoperative assessments were significantly impaired, compared to those of the healthy population (P<0.05). Working memory, visuospatial memory, and attention showed improvement, compared to those before the surgery. Deficits in the attention domain were greater in medulloblastoma.

Developing inpatient suicide prevention strategies in medical settings: Integrating literature review with expert testimony.

OBJECTIVE: According to some recent evidence, suicide rate is higher in inpatients than in the general population around the world. However, suicide prevention strategies (SPS) are poorly focused and understood in medical settings. This study aimed to develop effective SPS and interventions in medical settings of Iran and provide evaluation checklists/procedures for them. METHODS: The study was performed in two steps, including literature review and expert opinions panel. In the first stage, we conducted a comprehensive literature review to find relevant suicide prevention programs, strategies, interventions, or any efforts to prevent suicide in the medical settings. In the second stage, an expert panel was arranged for developing effective and feasible SPS in medical settings. Data were analyzed through content analysis approach. RESULTS: Overall, 11 records were included in the literature review. SPS varied from staff training, safety plan and quality improvements, and prevention programs to therapy methods. Finally, in the second stage, the following seven major SPS were recommended by the expert panel: 1) Integration and application of obtained suicidal behavior data through evaluating medical records, 2) Screening and suicide risk assessment, 3) Staff training, 4) Quality improvement, 5) Follow-up of inpatients with high-risk behaviors, 6) Reducing stigma and improving public awareness, and 7) Follow-up of discharged high-risk inpatients. Also, 23 interventions within the strategies were presented. CONCLUSION: Given that SPS are poorly focused in medical settings, the practical framework that emerged in this study could be used to develop or advance SPS in various medical settings.

PERSIAN Traffic Safety and Health Cohort: a study protocol on postcrash mental and physical health consequences.

BACKGROUND: Cohort studies play essential roles in assessing causality, appropriate interventions. The study, Post-crash Prospective Epidemiological Research Studies in IrAN Traffic Safety and Health Cohort, aims to investigate the common health consequences of road traffic injuries (RTIs) postcrash through multiple follow-ups. METHODS: This protocol study was designed to analyse human, vehicle and environmental factors as exposures relating to postcrash outcomes (injury, disability, death, property damage, quality of life, etc). Population sources include registered injured people and followed up healthy people in precrash cohort experienced RTIs. It includes four first-year follow-ups, 1 month (phone-based), 3 months (in-person, video/phone call), 6 and 12 months (phone-based) after crash. Then, 24-month and 36-month follow-ups will be conducted triennially. Various questionnaires such as Post-traumatic Stress Disorder Questionnaire, Patient Health Questionnaire, WHO Disability Assessment Schedules, Cost-related Information, etc are completed. Counselling with a psychiatrist and a medical visit by a practitioner are provided accompanied by extra tools (simulator-based driving assessment, and psychophysiological tests). Through preliminary recruitment plan, 5807, 2905, 2247 and 1051 subjects have been enrolled, respectively at the baseline, first, second and third follow-ups by now. At baseline, cars and motorcycles accounted for over 30% and 25% of RTIs. At first follow-up, 27% of participants were pedestrians engaged mostly in car crashes. Around a fourth of injuries were single injuries. Car occupants were injured in 40% of collisions. DISCUSSION: The study provides an opportunity to investigate physical-psychosocial outcomes of RTIs, predictors and patterns at follow-up phases postinjury through longitudinal assessments, to provide advocates for evidence-based safety national policy-making.

An Observational Cohort of First Episode Psychosis in Iran: The Azeri Recent Onset Acute Phase Psychosis Survey (ARAS Cohort) Study Protocol.

Background: Most of our knowledge about the etiology, course, treatment, and outcome of schizophrenia spectrum and other psychotic disorders stems from Western countries. Data from populations living in other geographical areas and low- and middle-income countries, with different genomes (ethnicity) and exposomes (e.g., culture and social support, drugs of abuse, religion), will add to our knowledge of this complex disorder. Methods: The Azeri Acute phase/Recent onset psychosis Survey (ARAS) has been initiated to study the course of the disorder in patients with recent-onset psychosis using validated diagnostic tools and a comprehensive outcome monitoring system, aiming to reveal indicators for understanding the risk and resilience factors and for choosing the best-personalized treatment strategy. All participants will be evaluated for clinical signs and symptoms as well as risk and resilience factors and will be followed up for 1, 3, and 5 years for outcomes in several domains. A hierarchical cluster method will be applied to identify the number of clusters for each outcome. Defined models will be applied to assess the predictive value of cognition on symptomatic and functional outcomes at follow-up. Discussion: The ARAS cohort will yield significant academic- (research and education) and care-related achievements. ARAS data and experience will have value both in being a useful model for other parts of this region and in an expansion of the currently available knowledge.

