Papers by fatemeh ranjbar
BMC Pregnancy and Childbirth, Jan 13, 2023
Background Successful breastfeeding is related to the psychosocial conditions of the mother. Covi... more Background Successful breastfeeding is related to the psychosocial conditions of the mother. Covid19 pandemic resulted in psychological consequences in women during postpartum period. Maternal anxiety and distress reduce the chances of exclusive breastfeeding. The present study aimed to investigate the effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy (BSE) during COVID-19 pandemic. Method This randomized controlled clinical trial was conducted on 64 breastfeeding mothers referred to health care centers in Tabriz, Iran in 2021. Participants were assigned into the intervention and control groups in a ratio of 1: 1 using block randomization in a block size of 4 and 6. The intervention group participated in six individual 60-90 min sessions. Spielberger State-Trait Anxiety Inventory (STAI), postpartum distress (PMD), and BSE questionnaires were completed before and 4-week after the intervention by the control and intervention groups. Independent t-test and ANCOVA were used to compare the outcomes between two groups. According to the ANCOVA results by controlling the baseline values and after the intervention, the mean score of anxiety in the intervention group was lower than that in the control group [Adjusted Mean Difference (AMD): -13.82, 95%, confidence interval (CI): -12.35 to -15.29, (p < 0.001)]. Further, the mean score of postpartum distress after intervention was lower in the intervention group compared with that in the control group [AMD:5.31 95% CI: -3.00 to -7.37 (p < 0.001)]. After the intervention, the mean score of BSE in the intervention group was significantly higher than that in the control group [AMD: 25.57, 95% CI: 22.85 to 28.29 (p < 0.001)]. Stress management counseling can improve postpartum anxiety and distress and BSE and increase breastfeeding. However, more studies are needed for a definitive conclusion. Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N6. Date of registration: 15/09/2021.
The annals of clinical and analytical medicine, 2018
Aim: Women who experience severe distress during the process of childbirth might develop Post-Tra... more Aim: Women who experience severe distress during the process of childbirth might develop Post-Traumatic Stress Disorder (PTSD) with feeling the danger of death or severe trauma for the mother or the infant. Considering the changes in the diagnostic criteria of traumatic birth from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) to DSM-V and the adverse consequences of PTSD following childbirth, the present study was conducted. Material and Method: This cross-sectional study was conducted from February to July 2017 on 375 postpartum women who experienced traumatic birth based on the criteria of DSM-V [A] and referred to the health centers of Arak, Iran, between 42-60 days postpartum. Data gathering tools were demographic and maternal-neonatal characteristics questionnaire, the PTSD Symptom Scale-Interview for DSM-5 (PSS-I-5), Mackey Childbirth Satisfaction Rating Scale and Winefield & Tiggmann Social support questionnaire. Chi-square test, trend Chi test, independent t-test and multivariate logistic regression test, were used for data analysis.Results: The prevalence of PTSD following childbirth was 26.7%. Logistic regression results found that childbirth satisfaction (OR=0.97, 95%CI: 0.96-0.98, P<0.001), and support during and after delivery (OR=0.62, 95%CI: 0.26-0.91, P=0.004) significantly decreased risk of PTSD following childbirth and infant's restlessness (OR=3.04, 95%CI: 1.39-6.64, P=0.004) increased its risk. Discussion: Considering the high prevalence of PTSD following childbirth, designing appropriate interventions for improving labor experiences and enhancing support during and after delivery to prevent PTSD seems necessary.
BMC Pregnancy and Childbirth
Background Successful breastfeeding is related to the psychosocial conditions of the mother. Covi... more Background Successful breastfeeding is related to the psychosocial conditions of the mother. Covid19 pandemic resulted in psychological consequences in women during postpartum period. Maternal anxiety and distress reduce the chances of exclusive breastfeeding. The present study aimed to investigate the effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy (BSE) during COVID-19 pandemic. Method This randomized controlled clinical trial was conducted on 64 breastfeeding mothers referred to health care centers in Tabriz, Iran in 2021. Participants were assigned into the intervention and control groups in a ratio of 1: 1 using block randomization in a block size of 4 and 6. The intervention group participated in six individual 60–90 min sessions. Spielberger State-Trait Anxiety Inventory (STAI), postpartum distress (PMD), and BSE questionnaires were completed before and 4-week after the intervention by the control and int...
