Seyed Kazem Malakouti

Iran University of Medical Science, Teheran, Tehrān, Iran

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Publications (26)26.43 Total impact

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    Maryam Pourshams, Seyed Kazem Malakouti
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    ABSTRACT: Zolpidem is a non-benzodiazepine hypnotic drug for treatment of insomnia. It has been introduced as a lower potential agent for dependency and abusive effects.Case summary: In this study, the reported case was a 62 years old female patient suffering simultaneously with Major Depressive Disorder and Opium Dependency. After abrupt discontinuation of zolpidem, 570 mg per day, she exhibited severe withdrawal symptoms, led her to be admitted to emergency department.
    Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences. 07/2014; 22(1):54.
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    ABSTRACT: Abstract Background and Objectives: Previous suicide attempt is the most important predictor of death by suicide. Therefore preventive interventions after attempting to suicide is essential to prevent reattempts. This study to answer the question that “whether phone preventive interventions or other reminders (e.g. postal cards, email, case management, etc.) are effective in reattempts after discharge” by providing an overview of studies related to suicide reattempts. Methods: This is a comprehensive review of the studies using the main scientific databases. Results: The research investigated in this review has been conducted from 1995 to 2014. A total of 23 cases related to the objective of this research were derived from 33 English articles with the aforementioned keywords. In summation, research shows that providing comprehensive aids, social support and follow-up after discharge can significantly prevent suicide reattempts. Interpretation and Conclusions: Most patients surviving one suicide attempt reattempt particularly a short time after discharge. Most suicides occur during the first month after discharge with a sudden increase during the first week. This rate is more than a hundred times in public population. Therefore it is essential to persist and maintain follow-up treatments. Several studies have shown that follow-up support (phone calls, crisis cards, mails, postal cards, etc.) after discharge can significantly decrease the risk of suicide. More random controlled trials (RCT) are required to determine what factors of follow-up are more effective than other methods. Keywords: fallow up, suicide attempt, telephone contact
    Jokull 05/2014; 64(5):173-183. · 1.00 Impact Factor
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    ABSTRACT: Major depression is a common disorder with great social and individual burdens. Transcranial sonography (TCS) is a useful and noninvasive measure for assessment of normal and impaired brain parenchyma. The brainstem raphe nuclei are in close association with dorsocaudal limbic system and plays an important role in depression. In this study we compared the echogenicity of the raphe nuclei in patients with major depressive disorder and the control group.
    Medical journal of the Islamic Republic of Iran 01/2014; 28:9.
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    ABSTRACT: Objective: Providing treatment and educational services for consumers and their caregivers is more effective if those services are implemented based on their characteristics and differences. To partly address this objective, the present study aimed to describe and compare characteristics and differences of chronic hospitalized and household maintained consumers and their caregivers who were regular users of educational and rehabilitation programs of the Iranian Society Supporting Individuals with Schizophrenia (ISSIS) in Tehran, Iran. Methods: Two hundred and thirty one consumers were evaluated based on demographics, and clinical and symptom-related characteristics. Their caregivers (n = 231) were independently evaluated based on their knowledge on schizophrenia, family function, burden, and availability of social services and support for them. Data were analyzed by performing independent sample t-test and Mann-Whitney U. Results: The study findings revealed hospitalized consumers were older, had longer length of illness, greater severity of positive and negative symptoms and lower efficacy in basic life skills in comparison with household maintained consumers. The caregivers of the hospitalized consumers had greater objective and subjective burdens and lower knowledge on schizophrenia in comparison with caregivers of household maintained consumers. While household maintained consumers had more access to medical insurance, their caregivers had more access to the supportive organizations, more availability of substitute caregiver and assistant caregiver compared with caregivers of hospitalized consumers. Conclusion: Our findings suggest the need to promote specific interventions and treatment programs for Iranian consumers and their caregivers based on their characteristics and differences due to schizophrenia. Declaration of interest: None.
    Iranian Journal of Psychiatry and Behavioral Sciences 01/2014; 8(1):5-12.