Assessment of Behavioral Approach and Behavioral Inhibition Systems in Mood Disorders.

INTRODUCTION: Psychiatric disorders could be evaluated in terms of behavioral activation and inhibition systems. Dysregulation of these systems may lead to development of manic or depressive episodes in patients with mood disorders. This study aimed to identify Behavioral Approach System (BAS) and Behavioral Inhibition System (BIS) hypersensitivity as the functional brain system behaviors in patients with major depressive disorder and bipolar mood disorder I, compared to healthy individuals. METHODS: This case-control study was conducted in Razi Psychiatric Hospital, a mental health referral center in Northwest of Iran. The study consisted of two groups of patients, one with major depressive and the other with bipolar mood disorders and one healthy group. Each group had 40 patients (20 men and 20 women). The study data were collected through BIS and BAS questionnaire, Beck Depression Inventory (BDI-II), Young Mania Rating Scale (YMRS). The obtained data were analyzed by SPSS version 18. RESULTS: The findings showed a significant negative correlation between BIS, BAS and BAS subscales with the severity of depression and positive correlation with mania symptoms (P<0.05). CONCLUSION: BAS and BIS dysregulations may predispose people to mood disorder symptoms. BAS is hyperactive during manic phase and may predict the symptom severity of bipolar mood disorder.

Comorbid Psychiatric Disorders in Children and Adolescents with Nocturnal Enuresis.

PURPOSE: The present study was conducted with the aim of identifying the frequency of comorbid psychiatricdisorders in children and adolescents with nocturnal enuresis (NE). MATERIALS AND METHODS: In this descriptive-analytical study, 183 children and adolescents aged 5-18 years withNE referred to psychiatric clinics at Tabriz University of Medical Sciences were selected in 2015. A structuredclinical diagnostic interview, the kiddie-schedule for affective disorders and schizophrenia (K-SADS), was employedbased on the diagnostic and statistical manual of mental disorders (DSM-IV-TR) for the diagnosis of NEand comorbid psychiatric disorders. RESULTS: In this study, 39 participants (21.3%) were female and 144 (78.7%) were male. The mean age of participantswas 8.69 ± 2.34 years. The lifelong incidence of mental disorders among enuretic children and adolescentswas 79.23%. The highest incidence belonged to attention deficit/hyperactivity disorder (ADHD) with 74.9%, oppositional-defiant disorder (ODD) with 53%, and tic disorders with 12% (motor tics together with a single caseof vocal tic). The lowest incidence was for conduct disorder, bipolar affective disorder, and post-traumatic stressdisorder (PTSD) with 5%. Based on the Fisher exact test, there was no significant difference between girls andboys in terms of psychiatric disorders incidence (P > .05). CONCLUSION: Comorbid psychiatric disorders with NE are common among children and adolescents. Therefore,in-depth examination of other psychiatric disorders needs to be carried out in enuretic children and adolescents,which will affect the treatment and prognosis of NE.

Efficacy of Self-Hypnosis in Pain Management in Female Patients with Multiple Sclerosis.

Pain is common in patients with multiple sclerosis. This study evaluated self-hypnosis for pain control in that population. A randomized clinical trial was conducted on 60 patients, who were assigned to either a control group or to a self-hypnosis group, in which patients performed self-hypnosis at least 10 times a day. All patients were trained to score the perceived pain twice daily on a numerical rating scale and also reported the quality of pain with the McGill Pain questionnaire. Repeated-measures analysis showed a significant difference between the groups; pain was lower in the self-hypnosis group but was not maintained after 4 weeks. Self-hypnosis could effectively decrease the intensity and could modify quality of pain in female patients with multiple sclerosis.

Knowledge and Attitude of Parents of Children With Attention Deficit Hyperactivity Disorder Towards the Illness.