Schizophrenia
The Middle East is underrepresented in psychosis research. The ARAS recent onset acute phase psyc... more The Middle East is underrepresented in psychosis research. The ARAS recent onset acute phase psychosis survey (ARAS) is a longitudinal cohort across multiple centers in Iran, established to investigate characteristics, determinants and early course of psychosis in a non-Western, Middle East context. Here, baseline characteristics of the ARAS cohort are reported. The ARAS cohort enrolled patients with recent onset psychosis from September 2018 to September 2021 in East Azerbaijan, Kermanshah and Tehran, including Iranian patients from different sociocultural contexts. The baseline assessment included demographics, socioeconomic status, clinical (positive, negative, depressive symptoms) and psychosocial (religiosity, social support, self-stigma) characteristics, cognitive functioning, metabolic profile, substance use and medication use measured by validated questionnaires. These assessments will be followed up after one and five years. A total of 500 patients with a first episode of p...
British Journal of Nutrition
Major depressive disorder (MDD) is regarded as an inflammatory disorder. Gut microbiota dysbiosis... more Major depressive disorder (MDD) is regarded as an inflammatory disorder. Gut microbiota dysbiosis, observed in both MDD and obesity, leads to endotoxemia and inflammatory status, eventually exacerbating depressive symptoms. Manipulation of gut microbiota by prebiotics might help alleviate depression. The present study aimed to investigate the effects of inulin supplementation on psychological outcomes and biomarkers of gut permeability, endotoxemia, inflammation, and brain-derived neurotrophic factor (BDNF) in women with obesity and depression on a calorie-restricted diet. In a double-blind randomised clinical trial, forty-five women with obesity and MDD were allocated to receive 10 g/d of either inulin or maltodextrin for 8 weeks; all the patients followed a healthy calorie restricted diet as well. Anthropometric measures, dietary intakes, depression, and serum levels of zonulin, lipopolysaccharide (LPS), inflammatory biomarkers (TNF-α, IL-10, monocyte chemoattractant protein-1, to...
Background: Maternal anxiety during pregnancy is sometimes considered a normal mechanism to overc... more Background: Maternal anxiety during pregnancy is sometimes considered a normal mechanism to overcome the mother’s mental preoccupation with having a child. However, stress and anxiety might become a medical condition, becoming so severe as to affect the mother’s mental health. Therefore, the present study aimed to investigate factors related to maternal anxiety during pregnancy in women referring to prenatal primary care centers in Tabriz. Methods: The target population in the present cross-sectional study was the pregnant women referring to primary care centers affiliated with Tabriz University of Medical Sciences in 2018-2019 (n=533). Sampling was carried out using the random cluster technique (separately for municipal centers). The data were collected using the study tools, including a questionnaire on demographic data, prenatal anxiety screening scale (PASS), and researcher-made questions on maternal anxiety during pregnancy.Results: In the present study, 37.5% of pregnant women...
Journal of hayat, 2016
Article type: Original Article Received: Aug. 2015 Accepted: Dec. 2015 Corresponding author: Elna... more Article type: Original Article Received: Aug. 2015 Accepted: Dec. 2015 Corresponding author: Elnaz Asghari e-mail: asghari.elnaz@gmail. com Background & Aim: Studies have shown that family caregivers’ attitude toward mental illness affects their caring to mental patients and may reduce the quality of caring to them. This study aimed to determine the effect of group psychoeducation on attitude toward mental illness in the family caregivers of patients with bipolar disorder. Methods & Materials: In this randomized clinical trial study conducted in 2015, 74 family caregivers of the patients with bipolar disorder who had been hospitalized in the psychiatric wards of Razi hospital in Tabriz were selected by random sampling method. Then, they were randomly assigned into the experimental and control groups. The families of experimental group participated in 8 continuous 90-minute 2 times a week psychoeducational sessions. Family caregivers’ attitude toward mental illness was measured using...
Iranian Journal of Psychiatry, 2016
Objective: The aim of this study was to evaluate the effect of Premenstrual Syndrome (PMS) treatm... more Objective: The aim of this study was to evaluate the effect of Premenstrual Syndrome (PMS) treatment with selective serotonin reuptake inhibitor (SSRI) on treatment response of refractory hypertension of the patients. Method: This was a triple-blind randomized clinical trial conducted on female patients suffering from refractory hypertension and PMS at the same time. We obtained informed consent from 40 patients who had inclusion criteria and selected 20 patients for the intervention (sertraline 50 mg daily) and 20 for the control groups. The study period was five weeks. The mean of systolic and diastolic blood pressure before and after intervention was measured separately for each individual in each group and the mean of blood pressure of the members of the two groups were compared with each other. Results: The mean age of the participants was 43.60 ± 4.57. In this study, systolic and diastolic blood pressure of both groups reduced after intervention. The mean of systolic blood pre...