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    ABSTRACT: Severe mental illness is responsible for a significant proportion of burden of diseases in Iranian population. People with severe mental illnesses are more likely to have high rates of non-attendance at follow-up visits, and lack of an active follow-up system, particularly in the country's urban areas that has resulted in the revolving door phenomenon of rehospitalizations. Therefore, there is an increasing need for implementation of effective and cost-effective aftercare services.Method/DesignThis is a randomized control trial with the primary hypothesis that aftercare services delivered to patients with severe mental illnesses in outpatient department and patient's home by a community care team would be more effective when compared to treatment as usual (TAU) in reducing length of hospital stay and any psychiatric hospitalization. Patients were recruited from three psychiatric hospitals in Iran. After obtaining informed written consent, they were randomly allocated into aftercare intervention and control (TAU) groups. Aftercare services included treatment follow-up (through either home care or telephone follow-up prompts for outpatient attendance), family psychoeducation, and patient social skills training that were provided by community mental health teams. Patients were followed for 12 months after discharge. The primary outcome measures were length of hospital stay and any hospitalization in the 12 month follow-up. Secondary outcome measures included patients' clinical global impression, global functioning, quality of life, and patient's satisfaction. The trial also allowed an assessment of direct cost-effectiveness of the aftercare services. This paper presents a protocol for an RCT of aftercare services delivered to patients with severe mental illnesses within patients' home or outpatient department. The findings of this study can influence policy and program planning for people with severe mental illnesses in Iran.Trial registrationIRCT201009052557N2.
    BMC Psychiatry 07/2013; 13(1):178. · 2.23 Impact Factor
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    ABSTRACT: Premenstrual syndrome (PMS) refers to a cyclic appearance of somatic and psychiatric symptoms that affect some women. Finding an effective and safe method for the treatment of PMS has always been a serious concern, because approximately 40% of women report PMS, and in 2-10% of cases it is severe enough to affect their life style and job. The purpose of the present study is to evaluate the effect of omega-3 fatty acids on the treatment of PMS. A randomized double blind controlled trial was performed on 184 eligible women. The eligible women were randomly assigned into two groups. The number of women who have finalized the study with us was 124. In the case group (omega-3 group=group A, n=70), omega-3 in an amount of 2g was prescribed for a one per day basis on a single dosage (two 1g pearls), and in the control group (placebo group=group B, n=69) 2 placebo soft gel, which were completely similar to omega-3 soft gels, were prescribed. The severity and duration of each of the symptoms were compared in both groups 1.5 and 3months after the beginning of treatment. There were no significant differences between the two groups according to age, BMI, level of education, and the severity and duration of primary symptoms. After 45days from starting omega-3, the mean severity of depression (P=0.03), anxiety (P=0.02), lack of concentration (P=0.03) and bloating (P=0.02) in the case group, were all significantly lower than in the control group. The duration of depression (P=0.04) and bloating (P=0.031) in the case group were less than in the control group. After 90days from starting the treatment, the mean severity of depression (P=0.007), anxiety (P=0.004), lack of concentration (P=0.009), bloating (P=0.004), nervousness (P=0.01) and the duration of depression (P=0.01), nervousness (P=0.02), anxiety (P=0.03), lack of concentration (P=0.02), bloating (P=0.004), headache (P=0.04) and breast tenderness (P=0.02) were all lower in the case group. It appears that omega-3 fatty acids may reduce the psychiatric symptoms of PMS including depression, nervousness, anxiety, and lack of concentration and may also reduce the somatic symptoms of PMS including bloating, headache and breast tenderness. These effects increased by longer duration of treatment.
    Complementary therapies in medicine 06/2013; 21(3):141-6. · 1.95 Impact Factor
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    ABSTRACT: Parkinson's disease is one of the most disabling diseases which by electrode implantation and stimulation of subthalamic nucleus (STN), much progress has been made in the treatment of drug resistant patient. This new method of neurosurgery may have some neuropsychological side effects on the patients. The main aim of this study is to evaluate the effects of this kind of treatment on the different neuropsychological aspect of patients.