BACKGROUND: The knowledge and attitude of parents about attention deficit hyperactivity disorder (ADHD) is a public health issue in which management and rehabilitation approaches may be influenced. OBJECTIVES: The current study aimed to evaluate the knowledge and attitude of the parents of children with ADHD towards this disorder in Tabriz, Iran. MATERIALS AND METHODS: The current cross-sectional study evaluated 295 parents of children and adolescents with ADHD referred to psychiatric clinics of Tabriz University of Medical Sciences. The subjects were diagnosed based on Kiddie schedule for affective disorders and schizophrenia for school-aged children (K-SADS) and recruited according to a convenience sampling method in the first five months of 2014. The parents' knowledge and attitude towards ADHD was studied by a researcher-made questionnaire. RESULTS: The overall knowledge of parents was 66% in which 76.72% were aware of related signs and symptoms and 43.38% were able to identify the aberrations. Meanwhile, 44.62% of the parents knew the etiology and 54.75% had information about treatment strategies. In addition, 33.55%, 37.91%, 25.52% were aware of ADHD consequences, diagnosis and prevalence dimensions, respectively. Moreover, 82.72% of the parents had a positive attitude towards ADHD. A positive correlation was found between parents' attitude towards ADHD and their overall knowledge (identification, etiology, treatment, consequences and prevalence dimensions), ranging from 0.12 to 0.36 (P < 0.50). Age, gender, and place of residence did not have a correlation with parents' knowledge and attitude towards ADHD. Parent's education level only had a positive correlation with the knowledge of symptoms, with a value of 0.19 (P < 0.01). Parents with a higher overall knowledge, knowledge of ADHD symptoms, and prevalence rates accepted combination therapy (P < 0.05). CONCLUSIONS: While the overall knowledge of parents regarding ADHD was favorable, they were mostly unable to identify the aberrations in children with ADHD. These results may help practitioners address pitfalls in parent management training programs.

Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study.

Objectives. Inflexible personality traits play an important role in the development of maladaptive behaviors among patients who attempt suicide. This study was conducted to investigate the relationship between personality profiles and suicide attempt via medicine poisoning among the patients hospitalized in a public hospital. Materials and Methods. Fifty-nine patients who attempted suicide for the first time and hospitalized in the poisoning ward were selected as the experimental group. Sixty-three patients hospitalized in the other wards for a variety of reasons were selected as the adjusted control group. Millon Clinical Multiaxial Personality Inventory, 3rd version (MCMI-III) was used to assess the personality profiles. Results. The majority of the suicide attempters were low-level graduates (67.8% versus 47.1%, OR = 2.36). 79.7% of the suicide attempters were suffering from at least one maladaptive personality profile. The most common maladaptive personality profiles among the suicide attempters were depressive personality disorder (40.7%) and histrionic personality disorder (32.2%). Among the syndromes the most common ones were anxiety clinical syndrome (23.7%) and major depression (23.7%). Conclusion. Major depression clinical syndrome, histrionic personality disorder, anxiety clinical syndrome, and depressive personality disorder are among the predicators of first suicide attempts for the patients hospitalized in the public hospital due to the medicine poisoning.

Psychiatric comorbidities in ADHD children: an Iranian study among primary school students.

BACKGROUND: This study was performed to determine the lifetime prevalence of psychiatric disorders concomitant with attention deficit/hyperactivity disorder (ADHD) among primary school students. METHODS: One thousand six hundred fifty-eight primary school students (781 females and 877 males) were selected in a cluster random manner in 2010. The first screening was performed by the Conner's teacher rating scale revised and Teacher ADHD rating scale-IV and then the students, in whom the ADHD was diagnosed by a child and adolescent psychiatrist according to DSM-IV-TR, were evaluated by K-SADS-PL semi-structured interview to detect the psychiatric comorbidities. RESULTS: The prevalence of psychiatric comorbidities in ADHD subjects was 62.5%. Oppositional defiant disorder (29.4%), specific phobia (21.9%), and enuresis (17.5%) were the most common comorbidities. The most common comorbidities in ADHD-IA (inattentive type) (n = 29) were specific phobia (34.5%), oppositional defiant disorder (20.7%), chronic motor tic disorder (17.2%), and enuresis (17.2%). The most common comorbidities in ADHD-HI (hyperactive/impulsive type) (n = 15) were chronic motor tic disorder (33.3%), oppositional defiant disorder (26.7%), and specific phobia (26.7%). The most common comorbidities in ADHD-C (combined type) (n = 116) were oppositional defiant (31.9%), enuresis (19%), and specific phobia (18.1%). The frequency of chronic vocal tic disorder was higher in ADHD-HI compared with ADHD-C (P = 0.01). CONCLUSION: The results of this study indicated that the frequency of other psychiatric comorbidities in primary school students with ADHD is high that may affect disease course and treatment. Hence, evaluation for other comorbidities in ADHD patients should be considered. 

