Razi Psychiatric Hospital Research Articles

Impact of Serum Folate and Vitamin B12 on Mental Health in Patient Admitted at Razi Psychiatric Hospital

Vitamin B12 (cobalamin) is one of the essential vitamins that affect various systems in the body, including the central nervous system and plays an important role in the metabolism of the nervous system, although its exact role under pathological conditions is not fully understood. The present study aimed to assessing vitamin B12 & serum folate in patient admitted at Razi psychiatric hospital. A cross section study subjects were inpatients with psychiatric disorder, patients from 21 to 60 years old. In this group of 40 psychiatric patients, there is no evidence of clinically relevant changes in serum vitamin B12 and folate level. Vitamin B12 deficiency can occur despite “normal” serum cobalamin levels; therefore, measuring homocysteine and methyl malonic acid can decrease false-negative findings.

Effects of transcranial direct current stimulation (tDCS) on positive and negative symptoms in patients with schizophrenia

Effects of transcranial direct current stimulation (tDCS) on positive and negative symptoms in patients with schizophrenia

Suicidal behaviors in mental illness: A case-control study. Suicidal behaviors in mental illness: A case-control study

IntroductionThe assessment of suicide risk remains a critical concern, especially within the psychiatric community. Mental health professionals continually work to identify and support individuals at risk, emphasizing the need for ongoing research and training in this area.ObjectivesThe objectives of our study were to understand the characteristics of patients hospitalized after a suicide attempt (SA), analyze the characteristics of these attempts, identify risk factors associated with suicidal behaviors, and determine predictors for recurring suicidal behavior.MethodsThe study’s methodology was retrospective, descriptive, and comparative. It was conducted with 277 patients hospitalized in the psychiatric department “C” of Razi Psychiatric Hospital in Manouba. The sample consists of 72 individuals who attempted suicide, divided into two groups: first-time attempters and recurrent patients, and 205 controls hospitalized for other reasons during the same period.ResultsResults showed a significant increase in the frequency of hospitalizations for SA, rising from 0.7% to 2.25% of the total admissions between 2018 and 2022. Those who attempted suicide were on average 32.5 years old, predominantly female, urban residents, with a moderate socioeconomic status, secondary or higher education, unemployed, unmarried, childless, and lacking strong family support.The study identified several risk factors associated with suicide attempts, including risky behaviors, previous life events, type II bipolar disorders, personality disorders, the number of psychiatric hospitalizations, and the quality of follow-up. However, schizophrenia was negatively correlated with SA.Suicidal recurrence was observed in 65.5% of attempters and was linked to personal psychiatric follow-up history, mood disorders, personality disorders, the presence of stress factors, and caustic substance ingestion.ConclusionsIn conclusion, the study underscores the importance of assessing suicide risk among individuals with mental disorders to implement appropriate prevention strategies.Disclosure of InterestNone Declared

Psychometric Properties of Cognitive Complaints in Bipolar Disorder Rating Assessment in Iranian Bipolar Patients

Background: Cognitive impairments are common in bipolar disorder, which can negatively impact patients' psychological and psychosocial functioning, but there are no tools for assessing cognitive deficits, especially in patients with bipolar disorder in Iran. Objectives: This study assessed the psychometric properties of the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) scale in Iranian patients with bipolar disorder (BD). Methods: Eighty patients diagnosed with bipolar spectrum disorder were selected from Tehran's major psychiatric facilities: Razi Psychiatric Hospital and Taleghani Hospital. A purposive sampling method was followed to select 80 non-patient control individuals from the general population in Tehran. Participants were evaluated using the Beck Depression Inventory-II (BDI-II), the Bech-Rafaelsen Mania Rating Scale (BRMAS), the Mini-Mental State Examination (MMSE), and the COBRA. The data were analyzed using SPSS-24 to evaluate convergent and discriminant validity, test-retest reliability, and internal consistency. Results: The convergent validity was examined by calculating the correlation between the scores on the COBRA and those on the MMSE; the results were significant (r = - 0.63, P < 0.001). Discriminant validity was assessed by comparing the COBRA total scores between the patients with BD and the control group; the results indicated a significant difference between the two groups (t = 6.413, P = 0.001). The CFA and EFA showed that the one-factor structure of COBRA was the best model. The Cronbach's alpha of 0.72 indicated an internal consistency. A test-retest reliability estimate of 0.84 indicated the high reliability of the scale. The current investigation suggested a cutoff score of 28, with 0.72 sensitivity and 0.69 specificity. Conclusions: Our translated version of the COBRA in Persian in this study showed adequate psychometric properties. This test can be considered an applicable instrument in investigating cognitive complaints in patients with bipolar disorder in Iran.

