Background: Family caregivers of patients with mental disorders play the most important role in the care of psychiatric patients (PPs) and preventing their readmission. These caregivers face different challenges in different cultures. We conducted this study to determine the challenges of caregivers of patients with mental disorders in Iran. Materials and Methods: This study is a narrative review with a matrix approach conducted by searching electronic databases, SID, IRANMEDEX, MAGIRAN, PUBMED, SCOPUS, Web of Sciences, from February 2000 to 2017. Searched keywords include challenges, family caregivers of psychiatric patient, family caregivers and psychiatric patient, mental illness, families of psychiatric patient, and Iran. One thousand two hundred articles were found in English and Farsi, and considering inclusion and exclusion criteria, 39 articles were examined. Results: The results of the studies show that not meeting the needs of caregivers, burnout and high burden of care, high social stigma, low social support for caregivers, and low quality of life of caregivers were among the most important challenges faced by caregivers. Conclusions: Despite the efforts of authorities in Iran, family caregivers of patients with mental disorders still face challenges. Therefore, the need for all-inclusive support for family caregivers of patients with mental health problems is necessary.

/pdf/challenges-of-family-caregivers-of-patients-with-mental-462aufae52.pdf

Challenges of family caregivers of patients with mental disorders in Iran: A narrative review

Objective: There are evidence-based practices in the field of family and patient psychoeducation for patients suffering from severe mental disorders. However, given the variation in resources and cultural contexts, implementation of these services, especially in low and middle-income countries is faced with challenges.

This study aimed to review articles on family and patient psychoeducation of severe mental disorders in Iran and to find the characteristics of the main components necessary for the implementation of such practices in clinical settings.

Method : All published studies on family and patient psychoeducation for severe mental disorders (schizophrenia, schizoaffective, and bipolar disorder) conducted in Iran were searched up to May 2018; and key features and findings of each study were extracted and presented.

Results: Forty-eight studies were included in this review, of which 27 were randomized controlled trials, and 20 were quasi-experimental. One study was an implementation and service development report. The main findings of these studies were a significant decrease in relapse rate and/or rehospitalization rate and a significant decrease of burden and distress of families.

Conclusion: Despite a wide diversity in approaches, this review showed that different psychosocial interventions in which psychoeducation is one of their core and main components have promising results, demonstrating the significance of this intervention in Iranian mental health research. In our opinion, based on evidence, even with limited resources, it is no longer acceptable to deprioritize some forms of psychoeducation for patients and their families in clinical settings.

/pdf/family-and-patient-psychoeducation-for-severe-mental-1dr1iebmyx.pdf

Family and Patient Psychoeducation for Severe Mental Disorder in Iran: A Review.

Objective: Bipolar disorder (BD) is a disabling psychiatric disorder with frequent recurrences. Besides pharmacotherapy, psychoeducation could be helpful in reducing symptoms as well as recurrence of this disorder, leading to improvement of patients’ quality of life. This study aimed at investigating the effectiveness of a culturally adjusted structured program for training Iranian BD patients. Method: In a 6-month course (spring and summer 2014), 24 BD patients, visiting the outpatient clinic of Ibn-Sina Hospital in Mashhad and experiencing euthymic phase, were allocated in to 2 groups of intervention and control. The intervention group received 8 sessions of psychoeducation in four weeks. Patients in the control group received the usual treatment. The patients were evaluated with Hamilton Depression Rating Scale, Young Mania Rating Scale, and Short Form 36 before the intervention and 4 weeks later, and the results were compared using independent t test. The patients were reexamined after 6 months for recurrence, hospitalization, treatment adherence, and visiting a psychiatrist, and were compared with patients in the control groups. Results: There was a significant difference in the intervention group in improvement in quality of life before and after treatment (p<0.003). In addition, the difference was significant between the 2 groups in the number of recurrence (p<0.001) and hospitalization (p<0.000) in 6 months. Conclusion : In addition to pharmacotherapy, psychoeducation of patients with BD can improve their quality of life and decrease the risk of disorder recurrence.

/pdf/effectiveness-of-psychoeducational-group-training-on-quality-20wo1uw4qq.pdf

Effectiveness of Psychoeducational Group Training on Quality of Life and Recurrence of Patients with Bipolar Disorder.

B ackground: The increase of hope and quality of life (QOL) can play a significant role in improving the mental health of drug addicts. Accordingly, the present study aimed to determine the effectiveness of positive thinking skills training on hope and QOL of drug-dependent people. Methods: The present study is a quasi-experimental research with pre- and post-test design with the control group. The study population consisted of all men dependent on drugs who visited addiction treatment centers in Tehran, Iran, in 2016. Thirty subjects were selected using cluster sampling and were randomly assigned to control and experimental groups. The results were analyzed using SPSS. Findings: The mean scores of pre-test and post-test for hope were 31.67 ± 6.47 and 49.68 ± 10.69, for physical fitness were 17.01 ± 4.21 and 22.84 ± 4.98, for psychological health were 15.36 ± 3.45 and 20.98 ± 3.32, for social relations were 7.80 ± 2.34 and 10.96 ± 2.64, and for environmental health were 20.47 ± 4.36 and 27.50 ± 4.80, respectively, in experimental group (P < 0.050). Conclusion: It is recommended that addiction treatment centers teach positive thinking skills to drug-dependent people in order to increase their hope and QOL.

http://ahj.kmu.ac.ir/article_84719_8549c00dad30f34d3565f1dc73fa14dc.pdf

Effectiveness of Positive Thinking Skills Training on the Hope and Quality of Life of Drug-Dependent People.

Background: Mood disorders related behaviors are imposed on family members and infl uence the family’s mental atmosphere and level of quality of life. Therefore, the researchers decided to study the effect of group psycho-educational program on the quality of life in families of patients with mood disorders. Materials and Methods: This is a two-group interventional study conducted on 32 members of families of the patients with mood disorders selected through random sampling. A group psycho-educational program was conducted in ten 90-min sessions (twice a week) for the study group. (World Health Organization’s Quality of Life-BREF WHOQOL-BREF ) questionnaire was adopted in the study and was fi lled before, immediately after, and 1 month after the intervention. Results: Independent t-test showed a signifi cant difference in the scores of quality of life in the domains of mental health, social communications, and environmental health, immediately after and 1 month after intervention in the study group compared to the control group. Repeated measure analysis of variance showed a signifi cant increase in the mean scores of quality of life in the study group. Conclusions: The results showed that the impact of group psycho-educational program is observed in the prevention of reduction in quality of life and its promotion in the families of patients with mood disorders.

/pdf/the-effect-of-group-psycho-educational-program-on-quality-of-dvzhi6px8k.pdf

The effect of group psycho-educational program on quality of life in families of patients with mood disorders

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M R Maraci

Papers

The effects of modified family psychoeducation on the relative's quality of life and family burden in patients with bipolar type i disorder