Opioid abuse is common in Iran. In 2005, a new version of locally produced illicit opioid vials, so called Norgesic, appeared in the illicit market, which gained popularity rapidly and led to an improvement of stigmatizing the general appearance of dependent cases. Later, some cases suffered Cushing's-like problems. A prospective case series was designed to evaluate 18 Norgesic-dependent subjects who volunteered for abstinence therapy in a rehabilitation clinic from November 1, 2005, to December 30, 2005. In this study, we aimed to describe the clinical and paraclinical findings in detail and define the potential determinants of this Cushing's syndrome outbreak. History, physical examination, plasma cortisol level, and urine screen tests were used to describe the patients. All subjects were male with a mean (SEM) age of 29.8 +/- 1.6 years. The opioid-dependence period was 8.4 +/-0.9 years. In an average of 4.7 +/- 0.3 months, subjects increased their usage to 5.5 +/- 0.5 vials a day. Patients claimed to gain weight. Striae were seen in 38.9%, previously documented psychological problems in 33.3%, weakness in 27.8%, high systolic blood pressure in 22.2%, moon face in 16.7%, hirsutism in 11.1%, extensive dermal infection in 11.1%, gynecomastia in 5.6%, back pain in 5.6%, insomnia in 5.6%, and lack of potency in 5.6%. Their cortisol level, on average, was 4.8 +/- 1.1 microg/dL. Hepatitis C virus was positive in 22.2%. Urine-screening tests were positive for morphine and negative for buprenorphine. In conclusion, these new vials contain steroids as well as opioids. This combination could be more dangerous than opioids themselves.

BackgroundSchools are ideal for promoting the mental health of school-age children, but the teachers' current knowledge is insufficient to play an influential role in mental health services at schools. Fortunately, however, teachers have a high sense of responsibility, interest, and talent to receive knowledge and the ability to participate in this field. This study aimed to examine whether a protocol focused on the role of teachers could identify, guide, and care for school-age children with behavioral and mental health problems.MethodThe current research was a “before and after” pilot quasi-experimental study conducted in three elementary, secondary, and high schools. The main intervention consisted of a 5-h workshop based on a ready-to-use booklet for teachers conducted separately in each school. A total of 58 teachers and 872 school-age children were included using a judgmental sampling technique.ResultsThe pre-and post-workshop mean scores of teachers' knowledge about common mental disorders in school-age children were 6.21 ± 4.58 and 12.50 ± 7.27, respectively. According to the Strengths and Difficulties Questionnaire (SDQ), the teachers made 127 referrals, of whom 102 school-age children had problems. Consultants diagnosed 114 school children who reflected 90% of all teachers' recommendations needing psychological care and counseling. Finally, only 50 diagnosed school-age children were followed up and attended therapy sessions at counseling centers. The sensitivity and specificity of this brief intervention in detecting school-age children with psychological problems were respectively 80.3 and 98.0%.ConclusionsThis study's results support teacher empowerment training's effectiveness in identifying and guiding school-age children needing mental health care. Psychological counseling programs in schools in various quantitative and qualitative dimensions, including responding to school-age children's needs and psychological problems, should be adequately evaluated, and appropriate measures should be taken to promote mental health services. Collaboration between health systems and the education department will increase the effectiveness of mental health programs' promotion and drug abuse prevention. These pilot data lead the way to designing scientifically sound follow-up studies that will concretely ascertain the benefit of this program.

Background: Familial psycho-education is a training model dedicated to providing essential information and educating families with a psychiatric patient to work with mental health professionals as part of a treatment plan for their ill family members. Objectives: Our aim of this study was to investigate the effectiveness of the family psychological didactic program as an adjunctive treatment to medication in hospitalized patients with schizophrenia to reduce negative and positive symptoms. Methods: In this clinical trial, we included 49 Iranian inpatients with a diagnosis of schizophrenia hospitalized at Shiraz Psychiatric Hospital from September 2016 to May 2017. They were randomly assigned to experimental (n = 24) and control (n = 25) groups. All groups were prescribed their usual pharmacological treatments. Additionally, in the experimental group, a psychological education intervention was planned for their families. This intervention consisted of six 90-minute sessions that lasted for three weeks. Before the intervention, after the intervention, and two months after the intervention, all subjects completed the Positive and Negative Syndrome Scale (PANSS). Results: This study was undertaken on 50 hospitalized schizophrenic patients. Most were male (72%). The mean PANSS scores at the pretest and posttest were 82.5 ± 12.594 and 84.72 ± 9.629 for the intervention group and 50.08 ± 11.477 and 51.92 ± 9.823 for the control group, respectively. Based on the ANCOVA, all groups showed the same decrease in the posttest PANSS score, although there was no considerable difference among the groups (F = 0.049; P = 0.825) in the posttest. Nevertheless, eight weeks after the completion of the intervention program, the severity of symptoms was significantly reduced in the intervention group compared to the control group. (F = 165.931; P = 0.001). Conclusions: The family psychological training intervention as an additional treatment for hospitalized patients with schizophrenia can increase the effectiveness of drug treatment. Of course, we must consider the small research sample when generalizing the results.