    Autonomic neuroscience: basic & clinical 01/2013; 4(3):217-23. · 1.82 Impact Factor
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    ABSTRACT: Objective: Psychiatric hospitalization of patients imposes heavy burdens on caregivers, but little is known about this issue in Iran. The present cross-sectional study aimed to investigate the risk factors associated with psychiatric hospitalization of patients with schizophrenia who were the regular clients for the educational programs of The Iranian Society for Supporting Individuals with Schizophrenia (ISSIS) in Tehran, Iran. Methods: 231 male and female study subjects and 231 of their caregivers participated in the study. The study subjects were independently assessed in demographics, clinical and symptom-related characteristics and basic life skills domains. Their caregivers were assessed in domains of knowledge on schizophrenia, burden, social support, family function, and the patterns of relationships with their patients and the role of health and supportive services. Data were analyzed by performing logistic regression model. Results: Old age, low level of education, unemployment, greater severity of positive and negative symptoms, poor basic life skills among subjects, and objective family burden, inadequate knowledge on schizophrenia, low perceived social support and lack of medical insurance among caregivers were the most important factors associated with psychiatric hospitalization among the clients. Conclusions: Some factors originated in Iranian patients and their caregivers could cause patients' pathways to psychiatric hospitalization. Although the study results did not establish causation, based on the findings, psychoeducational interventions may reduce schizophrenia referral and lower the rate of need to inpatient services in Iran. Declaration of interest: None.
    Iranian journal of psychiatry and behavioral sciences. 01/2013; 7(2):16-23.
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    ABSTRACT: The aim of this study is to determine the frequency of various methods of suicide in Eastern Mediterranean Region by a systematic review and meta-analysis. All published articles in international database were systematically searched before September 2011. In order to analyze the data we used STATA, ver.10 software. We reported proportions with standard errors (SE) for single studies and pooled estimates for proportions of different suicidal methods based on random model meta-analysis. We included 19 articles in the final analysis. The pooled proportion of hanging, self-immolation, and poisoning were 39.7% (95% CI: 26.8%-52.7%), 17.4% (95% CI: 10%-24.8%), and 20.3% (95% CI: 14%-26.5%) respectively. Self-immolation and poisoning were gender dependent and hanging was country dependent in the meta-regression method. We found out that the 3 most common methods of suicide in EMR are hanging, poisoning, and self-immolation. These methods are estimated to account for 77.4% of all methods of suicide in EMR.
    Archives of suicide research: official journal of the International Academy for Suicide Research 01/2013; 17(4):335-44.
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    ABSTRACT: Comorbidity of chronic tinnitus and mental disorders may result in more disability. This research provides an evaluation about the effects of medically treated comorbid mental disorder on chronic tinnitus. Fifty-five patients diagnosed with chronic tinnitus and mental disorders were randomly requited by producing a before-after design. They underwent three months of drug therapy for comorbid mental disorders by psychiatrists. Study instruments are Tinnitus Handicap Inventory, Tinnitus Questionnaire, Loudness Match Tinnitus, Hamilton Depression Rating Scale, Beck Anxiety Inventory, The Structured Clinical Interview and Symptom Check List -90. Three months medical treatment puts forward the argument that among mental disorders, anxiety and major depressive disorder demonstrate a significant reduction. Pearson Correlation coefficient ostensibly reveals that there is no significant relationship between mental disorders and tinnitus severity. The statistics lend support to profound effect of major depressive disorder as a key factor on tinnitus disability exacerbation. Medical treatment also touches on issue such as tinnitus severity, its disabling effects and TQ subscales that statistics shows significant trends in their reduction. Findings lay emphasis on tinnitus severity reduction and connection might be established between alleviated mental disorders comorbidity and the improvement of quality of life.
    The international tinnitus journal 12/2012; 17(2):163-168.