International Journal of Women's Health and Reproduction Sciences, 2017
Violence refers to any act that results in physical, sexual, or psychological harm or individual'... more Violence refers to any act that results in physical, sexual, or psychological harm or individual's suffering and it includes threats, coercion, and deprivation of freedom whether occurring in public or in private life. About 1/3 of women experience physical or sexual violence by an intimate partner (1). Domestic violence exists in all societies with varied prevalence rates. In a national survey conducted in 28 provinces of Iran, the reported prevalence of violence against women was 66% (2). However, we found no study on the prevalence of violence in women with psychiatric diseases in Iran. Adverse effects of domestic violence on health are the same around the world but may vary from short-term to long-term physical and mental effects, including anxiety, depression, post-traumatic stress, substance abuse to suicide, and violence-induced death There is an association between intimate partner violence (IPV) against women and mental disorders. A systematic review indicates a greater likelihood of IPV victimization in women across all mental disorders (5). In addition, women with mental illnesses are more vulnerable to violence. It increases duration and recurrence of the disease (6,7), as well as the likelihood of suicide attempts, substance abuse, noncompliance with treatment, and disruption of family and social relations (8,9). On the other hand, another systematic review showed that IPV victimization significantly increases the occurrence of most mental disorders like perinatal depression and anxiety (10). For example, a study in Turkey indicated significant relationships between violence against infertile women and mental health sequels including depression, anxiety, psychosomatic symptoms, homicide, and suicide (11).
BMC Pregnancy and Childbirth, 2021
Background Given the importance of screening pregnant women’s distress, it was intended to invest... more Background Given the importance of screening pregnant women’s distress, it was intended to investigate the psychometric properties of the Persian version of the Tilburg Pregnancy Distress Scale (TPDS-P) for screening pregnancy distress. Methods This methodological psychometric study was conducted with participation of 360 pregnant women. The TPDS was translated into Persian. Factor analysis was used to investigate the construct validity. The results of the correlation test between the results of the two questionnaires, Depression Anxiety Stress Scales-21 (DASS-21) and TPDS-P, were used to determine the criterion validity of TPDS-P. Internal consistency of the items was calculated by the Cronbach's alpha coefficient. Stability of the results was examined by test-retest method and Intra-class Correlation Coefficient (ICC) was calculated. Examining the structure of the factors derived from exploratory factor analysis, fitness of the model was done through confirmatory factor analys...
International Journal of Women's Health and Reproduction Sciences, 2017
Objectives: Considering the importance of breastfeeding and positive role of the quality of life ... more Objectives: Considering the importance of breastfeeding and positive role of the quality of life (QoL) of mothers in it, we intended to investigate QoL predictors. Materials and Methods: This cross-sectional study was conducted on 547 eligible breastfeeding mothers with infants, aged between 2 and 6 months, referred to health centers in Falavarjan, a city in Iran. Participants were selected randomly. The socio-demographic questionnaire and QOL Inventory of the World Health Organization (WHO) were completed through interview. The multivariate linear regression analysis was carried out to investigate the relationship of QoL with socio-demographic characteristics. Results: The mean score (standard deviation) of QoL was 67.6 (13.7) from a range between 0 and 100. According to the multivariate linear regression analysis, the variables of mother's age, spouse's age and job, economic status, gestational age at delivery, gravidity, tendency towards pregnancy, breastfeeding history, and breastfeeding training had relationship with QoL. Conclusion: Considering that the effects of socio-demographic factors on QOL in breastfeeding mothers can be moderated, it seems that the QOL of such mothers can be improved through extensive planning and supportive strategies by family and society.
Iranian Red Crescent Medical Journal, 2019
Background: Echium amoenum (E. amoenum) is an Iranian medicinal plant with mood-enhancing effects... more Background: Echium amoenum (E. amoenum) is an Iranian medicinal plant with mood-enhancing effects. Objectives: This study was designed to investigate the effect of standardized E. amoenum hydroalcoholic extract on restraint stress (RS)-evoked anxiety-and-depressive-like behaviors in mice.