Comparison of Caregivers' Burden among Family Members of Patients with Severe Mental Disorders and Patients with Substance Use Disorder.

Objective: The burden on caregivers of patients with severe mental disorders is significantly higher than the care burden of patients with other medical conditions. Substance use disorder is also one of the most common psychiatric disorders that has negative effects on people's quality of life. This study was designed to investigate caregiver burden in severe mental disorders versus substance use disorder. Method : First-degree relatives of patients admitted to the Razi Psychiatric Hospital of Tehran with a diagnosis of schizophrenia, bipolar disorder type1, schizoaffective disorder, or substance use disorder entered this study. They completed the sociodemographic questionnaire for patients and caregivers and the Zarit burden interview for caregivers. Results: Our study shows that caregiver burden in substance use disorder has no significant difference with that in severe mental disorders (P > 0.05). In both groups, the highest spectrum of burden was moderate to severe. To find caregiver burden related factors, a general linear regression model with multiple predictor variables was fitted. In this model, caregivers' burden was significantly higher in patients with comorbidity (P = 0.007), poor compliance (P < 0.001), and in female caregivers (P = 0.013). Conclusion: Statistically speaking, the caregiver burden in substance use disorders is as severe as other mental disorders. The considerable burden on both groups necessitates serious efforts to minimize its negative effects.

The relationship between coping styles and family burden in chronic schizophrenic and bipolar type I patients’ caregivers

BackgroundCaregivers play an essential role in caring of patients with psychiatric disorders. It is important to focus on family burden and coping styles of chronic psychiatric disorders’ caregivers. In this survey, the aim was to measure coping styles’ of schizophrenic and bipolar type I patients’ caregivers, their burden and its relationship between these scales. In this cross-sectional study, 100 main caregivers of patients (50 schizophrenic patients, 50 bipolar type I patients) from both Razi psychiatric hospital were enrolled in the study in 2014. The instruments were family burden interview schedule (FBIS) and Weintraub coping orientations to problems experienced (COPE). Chi-square, Pearson correlation coefficient, and independent t-test were used for data analysis.ResultsThere was inverse correlation between burden and problem-focused coping strategy about caregivers of both groups (r = − 0.29, P < 0.01). There was a direct correlation between burden and emotional-oriented and less benefit and not effective coping strategies, but it was not significant. The independent t-test demonstrated caregivers’ burden is not significantly different between bipolar mood disorder and schizophrenia.ConclusionsSocial support and health services to caregivers of chronic schizophrenia and bipolar disorder are necessary. Training effective coping style reduces perceived caring burden.

The process of stigma experience in the families of people living with bipolar disorder: a grounded theory study

BackgroundOne of the most challenging issues faced by families of people living with bipolar disorder is stigma. This study was conducted to explain the process of stigma experience in the families of people living with bipolar disorder using the grounded theory method.MethodsData for this study were collected through semi-structured interviews with participants in Razi Psychiatric Hospital in Tehran, Iran, via purposive sampling and field notetaking. The dependability, conformability, and transferability measures were included to support the data accuracy and robustness, and MAXQDA 2020 software was used to facilitate data coding. The Strauss–Corbin method was used to analyse the data.ResultsA total of 20 family members of people living with bipolar disorder, four people living with bipolar disorder, and three mental health professionals participated in this study. The analysis of participants’ experiences led to identifying 64 subcategories, 21 categories, and six main concepts, including social deprivation, being labelled, cultural deficiency and lack of awareness, economic challenges, forced acceptance of the existing situation, and social isolation.ConclusionFamilies of people living with bipolar disorder experience social deprivation, social isolation, and social rejection, which have irreparable consequences for them. Overcoming stigma in these families should be a priority of policymakers and planners in the field of psychosocial health.

