Background:Hemodialysis as a solution for patients with chronic renal failure is a stressful process. Anxiety and depression after hemodialysis could have negative impacts on quality of life, treatment and prognosis of the disease. Some studies indicated that educating patients prior to hemodialysis could enhance patients’ quality of life and increase the likelihood of their survival.Objectives:This study investigated psychological impacts of psycho education on anxiety and depression symptoms in patients under dialysis.Patients and Methods:This was a prospective, experimental intervention study with pretest and post-test. Eligible patients (n = 60) were selected randomly from dialysis center of Imam Khomeini Hospital in Sari in 2009. Hospital Anxiety Depression Scale (HADS) score of patients were eight or greater. They were divided into two matched groups. In one group, patients were given psycho education during three sessions of one-hour, while patients in the control group did not receive any education. HADS was completed for both groups before dialysis and one month after the end of educational sessions. The data were compared and analyzed using paired t-test and Chi-square test.Results:Psycho education decreased depression score (P < 0.001) and the HADS (P = 0.008) significantly. These decreases were not significant for anxiety scores of patients (P = 0.185).Conclusion:This research indicated that psycho education based on the designed protocol decreased the scores of depression and total scores of HADS.

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Methylmalonic acidemia (MMA) is the most common organic acidemia in Asian cases. We report a 14-year-old boy who was admitted to psychiatric clinic with affective symptoms. MMA was diagnosed after extensive laboratory tests. This emphasizes that even a typical psychiatric disorder can actually represent part of the spectrum of an underlying systemic disorder. MMA is an autosomal-recessive inborn error of metabolism. The incidence might be as high as 1 in 25,000. It is believed that this disease is more prevalent in the Middle East because of consanguineous marriages. MMA usually presents clinically with nonspecific symptoms such as seizure, poor feeding, loss of consciousness, psychomotor retardation. As a consequence, patients often undergo extensive work-up before the correct diagnosis is made. MMA is usually diagnosed in the first year of life. however, this report deals with a patient whose disease could not be diagnosed until the age fourteen.The most common phenotype features appear during infancy. Rare patients may present as adolescents or adults with CNS disease. Our patient had episodes of confusion and mood lability which could be related to metabolic decompensation episodes. When a patient has been labeled as having a psychiatric illness, other general medical conditions (especially rare diseases) might be ignored. This emphasizes that even a typical psychiatric disorder can actually represent part of the spectrum of an underlying systemic disorder.

Objective: Due to the high prevalence of anxiety and depression in parents of children with chronic diseases and also because of the high prevalence of asthma, the current study aimed at evaluating the relationship between the level of parental anxiety and asthmatic severity in children.Methods: It was a cross sectional study. Sampling was done continually among 134 parents of 5-to 15-year-old children with allergic asthma referred to allergy and asthma clinic in Sari, Iran, in autumn and winter 2013. To evaluate the parental anxiety and asthmatic severity in children, the Beck anxiety inventory and the global initiative questionnaire for asthma were used, respectively. To evaluate the relationship between parental anxiety and asthmatic severity in children, the Gamma and Kendall Tau test was used. Results:The Kendall Tau and Gamma test showed a significant relationship between the number of hospital admissions (P < 0.001) and asthma attacks in children with parental anxiety. These tests also demonstrated a relationship between FEV/FVC (forced expiratory volume/forced vital capacity) and Beck test scores of parents (P < 0.001). Conclusion:The results of the current study indicated a significant relationship between the intensity of anxiety in parents and severity of asthma in their children. Therefore, it is recommended that specialists do some interventions to control asthma better; and consequently control the parental anxiety better.

Context: Smoking in adolescence is a worldwide health problem. Understanding the prevalence of smoking and its clinical correlates in adolescent inpatients is useful for mental health staff to plan effective programs to reduce its detrimental consequences. In this study, we investigated the prevalence and correlates of cigarette smoking and its sociodemographic and clinical correlates. We performed a narrative review of cigarette smoking prevalence among adolescents as well as a descriptive study in inpatient adolescents in Iran. Evidence Acquisition: This was a multicentric, cross-sectional, and hospital-based survey. In total, 82 patients (male/female: 66.9% vs. 33.1%) were consecutively recruited from 5 child and adolescent inpatient psychiatric wards of Iran. The study data were collected from patients, their family members and patients' medical records. The descriptive statistics, Pearson's chi-squared test, and univariate logistic regression analyses were employed to analyze the obtained data. Additionally, we added a narrative review to understand the prevalence rate of smoking and its clinical correlates in adolescent inpatients. Results: The prevalence rate of smoking was 30% in our study sample (24.5% in boys and 39.5 % in girls). There was a significant association between smoking with family size, history of suicide attempt, physical illness, drug misuse in patients, and alcohol or drug misuse in family members. The prevalence of mood disorders in the nonsmokers and smokers were 37.5% and 62.5%, respectively. Overall, 26.6% of the subjects had a history of suicide attempt of whom, 52.9% were smokers. Conclusions: Results of this study about the association between smoking with family size, history of suicide attempt, physical illness, drug misuse, and other related factors, call for both careful screening of smoking and specially designed integrated psychiatric/smoking treatments in these patients.