Sexual Knowledge among High School Students in Northwestern Iran.

Objectives. Regarding the importance of sexual desire in adolescence period and public and parental concerns about it and considering the lack of studies on sexual knowledge especially in adolescents in Iran, this study was conducted to evaluate the sexual issues in high school girls and boys. Patients and Methods. The cross-sectional study was performed on 2700 high school students. Students were selected through a multi-staged randomized sampling method in Tabriz and by the convenience method in Ardabil and Urmia. Data collection tool was a questionnaire including knowledge questions and measured by a three-point scale. Data were statistically analyzed with SPSS version 11.5 software. Results. 11.8% of the students had a low sexual knowledge, 46.7% had average and 41.5% had a high one. There was no significant difference between male and female students' general sexual knowledge. The highest knowledge was about being aware of the religious rules concerning sex. Conclusion. Adolescents should be trained and acquire information about the different aspects of sexual issues. Female adolescents especially need to be educated about puberty physiology, fertility physiology and STDs.

A study on the sources of sexual knowledge acquisition among high school students in northwest Iran.

BACKGROUND: Considering the importance of sexual drive among teenagers, parental and societal concerns about teenagers' sexual drives, particularly in religious communities such as Iran is of practical importance; therefore, this present research was designed to study students' sources of sexual knowledge acquisition. METHODS: This research was carried out among 2600 high school students in the cities of Tabriz, Urmia, and Ardabil in Northwest Iran. Students were selected through a multi-staged randomized sampling method in Tabriz and by the convenience method in Ardabil and Urmia. The instrument was a self-administered questionnaire, which included 19 different resources. The resources were categorized into seven main groups and the results were statistically analyzed with SPSS version 11.5 software. RESULTS: Based on the mean score of each of the seven main groups of resources, the ranking order of the resources was as follows: 1) immediate friends and peers 2) pictures, magazines, and books 3) audiovisual (CDs, foreign movies, satellite programs, and the Internet) 4) school trainings 5) physicians, clergy, and counseling centers 6) family (parents and siblings) and 7) close family members. The differences between the resources were statistically significant (P value= 0.0001). CONCLUSION: Results of the present study emphasize that teenagers should be educated in different areas of sexual problems with the help of parents, schools, and official sources and centers in the society as confident sources of obtaining sexual knowledge. There is a need to prepare a codified educational curriculum in different levels in order to offer teenagers' sexual education in the form of books or specific school credits.

Do mental health and self-concept associate with rhinoplasty requests?

SUMMARY: Considering the increasing tendency towards cosmetic rhinoplasty and conflicting data in this regard, and in order to assess the role of mental health and self-concept in rhinoplasty patients, this study was performed at Taleghani Hospital in Tehran during 2003-2004. This was a case-control study of 52 rhinoplasty patients admitted to the ear, nose and throat (ENT) and oral and maxillofacial surgery (OMFS) wards of Taleghani Hospital and 52 control subjects who were matched according to age, gender, marital status, economic state, education level and occupation with the former group. Data were gathered using the 'General Health Questionnaire-28' and 'Roger's Self-Concept questionnaire', and then were analysed by t, Pearson, Chi-square and Fisher's exact tests. The comparison of mental health (including the total score and the scores of subscales for depression, anxiety, somatic complaints, and social incompatibility) and self-concept between rhinoplasty patients and the control group has not been shown to be statistically different. It seems that there is no relationship between mental health, self-concept and the decision to undergo rhinoplasty. However, more elaborate studies are needed to bring the demographic, sociocultural and psychological factors into consideration.