Relationship of Health Status and Micronutrients Level With Nutritional Status of the Elderly With Psychological Disorders

Objectives Elderly with psychological disorders are at risk of malnutrition. Investigating the nutritional status and identifying the effective factors among the preventive and control measures. This study aims to investigate the nutritional status and its relationship with health status and micronutrients level in older people with psychological disorders. Methods &amp; Materials In this cross-sectional survey, 101 older people admitted to Razi Psychiatric Hospital in Tehran, Iran in 2018 participated. The data were collected after blood sampling and assessing body mass index (BMI) using a demographic form, the Mini Nutritional Assessment tool and a health status questionnaire. The collected data were analyzed by the chi-square test, ANOVA and logistic regression analysis in SPSS v. 21. Results Almost three-quarters of the participants had an abnormal nutritional status. The results showed that the nutritional status of participants had a significant relationship with dental health status, physical activity, the serum levels of vitamin D and vitamin B12, and BMI (P&lt;0.05). After logistic analysis, vitamin B12 level (OR=1.007, 95% CI: 1.002-1.012), physical activity (OR=8.539, 95%CI: 1.142-63.85) and dental health status (OR=23.119, 95%CI:1.401-38.788) were reported as the predictors of nutritional status. It was reported that 95% of the elderly had vitamin D deficiency. Conclusion Most of the elderly with psychological disorders are at risk of malnutrition or have malnutrition. The identified predictors of malnutrition for this group are modifiable. Therefore, regular screening and nutritional management should be strengthened for their therapeutic interventions.

Bipolar disorder and grey matter heterotopia : a case report

IntroductionThe grey matter heterotopias are a relatively common group of conditions characterized by interruption of normal neuronal migration from near the ventricle to the cortex. Subependymal grey matter heterotopia, also known as periventricular heterotopia, is the most common form.ObjectivesTo search a link between bipolar disorder and grey matter heterotopiaMethodsA case report of a woman with grey matter heterotopia who is diagnosed as bipolarResults A 34 year old woman was admitted at Razi psychiatric hospital 3 months after childbirth. She was agitated, logorrheic with multiple projects and insomniac. The diagnosis was a manic episod with a marked score of 28/44 at The Bech-Rafaelsen Mania Scale (MAS). The patient was treated with 4 mg of risperidone and 1000 mg of sodium valproate with partial remission after two weeks. One month after her discharge, she had depressive mood, asthenia, anhedonia and insomnia. She had a score of 19 at Hamilton Depression Rating Scale (HDRS). She was switched from risperidone to olanzapine 15mg/j with partial remission after two weeks. In front of persistent symptoms with labile mood, she took lithium 1000 mg/j. She was complaining of a headache and a fluctuating heaviness of the right upper limb. At brain imaging, she had periventricular nodular heterotopia. The patient was adressed to neurology department.ConclusionsGrey matter heterotopia can cause a variety of neuropsychiatrc symptoms which can lead to diagnosis difficulties. Therefore, in front of atypical symptoms or drug-resistance, patients should be referred for brain imaging.DisclosureNo significant relationships.

Misdiagnosis and therapeutic impasse in psychiatry

IntroductionWe frequently receive patients with atypical psychiatric symptoms admitted in our department after consulting other psychiatrists and triying several treatments.ObjectivesTo highlight the factors of misdiagnosis in patients of our department.MethodsWe recruited 70 patients during their appointment or during their hospital admission in our department between March and April 2021. We collected the patients’ socio-demographic and clinical data using a pre-designed questionnaire.ResultsPatients were aged between 17 and 68 years with a sex ratio (M/F) of 1. Mood disorders accounted for 24.6% of disorders (N=17) whereas schizophrenia 66.7% (N=46). Patients resided in urban areas in 88.6% of cases (N=69). The average number of hospitalizations was 2.7 with extremes ranging from 0 to 14. The average time between the onset of the symptoms and the first consultation was 1 year. The mean time from onset to hospitalization was 4.37 years. The rate of consulting a psychiatrist prior to admission was 42.8%. The diagnosis was corrected during the follow-up of the patients in 24.3% of cases. Conventional neuroleptics were prescribed as first-line treatment in 42.85% of cases. Due to poor tolerance or ineffectiveness of the treatment, 31.42% of patients had to change treatment.ConclusionsPatients, who were desperate to find an adequate treatment for their disorders, put a lot of hope in the Razi psychiatric hospital. But after several years of evolution of their disease, we are faced with a therapeutic impasse. Raising awareness of mental illnesses is necessary for an early and adequate treatment.DisclosureNo significant relationships.