Journal of Injury and Violence Research, 2020
Background: Burn injuries are most certainly stressful events, particularly when permanent disfig... more Background: Burn injuries are most certainly stressful events, particularly when permanent disfigurement is a result. Survivors of burn events are even more susceptible to psychological disorders compared to other groups. Purposes Present study was conducted to assess predictors of emotional distress and possible psychiatric morbidity in burn patients. Methods: This cross-sectional study was carried out on a total of 255 burn patients. In order to assess emotional distress and irrational beliefs, General Health Questionnaire (GHQ) and Scale for Irrational Thoughts after Burning (SITB) was used. To identify predictors of emotional distress, both bivariate and multivariate analysis method were conducted. In multivariate linear regression, forward strategy was used for building the model. Preliminary variable selection for model design was based on a P<0.2 and final decision for keeping the variables in the model was based on a P< 0.05. The results of bivariate analysis showed that gender, occupation, history of referral to psychiatrist, history of consumption depression drugs, percentage of Total Body Surface Area (TBSA) burned history of special disease; and also irrational beliefs and geographical areas had significant relationships with emotional distress. (P< 0.05) Using forward linear regression, gender, irrational beliefs, history of referral to psychiatrist, geographical areas, etiology of burning, environment, duration of burn, history of special disease, body location burned (face only, head and neck, private exposed) and intent of injury were significant predictors of the emotional distress. The models predicted 29 percent (p < 0.001) of emotional distress. Conclusion: Considering to possible psychiatric morbidity and development of facilities for screening is necessary. Moreover, consultation with mental health experts after burn injuries is highly recommended.
International Journal of Nursing Sciences, 2019
Objectives: This study aimed to identify coping strategies used by family caregivers of patients ... more Objectives: This study aimed to identify coping strategies used by family caregivers of patients with schizophrenia and their determinants. Methods: This was a descriptive correlational study. Participants were 225 family caregivers of patients with schizophrenia who were referred to the psychiatric clinic at one large teaching referral hospital in Iran. They were selected through purposive sampling method. Data collection tools were demographic and clinical data form, the Zarit Burden Interview (ZBI) and the Family Coping Questionnaire (FCQ). Results: The score of caregiver burden was 65.14 ± 9.17. Of 225 family caregivers, 23.11% used an avoiding coping strategy. There was a significant relationship between caregiver burden and coping strategies (P < 0.001). The regression model showed that adaptive coping strategies were significantly associated with some demographic characteristics including age, education level, gender, employment status, losing the job because of caregiving responsibilities, perceived income adequacy, duration of illness, duration of caregiving and caregiver burden (P < 0.05). Conclusion: Family caregivers of patients with schizophrenia experience a high level of burden, which can put them at risk of using maladaptive coping strategies. Mental health professionals should plan programs that support both family caregivers and patients in clinical and community settings.
Annals of Psychiatry and Treatment, 2016
The aim of this study was to investigate the psychopathology of parents of autistic children base... more The aim of this study was to investigate the psychopathology of parents of autistic children based on clinical personality disorders. In this is a cross-sectional study,130 parents of autistic children were selected from autism community rehabilitation centers in Tabriz, Iran and 154 parents of the mentally healthy children were selected as controls. Diagnostic interview based on DSM-IV-TR criteria was used to diagnose autism by two child and adolescent psychiatrists. The Millon Clinical Multiaxial Inventory-III (MCMI-III) was used to evaluate parents' personality profiles. The frequency of having personality disorders was higher in the parents of autistic children than controls (p<0.01).The most common psychiatric conditions among parents of autistic children were melancholic personality, persistent depression and negativism (44.6%, 29.2% and 25.4% respectively). Alcohol and substance use and antisocial personality were the least prevalent. Clinical patterns of personality disorders (avoidance, depressed, sadist, negativist, masochist), severe personality pathology (schizotypal, borderline, paranoid), clinical syndromes (generalized anxiety, somatoform, bipolar, persistent depression, PTSD), and severe clinical syndrome (thought disorder, delusional disorder) were higher in parents of autistic children than controls (p<0.05) and prevalence of histrionic personality disorder was lower (p<0.01). Parents of autistic children have higher rate of psychopathology. Another report showed that mothers of autistic children experienced higher stress and broader autism phenotype in comparison with the mothers of children without autism disorder. Controlling the severity of autism in children, parental stress and broader autism phenotype were the predictors of depressive symptoms in mothers .
Qualitative health research, 2018
The broad spectrum of problems caused by caring for a patient with mental illness imposes a high ... more The broad spectrum of problems caused by caring for a patient with mental illness imposes a high burden on family caregivers. This can affect how they cope with their mentally ill family members. Identifying caregivers' experiences of barriers to coping is necessary to develop a program to help them overcome these challenges. This qualitative content analysis study explored barriers impeding family caregivers' ability to cope with their relatives diagnosed with severe mental illness (defined here as schizophrenia, schizoaffective disorders, and bipolar affective disorders). Sixteen family caregivers were recruited using purposive sampling and interviewed using a semi-structured in-depth interview method. Data were analyzed by a conventional content analytic approach. Findings consisted of four major categories: the patient's isolation from everyday life, incomplete recovery, lack of support by the mental health care system, and stigmatization. Findings highlight the nece...