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    ABSTRACT: This study aims to demonstrate the sexual functioning of elderly Iranian retirees who reside in Tehran, Iran. The participants' sexual interests are also reviewed in association with their physical and mental health status. The authors recruited 390 elders (199 men, 191 women) by convenient sampling from 4 retirement organizations in Tehran from April 2007 to October 2008. Tools for evaluation included use of a demographic questionnaire, modified Brief Index of Sexual Functioning for Women, Brief Sexual Function Inventory for Men, and the General Health Questionnaire. Sexual activity was "important/very important" in 56.6% and 17.0% of men and women, respectively (p < .005), but their satisfaction from sexual life was similar. Sexual desire and activities were more common among men than among women (p < .05). Impotency and ejaculatory problems were 40% and 33%, respectively, among the male study participants. This study indicated that having a sexual partner was the most important variable for sexual activities. This study provides a profile of sexual behaviors among elderly people in Iran and shows that although sexual decline and dysfunction are seen in both genders, both groups express satisfaction with their sexual affairs when they have a partner available.
    Journal of Sex and Marital Therapy 07/2012; 38(4):365-77. · 1.27 Impact Factor
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    ABSTRACT: This study aimed to validate the Farsi version of Neuropsychiatric Inventory (F-NPI), with the aim of promoting clinical assessment and local research on evaluation of neuropsychiatric symptom profiles of individuals with dementia in Iran. In this cross-sectional, psychometric study, 100 patients with dementia in the age range of 60–90 years participated. Two trained psychiatrists interviewed the study subjects. Positive and Negative Symptoms Scale (PANSS) and Geriatric Depression Scale (GDS) were used to determine the concurrent validity. Testretest,inter-rater reliability and internal consistency were calculated. Discrimination validity was determined,using a matched control group consisting of 49 participants without dementia. Cronbach’s α and Pearson’ scorrelation coefficients were used to analyze the data. The internal consistency (Cronbach’s α = 0.9) was excellent. The inter-rater reliability varied between 0.6 and 0.98 for frequency, severity and total scale of the F-NPI, and test-retest reliability was between 0.4 and 0.96. Concurrent validity varied between 0.3 and 0.9 (P < 0.05). The most prevalent symptom was “apathy” and the least prevalent was “euphoria”. The Farsi version of NPI has satisfactory psychometric indexes and is applicable for clinical and study works in Iranian community.
    International Psychogeriatrics 02/2012; 24(2):223-30. · 2.19 Impact Factor
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    ABSTRACT: Objective: Complaining of psychiatric symptoms is more common among individuals suffering from tinnitus. The aim of this study is to determine the psychiatric diagnosis and symptoms of patients with chronic tinnitus. Materials and Methods: Four hundred patients with chronic tinnitus from the registry of Otorhinolaryngology Research Center of Rasoul General Hospital, Tehran, Iran were enrolled. The study instruments were Structured Clinical Interview for DSM-III-R, axis I psychiatric disorders, Tinnitus Handicap Index (THI) and Symptom Check List-90-Revised. Results: The lifetime and current psychiatric disorders among patients with chronic tinnitus were 60% and 55% respectively. Depressive and anxiety disorders were the most common type. Females with severe THI were 75.6% versus 63.9% in men. Discussion: The comorbidity of chronic tinnitus with depressive and anxiety disorders is more common. This may have treatment implication to alleviate the stress and dysfunction resulted from chronic tinnitus.
    The international tinnitus journal 01/2011; 1616(16):118-22.
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    Seyed Kazem Malakouti, Marzieh Nojomi, Maryam Salehi, Bita Bijari
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    ABSTRACT: In the last 30 years, ever since the PHC network in Iran has been established, the job duties of Behvarzes (Mental Health Workers in rural areas) have been constantly increasing. The aim of this study was to determine the burnout level, mental health status and the severity of occupational stress among Behvarzes. All Behvarzes (227) working in areas covered by Iran University of Medical Sciences were considered for participation in the study. Maslach Burnout Inventory, GHQ-12, and Stainmentz questionnaires were used. The completed questionnaires were returned by 93% of the subjects. The mean score of job stress was in the first percentile (42.8 ± 27.16). 17.6% of the study subjects had moderate to severe level of burnout; 12.3%, 5.3% and 43% of the subjects had abnormal scores on emotional exhaustion, depersonalization and personal subscales respectively; and 28.3% of the cases were suspected to have mental disorders by GHQ. In spite of increasing assigned jobs to Behvarzes, job stress and burnout are not seriously distressful. Providing more desirable personal accomplishment for Behvarzes by reducing job ambiguity/ conflict, participating in planning new programs, and improving interaction with health authorities may help them to overcome their job related pressure and increasing workload.
