Background: The main objectives of this study were the translation, cultural adaptation, and assessment of the psychometric properties of the Persian version of Mini International Neuropsychiatric Interview (MINI). Methods: All processes of linguistic methodology were conducted according to the published guidelines. A total of 180 patients with psychiatric problems were interviewed using MINI and Structured Clinical Interview for DSM-5(R) - Clinician Version (SCID-5-CV) by different interviewers. Another 30 patients were selected for examining the test-retest reliability. The study sample was recruited from a psychiatric hospital and a general hospital in Tehran, Iran. Face validity, feasibility, time of the interview, test-retest reliability, and concurrent validity were evaluated. Results: Mean interview time was 19.76±10.30 minutes, indicating satisfactory feasibility. The test-retest reliability was very good (phi=2, Cramer’s V=0.89, P<0.0001). The kappa values showed good or excellent agreement between MINI and SCID-5-CV for psychotic disorders (0.88), substance-related disorders (0.86), bipolar disorder (0.85), major depressive disorder (0.84), obsessive-compulsive disorder (0.74), and mental disorder due to other medical disorders (0.7). However, the kappa values were found to be lower for generalized anxiety disorder (0.44) and posttraumatic stress disorder (0.32) diagnoses. Conclusion: The Persian version of MINI is a feasible, reliable, and valid instrument for diagnosing some mental disorders. Further research is needed to evaluate the validity of this instrument in other categories of psychiatric diagnoses in the general population.

Objective. Obsessive-compulsive disorder (OCD) is a frequent and disabling neuropsychiatric disorder with a lifetime prevalence of 3%. About 40% to 60% of patients show no or just partial symptom improvement to treatment with a first-line drug and cognitive behavior therapy. Ten percent of patients remain treatment refractory despite several treatments. For these patients, repetitive Transcranial Magnetic Stimulation (rTMS) has been suggested as a treatment option. Method. We investigated the efficacy of rTMS on the Supplementary Motor Area (SMA) in 16 right handed pharmaco-resistant OCD patients in an outpatient setting. The patients have been diagnosed with OCD by two psychiatrists and referred for rTMS intervention. Patients received 16 sessions of low frequency (0.5 HZ) rTMS on SMA,100% motor threshold, 1200 stimuli/day for 40 minutes every other day. OCD, depression, and anxiety symptoms were measured at baseline, 2, 6, and 12 weeks by Yale-Brown Obsessive Compulsive Scale(Y-BOCS) and Hamilton Depressive and Anxiety rating scales (HAM-D and HAM-A). We assessed the side effects of rTMS by a self-administrative questionnaire. Results. Patients’ scores in Y-BOCS, HAM-D, and HAM-A were significantly decreased following rTMS treatment. The baseline and 12 weeks scores of Y-BOCS were 28.94 and 18.31 (P-value < 0.01), HAM-D were 14.69 and 7.94 (P-value <0.01) and HAM-A were 16.38 and 6.94 (P- value < 0.01), respectively. The patients reported no serious side effects of rTMS except two case that reported light headach. Conclusion. This study showed that low-frequency rTMS on SMA improved OCD, anxiety, and depression symptoms after 16 sessions.

No abstract

AimDespite the significant evidence of the importance and high prevalence of functional neurological disorders (conversion disorders), these patients‘ referral pathway has not yet been fully explained and elaborated among different physicians. We aimed to determine the pathway to care for patients with functional neurological disorders (conversion disorders) in Roozbeh Psychiatric Hospital. The fact that misdiagnosis of conversion disease is common among neurologists and psychiatrists, and it will be harmful to both patients and mental health systems, this study would be helpful.MethodsIn this cross-sectional study, 101 patients attending the psychiatric clinic of Roozbeh Hospital in Tehran during 2019–20 due to symptoms of conversion disorder were studied. The probable diagnosis was based on the diagnosis of a non-psychiatric physician. We identified the psychiatric disease in these patients based on clinical symptoms; then the diagnosis was confirmed with another psychiatrist using the FNSS scale and taking history. Comorbid conditions were diagnosed by using clinical diagnosis. Then, a basic information questionnaire and an interview form were completed to determine the path of seeking treatment in a patient with a conversion disorder. All analyses ere performed in SPSS v26 software. To examine the qualitative variables, the relationships Chi-square test and Fisher exact Test were used. The quantitative variable distribution of ‘the time of onset to diagnosis’ was examined by the Shapiro-Wilk test. Due to abnormal distribution, the Mann-Whitney test and Kruskal-Wallis test were used to evaluate differences in the duration of illness between different groups. P-value was statically significant in p<0.05.Results101 patients (66.3% female, 55% married) with a mean age of 36.0 ± 12.98 years participated in this study. Most of them were family members of 4 and 5 and unemployed (40.8%). Most people were referred to a neurologist (38.6%) and a general practitioner (37.6%) at the first visit. The mean number of visits to the first therapist was 3.46 ± 2.94 times. Treatment was useless in 61.8% of patients. The most common symptoms were convulsive movements (15.8%), the most common comorbid disorders were major depressive disorder (44.4%). A significant amount of the patients (78%) were affected by different stressors, and among them, family quarrels were the most(17.1%). The disease duration had a statistically significant relationship with supplementary insurance, type of symptom presentation and associated mental disorder. There was a statistically significant relationship between generalized anxiety disorder with family quarrels and the death of a relative and between major depressive disorder and the death of a relative.ConclusionsIt seems that reaching patients with functional neurological disorders to a mental health professional is too late when they have spent a lot of time and money on unnecessary investigations and treatment. Irrelevant therapies and their adverse effects on the recovery and treatment of patients should be recognized, and it is essential to identify Solutions to improve them. Also, considering psychosocial factors is very important because 78 per cent of patients had a specific stressor before presenting the symptoms.