Background and Aim: Bipolar disorder type 1 is a chronic, debilitating and recurrent disorder that is defined by specific periods of mania and this disorder causes a great deal of intrapersonal and interpersonal disorder. Overall, the present study aimed to investigate the effectiveness of dialectical behavior therapy based on emotion regulation skills training on impulsivity and how to cognitively regulate emotion in type 1 bipolar patients. Materials and Methods:The present study was based on quasi-experimental studies with pretest-post-test design with a control group. The statistical population of this study consisted of all male patients admitted to Razi Hospital in Tabriz in 2018. Purposeful sampling method was used to obtain a statistical sample (30 people); Also, to reduce the difference between the groups, the sample was randomly divided into experimental and control groups. In order to obtain the research data, Barthes Impulsivity Questionnaire and Gabreski Emotion Cognitive Emotion Regulation Strategies were used. To analyze the obtained data, multivariate analysis of covariance with SPSS-24 statistical software was used. Results:The results of statistical studies showed that dialectical behavior therapy had a significant effect (p <0.05) on improving impulsivity and cognitive emotion regulation strategies (except blaming others and refocusing on planning, accepting and adopting other perspectives) of bipolar patients. Conclusion:The findings indicated that dialectical behavior therapy based on emotion regulation skills training can be used to reduce impulsivity and cognitive emotion regulation in patients with type 1 bipolar disorder in combination with medication.

No abstract

Background. Suicide is recognized as a public health issue in Malekan County through a health community assessment. A community-based suicide prevention program was conducted during 2014-2017. Methods. This health system research was conducted in seven steps, including conducting systematic reviews, gathering expert opinions, improving the coverage of suicide attempt records, conducting research to identify regional risk factors, conducting follow ups and managing the individuals attempting suicide, training health gatekeepers, and launching public awareness campaigns. Our goal was to lower the rates of suicide, and suicide attempt by 15% and 20%, respectively. Multiple logistic regression was calculated to estimate the adjusted odds ratios and the 95% confidence intervals. Result. 821 suicide attempts and 32 suicides had been recorded in the county. 70% of the suicides had been committed by men while the majority of attempters were females (64%). Most of the suicides (18cases-56.25%) had occurred in the spring while the majority of suicide attempts (288cases-35.8%) had been recorded in the summer. The common methods (62%) suiciders used were hanging and poisoning, which increased death risk significantly (OR: 8.5, 95% CI: 2.9–76.99). The incidence rates of suicide and suicide attempts reduced from 11.22, and 203 per 100,000 in 2013 to 2.63, and 157 in 2017, respectively. Suicide re-attempts also diminished from 12% in 2013 to 6.7% in 2017. Conclusion. Suicide, SA, and re-attempt were lowered by 75%, 22%, and 42%, respectively. Practical Implications. The practical framework that emerged out of the present study can be used for generating future suicide prevention strategies. Furthermore, our study highlights the need to consider a wide range of contextual factors when developing suicide prevention programs.

Background. Primary health care system provides appropriate prevention and primary mental care services for the rural population, but not in urban areas. Therefore, the Community Mental Health Center (CMHC) was developed to provide mental health services in urban areas. The present study aimed to outline the performance, achievements and challenges of CMHC in one of the main cities in north west of Iran. Methods. This was a case study with in-depth interview approach. The outcomes, implications, and challenges of CMHC in Tabriz city of Iran were evaluated from 2015 to 2019 using three methods: 1) in-depth interviews with two executive managers, 2) focus group discussion with managers and mental healthcare providers, and 3) collection of mental health care indicators which was collected from patient health records. After the final evaluations, the challenges and appropriate recommendations were presented for improving mental health services in urban areas. Results. A total of 17 specialists and general medical doctors collaborated in conducting the study. During the study, 1053 initial visits and/or screenings, and 2313 patients with psychological disorders were identified and recorded. Moreover, a total of 988 mental training sessions were held for patients and their families. Five main themes, including the necessity for establishment and objectives, implementation process, achievements, challenges, and recommendations, with many sub-themes were identified during in-depth interviews and focus group discussions. Conclusion. It seems that CMHC is an appropriate strategy and model for providing basic mental health services, especially in metropolitan cities. Longitudinal studies with a randomized controlled trial design as well as cost-effectiveness evaluation studies are required to confirm CMHC in the Iranian context.