Women’s access to mental health care in Tunisia

IntroductionTunisia is viewed as an advanced country in terms of women’s rights in the Arab world. However, women are more exposed than men to many specific risk factors which greatly contribute to threaten their mental health.ObjectivesThe main objective of this study was to find out the sociodemographic and clinical profiles of women admitted in Razi psychiatric hospital and their access to mental health services.MethodsA cross sectional and descriptive survey was conducted between March and April 2021 in the department of psychiatry D of Razi Hospital including 40 female inpatients.ResultsThe majority of patients had low (37.1%) to moderate (61.9%) socio economic status, with primary education (40%), secondary education (20%) and higher education (28.6%). The majority was unemployed (68.8%). A significant difference was observed between adherence to treatment and family support (p=0.04). It was mainly the father or the husband who was taking care of the patient in 50% of cases. The first psychiatric consultation was 2.68 years after having symptoms. Hospitalization was about 4.94 years later. Twenty five percent of them have seen a tradipractioner before consulting. About 46.87% of patients had conflicts with a member of her family and 15.62% of them were victims of either domestic or family violence. The main diagnoses were mood disorders (31.4%) and schizophrenia (42.9%) Time between symptoms onset and hospitalisation was significantly associated with socioeconomic status (p=0.047) and cultural beliefs (p=0.026).ConclusionsThe protection of women’s mental health is not only a medical challenge but also a cultural and political one.DisclosureNo significant relationships.

Uric acid levels among Tunisian patients with bipolar disorder during different phases of illness

IntroductionBipolar disorder is a recurrent chronic disorder characterised by fluctuation of mood state. Recent studies focused on the involvement of adenosine and the purinergic system in the pathophysiology of bipolar disorder.ObjectivesWe aimed to investigate the difference in (SUA) levels between different phases of relapse and remission period.MethodsFor this aim a prospective study was conducted during six months at Razi psychiatric Hospital in Tunisia with patients diagnosed with BD The socio-demographic, clinical data were gathered from patient and a psychometric assessment using YMRS and Beck scale was employed. Uric acid level was studied during relapse and remission period.ResultsAmong 30 consentent patients included in the study : 65.7% were women, The age of the participants varied between 22 and 65 years old. Uric acid level at the relapse varied between 328 and 499 mmol/L and level of controlled value at the remission period which is eight weeks under treatment varied between 137 and 307 mmol/L. Patients under antipsychotic treatment were 55.9% the other were under lithium or mood stabilizer. There is no significant difference between patients with bipolar disorder type I or II neither for the molecule chosen for treatment (p&lt;0.05).ConclusionsBipolar disorder is a chronic psychiatric disease which needs to be regulary controlled. Uric acid levels were higher in manic or depressive phases as compared with euthymia phase. Uric acid could be used as a trait marker in bipolar disorder and help psychiatrist to monitor patients and to adjust treatment in order to avoid relapsing.DisclosureNo significant relationships.

Effect of low-level laser therapy (LLLT) on cognitive impairment among patients with chronic schizophrenia: a double-blind randomized placebo-controlled clinical trial.