Bulletin of emergency and trauma, 2016
To determine the type and pattern of arrhythmic events following the 2012 Ahar-Varzegan Earthquak... more To determine the type and pattern of arrhythmic events following the 2012 Ahar-Varzegan Earthquake among patients implanted with cardiac defibrillators (ICDs) in East Azarbaijan province. In a prospective cohort study, conducted in East Azerbaijan Province of Iran, 132 patients were enrolled in two comparison groups according to the region of residence i.e., earthquake region (n= 98) and non-earthquake (n= 34) region in 2012. Data were collected for those meeting standard criteria for sustained ventricular arrhythmias (VAs), or supraventricular tachycardias (SVTs) and triggered ICD therapies, either shock or anti-tachycardia pacing (ATP). The state version of the State-Trait Anxiety Inventory (STAI-S) was used to assess general symptoms of anxiety in both groups. Males comprised 81.1% of the participants. Mean age of the participants was 59.7 ±15 years. The frequency of patients with sustained VAs increased significantly after the earthquake (=0.008). There were more VAs (mean 2.16...
Iranian Red Crescent Medical Journal, 2017
Background: More than half of sexual problems, which cause destruction of life and marital relati... more Background: More than half of sexual problems, which cause destruction of life and marital relations is due to insufficient knowledge and wrong health beliefs regarding sexuality. Genital self-image plays an important role in sexual health, genital appearance, and sexual function. Objectives: This study aimed to determine the effect of training package on genital self-image and sexual function in health centers of Qazvin, Iran. In this randomized clinical control trial, 124 Iranian women, between the ages of 18 -40 years, from Qazvin, were randomized into 2 groups, training and control. The intervention group received 3 training sessions weekly for 1 hour daily. Female Sexual Function Index (FSFI) and the genital self-image scale were completed before and 4 weeks after the end of intervention in both groups. P < 0.05 was considered as significant. Results: Between 2 groups, in terms of socio-demographic characteristics, there was no significant difference (P > 0.05). The mean (SD) score of genital self-image in the intervention group before and after intervention was 72.0 (11.4) and 75.7 (11.7), respectively. The mean (SD) score of genital self-image in the control group before and after intervention was 72.9 (12.3) and 75.7 (10.9), respectively. According to the ANCOVA test, there was no significant difference between groups at 4 weeks after intervention in terms of sexual function (mean differences: 0.8; confidence interval 95%: -0.6 to 2.3; P = 0.257) and genital self-image (mean differences: 0.5; confidence interval 95%: -3.3 to 4.4; P = 0.808). The results showed that training has no effect on the genital self-image and sexual function in women. The systematic planned training could be designed for those suffering from body image disorders and sexual dysfunction in order to promote their sexual function and body image.
Neuropsychiatric disease and treatment, 2017
The Derriford Appearance Scale 59 (DAS59) is a widely used measure of the spectrum of psychologic... more The Derriford Appearance Scale 59 (DAS59) is a widely used measure of the spectrum of psychological distress and dysfunction that is characteristic of disfigurement. Also, disfigurement due to burn injury leads to feeling guilty or less socially competent, avoiding social situations, suicide, poor self-esteem, sexual difficulties, and depression. Therefore, the purpose of this study was to translate and culturally adapt three subscales of DAS59 into Persian language and to investigate its factor structure for Iranian burned patients. Translation-back translation of the scale into Persian was done. The internal consistency of the translated scale was evaluated by Cronbach's alpha. Next, construct validity of the translated instrument was assessed by exploratory factor analysis using principal components and rotation of varimax methods. This research involved a convenience sample of 189 adult burned patients with disfigurement in their face, head, ears, neck, hands, and legs. The ...
Journal of caring sciences, 2016
Introduction: Medication nonadherence is highly prevalent in patients with bipolar disorders and ... more Introduction: Medication nonadherence is highly prevalent in patients with bipolar disorders and often results in worsening disease prognosis. The purpose of this study was to investigate the effect of group psychoeducation on medication adherence in female patients with bipolar mood disorder type I. Methods: This randomized controlled trial was conducted on 76 patients with bipolar mood disorder admitted in female psychiatric wards of Razi teaching hospital, Tabriz, Iran. The participants were selected by convenience sampling method and were randomly assigned to experimental and control groups. Patients in experimental group received 10 continuous 90 minutes sessions of psychoeducation, two times a week. Medication adherence was measured using the medicine check list and medication adherence rating scale (MARS) before and after intervention. Data analysis was performed with SPSS ver.13. Results: There was no significant difference between two groups regarding medication adherence b...
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Papers by fatemeh ranjbar