Low-level laser therapy (LLLT) is a noninvasive technique used in different medical fields. It has been applied in different medical areas such as wound healing, traumatic brain injuries, neurological disorders, cognitive disorders, Alzheimer's disease, pain, and arthritis, with different results. We studied the effectiveness of LLLT on cognitive impairment in patients with chronic schizophrenia. A randomized controlled double-blind clinical trial was performed in a men's chronic treatment center, in Razi Psychiatric Hospital, in Tehran, Iran. We screened the cognitive impairment by Mini-Mental State Examination (MMSE). Positive And Negative Syndrome Scale (PANSS) was also used to assess the patients' positive and negative symptoms. Seventeen consenting patients were randomly allocated to the treatment arm, and 15 to the sham treatment control arm. The mean age of the control and treated patients was 49.47 ± 6.99 and 50.24 ± 7.69, respectively. No significant difference in PANSS and MMSE test scores was detected in both groups after the 6th session and after 2months of follow-up after laser therapy. The positive and negative scales and agitation and excitement levels did not change significantly in either group. Nevertheless, the depression/anxiety subscale in the PANSS test showed a significant reduction after 6 sessions but did not persist after 2months. No improvement in cognitive impairment or the positive and negative symptoms was detected after LLLT in patients with chronic schizophrenia. Trial registration: IRCT 20210520051349N1.

DNA Banking to Assess Genetic Influences on Schizophrenia.

Background: Schizophrenia is among the most prevalent psychiatric disorders globally, with a lifetime prevalence rate of 0.3% to 0.7%, characterized by the heterogeneous presence of positive, negative, and cognitive symptoms that affect all aspects of mental activity. We aimed to describe the genetics of schizophrenia to widening our understanding of the inheritance of this illness. Methods: This quasi-experimental study was conducted in Razi psychiatric hospital in Tehran province, Iran. Recruitment of the study samples was conducted in Tehran, Iran, among patients with schizophrenia and their families. For this purpose, individuals with schizophrenia in 40 families with at least 1 to 2 affected members were identified and selected based on a clinical interview conducted by a psychiatrist and according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. The clinical and paraclinical data, drug and substance usage, and medical treatments were collected through a standardized clinical questionnaire. Besides, the Global Assessment Scale and the Positive and Negative Syndrome Scale were completed for all study participants. Results: A total of 22 families had a negative family history, and 1 affected member and the rest of the studied families had a positive family history and at least 2 affected members. In addition, genealogical data (family tree) and lymphoblastic cell categories were developed to examine genes, and subsequent research results will be reported in the future. Conclusion: As the research continues, the approach to sampling must be modified to ensure that the deoxyribonucleic acid bank is as extensively representative as possible of all schizophrenia cases.

An Innovative Appraisal of Psychopathology in Extant Criminological Psychiatry

Saeed Shoja Shafti* Author Affiliations Professor of Psychiatry, Razi Psychiatric Hospital, Tehran, Iran Received: June 16, 2021 | Published: July 01, 2021 Corresponding author: Saeed Shoja Shafti, Professor of Psychiatry, Razi Psychiatric Hospital, Tehran, Iran DOI: 10.26717/BJSTR.2021.36.005923

Elderly criminal patients in Razi psychiatric hospital of tunis

IntroductionCriminality has become of increasing concern in the practice of psychiatry. However, violence among elderly psychiatric patients is an underestimated and understudied phenomenon.ObjectivesThe aim of the study is to identify differences in the socio-demographic, clinical and criminological profiles between elderly criminals under treatment for psychiatric disorders and those not known to have mental disorders prior to the criminal offense in Tunisia.MethodsWe present a retrospective study on twenty male criminal mental patients, aged sixty years or older, who were hospitalized in the Forensic Psychiatry Department of Razi Hospital during 18 years, following a dismissal for insanity under Article 38 of the Penal Code and Article 29 of Law 92/83 on Mental Health.ResultsPrevalence was higher among elderly criminals without a known psychiatric history (2.42% versus 1.98%). The average age was roughly the same, around 73 years old.Neurological and cardiovascular histories were the most common in both groups. The criminal act was indicative of dementia in 8 cases. Criminal history was more frequent in elderly patients with a personal psychiatric history (55.5% versus 18.2%). Patients whose act was revelatory of their mental disorder committed more violent crimes (63.7% versus 44.4%) using blunt objects (71.4% versus 0%).The victim most often belonged to the aggressor’s family, particularly the spouse (87.5%).ConclusionsScreening for criminal risk factors in the elderly, early diagnosis of mental disorders and a comprehensive therapeutic project are necessary to prevent the risk of violent behaviour.

Medical Comorbidity in Elderly Schizophrenic Patients: A Preliminary Study in Iran

Background: While comorbidity between mental disorders and physical illnesses is the rule rather than an exception, appraising the impact of comorbidity is challenging due to lack of consensus about how to define and measure the concept of comorbidity. Objective: The aim of the present evaluation was to appraise the prevalence and features of medical comorbidities among a group of native elderly schizophrenic patients. Methods: Geriatric unit of Razi psychiatric hospital was selected as the field of investigation and 168 elderly schizophrenic patients (≥65 years old), including 101 males and 67 females, who have been hospitalized there as chronic cases, were chosen as an accessible sample, and were surveyed with respect to existing comorbid medical disorders. Psychiatric diagnosis was based on ‘Diagnostic and Statistical Manual of Mental Disorders’, 5th edition (DSM-5), and the medical diagnosis was based on ‘International Classification of Diseases’, 10th edition. Results: As shown by the results, 89% (n=151) of elderly schizophrenic patients had some kind of registered physical co-morbidity, which was more significant than the frequency of medical comorbidities among native senior citizens. Amongst the listed co-morbidities, falls, hypertension and osteoarthritis were the most prevalent comorbidities with a frequency of around 48.8%, 44.6% and 39.2%, respectively. Hypertension, renal disease and malnutrition were significantly more prevalent among male patients (p&lt;0.0000, p&lt;0.0045 and p&lt; 0.0018, respectively) and hyponatremia, aspiration/ asphyxiation and seizure were meaningfully more prevalent among female patients (p&lt;0.0075, p&lt;0.0000 and p&lt;0.0009, respectively). As stated by the findings and in comparison with the native seniors, while diabetes, renal diseases and malnutrition were significantly more frequent, coronary artery disease, gastrointestinal disorder and osteoarthritis were significantly less frequent in the existing sample of elderly schizophrenic patients. Conclusion: In comparison with the native senior people, the rate of medical comorbidities, particularly diabetes, renal diseases and malnutrition, was significantly higher in elderly schizophrenic patients, a significant difference, was observed regarding physical comorbidities between male and female patients, which demands further methodical and gender-based studies for defining more appropriate care.

Clinical Profile of Mortality among Chronic Schizophrenic Patients: A Local Pilot Survey in Iran

Background: Many scholars believe that mental disorders may increase the risk of mortality among psychiatric patients in comparison with ordinary people. Unfortunately, since there is no systematic psychiatric case register system in Iran, a precise study of the rate of mortality of psychiatric patients in Iran is not easy. Objective: The objective of the current study included estimation of the rate of mortality and clinical profile of the died patients in a group of non-western aged schizophrenic patients. Methods: Senior section of Razi psychiatric hospital was selected as the specific field of investigation, and all elderly schizophrenic patients (≥65 years old), who had been hospitalized there, were nominated as the accessible sample and estimated with respect to the objectives of the present assessment. For survey, all deaths in the said district, which had occurred throughout the last sixty months (April of 2014-August 2019), had been listed by the supervisor of the mortality committee of the hospital. The clinical diagnosis was based on ‘Diagnostic and Statistical Manual of Mental Disorders’, 5th edition, criteria. Results: Among 840 chronic elderly schizophrenic patients, 69 deaths were registered by the mortality committee of the hospital. As evident by the results, the annual rate of mortality among elderly schizophrenic patients in the present assessment was around 0.015 (0.15 per 1,000 individuals per year) and 0.017 (0.17 per 1,000 individuals per year) among male and female aged patients, respectively, which was significantly lower than the native crude death rate. While the average age of the expired female patients was significantly longer than male cases, the life expectancy of both male and female patients was significantly shorter than the life expectancy of native people. Besides, while among the present sample of old schizophrenics cardiac disease was the main leading cause of death, other causes, like violence, suicide, road traffic accidents, falls, fires, drug use, tuberculosis, drowning, epilepsy, and Parkinson’s disease were not liable at all. Conclusion: While the rate of mortality among aged schizophrenics was significantly lower than the native crude death rate, the age of the expired female patients was significantly longer than the male cases and the life expectancy of both male and female patients was significantly shorter than the life expectancy of native people. Cardiac disorder was the leading cause of death among the present sample of aged schizophrenics.

Medication-precipitated Seizure in Psychiatric Patients: Typical vs. Atypical Antipsychotics

Backgrounds: It is unknown whether second-generation antipsychotics are safer than first-generation antipsychotics in terms of seizure induction. Objective: In the present assessment, the relationships between the incidence of seizure attacks among a great sample of non-western psychiatric inpatients and prescribed typical and atypical antipsychotics have been probed and analyzed based on the existing data in the literature. Methods: Razi psychiatric hospital, as one of the largest and oldest public psychiatric hospitals in the Middle East, had been selected as the field of study in the present retrospective estimation. For assessment, all inpatients that had suffered a seizure during the last sixtyfour months had been included in the current study. Results: Among seventy-four patients who had experienced seizure attack during the inpatient management, and had been prescribed antipsychotics for symptomatic management of primary psychiatric disorders, 67.56% had received atypical antipsychotic and the remaining (32.43%) had received typical antipsychotics, which revealed a significant quantitative difference between them (p&lt;0.000). Among atypical antipsychotics, olanzapine was the most recommended antipsychotic (33.78%), followed by risperidone (34%), quetiapine (9.45%), and clozapine (n=1, 1.35%). Among typical antipsychotics, too, haloperidol (28.37%) was significantly more prescribed than chlorpromazine (2.70%) and thioridazine (1.35%) (p&lt;0.000). By the way, there was no significant difference, quantitatively, between olanzapine and haloperidol in the present evaluation (p&lt;0.47). Conclusion: Atypical antipsychotics have comparable potentiality, as typical antipsychotics, for triggering seizure attacks, which demands indispensable cautiousness by clinicians when prescribing such a group of medications for epileptic and neuropsychiatric patients.

Local Estimation of Rate and Clinical Outline of Mortality in Old Schizophrenics

Introduction: Researchers have consistently reported that people with mental disorders have elevated mortality compared with the general population. In Iran there are not systematic psychiatric case registers that could allow us to study precisely the mortality of psychiatric patients. The aim of the current study was to determine the mortality rate and clinical profile of death in a group of non-western chronic elderly schizophrenic patients. Methods: chronic geriatric subdivision of Razi Psychiatric hospital with a capacity around 220 beds (110 for each of male and female elderly patients) had been selected as the specific arena of investigation. For the present retrospective survey, all recorded deceases during the last sixty months (April of 2014-August 2019) in the said senior wards had been included in the current study. Clinical diagnosis, too, was essentially based on ‘Diagnostic and Statistical Manual of Mental Disorders’, 5th edition (DSM-5). Results: Among eight-hundreds and frothy chronic elderly schizophrenic patients, sixty-nine deceases had been registered by the mortality committee of the hospital. As said by results, the annual rate of mortality among elderly schizophrenic patients in the present assessment was around 0.015 (0.15 per 1,000 individuals per year) and 0.017 (0.17 per 1,000 individuals per year) among male and female aged patients, respectively, which were significantly lower than current native crude death rate (p&lt;0.000). While the age of the expired female patients was significantly more than the died male schizophrenics (p &lt; 0.001), the life expectancy of both male and female expired patients was significantly shorter than the public’s life expectancy (p&lt; 0.000). Besides, in the present evaluation, while cardiac illness was the main leading cause of death among old schizophrenics, reasons like suicide, falls, drug use or tuberculosis, were not applicable at all. Conclusion: While the rate of mortality among elderly schizophrenics was significantly lower than public’s crude death rate, age of the deceased female patients was significantly longer than the male expired patients and life expectancy of both male and female died patients was significantly lower than native public’s life expectancy. Cardiac disorder, as well, was the main leading cause of death among aged schizophrenic patients.