    Iranian journal of psychiatry. 01/2011; 6(2):70-4.
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    ABSTRACT: Objective: Complaining of psychiatric symptoms is more common among individuals suffering from tinnitus. The aim of this study is to determine the psychiatric diagnosis and symptoms of patients with chronic tinnitus. Materials and Methods: Four hundred patients with chronic tinnitus from the registry of Otorhinolaryngology Research Center of Rasoul General Hospital, Tehran, Iran were enrolled. The study instruments were Structured Clinical Interview for DSM-III-R, axis I psychiatric disorders, Tinnitus Handicap Index (THI) and Symptom Check List-90-Revised. Results: The lifetime and current psychiatric disorders among patients with chronic tinnitus were 60% and 55% respectively. Depressive and anxiety disorders were the most common type. Females with severe THI were 75.6% versus 63.9% in men. Discussion: The comorbidity of chronic tinnitus with depressive and anxiety disorders is more common. This may have treatment implication to alleviate the stress and dysfunction resulted from chronic tinnitus.
    The international tinnitus journal 01/2011; 1616(16):118-22.
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    ABSTRACT: Complaining of psychiatric symptoms is more common among individuals suffering from tinnitus. The aim of this study is to determine the psychiatric diagnosis and symptoms of patients with chronic tinnitus. Four hundred patients with chronic tinnitus from the registry of Otorhinolaryngology Research Center of Rasoul General Hospital, Tehran, Iran were enrolled. The study instruments were Structured Clinical Interview for DSM-III-R, axis I psychiatric disorders, Tinnitus Handicap Index (THI) and Symptom Check List-90-Revised. The lifetime and current psychiatric disorders among patients with chronic tinnitus were 60% and 55% respectively. Depressive and anxiety disorders were the most common type. Females with severe THI were 75.6% versus 63.9% in men. The comorbidity of chronic tinnitus with depressive and anxiety disorders is more common. This may have treatment implication to alleviate the stress and dysfunction resulted from chronic tinnitus.
    The international tinnitus journal 01/2010; 16(2):118-22.
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    ABSTRACT: The objective of this study was to evaluate the effectiveness of case-management services and the feasibility of considering the Consumers' Family Members (CFM) as service providers in Iran as a developing country. Three trained case-managers were allocated into each group (Mental Health Worker-MHW and CFM), providing 12 months of home-visit services for 129 individuals with schizophrenia. Burden, knowledge, quality of life and the general health condition of the caregivers, as well as positive/negative symptoms and social skills of the consumers were evaluated. Most clinical variables were improved without significant differences between groups. The hospitalization rate was reduced by 67%.
    Community Mental Health Journal 06/2009; 45(6):447-52. · 1.03 Impact Factor
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    ABSTRACT: Complaints of sleep disturbance increase with age and many studies have reported on the relationship of sleep problems to the greater use of health services, physical and mental morbidity, functional decline, and all causes of mortality. This study aimed to examine sleep patterns and sleep disturbances in Iranian elders and correlate their sleep quality to their health status. Four hundred men and women, aged 60 years or older, were interviewed by trained interviewers regarding their physical and mental health status. The Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale (ESS), and a General Health Questionnaire (GHQ) were then administered to each participant. The data gathered were analyzed using chi(2)-test, t-test, and one-way analysis of variance and logistic regression. The results indicated that the majority of participants (82.6%) suffered from poor sleep quality and approximately one-third (29.2%) experienced sleepiness during the daytime. Difficulty falling asleep (p < or = 0.001) and maintaining sleep (p < or = 0.01) and the feeling of being too hot at night (p < or = 0.005) were significantly more prevalent in women, but men suffered more from leg twitching (p < or = 0.01). Being female (OR = 2.52), and having GHQ scores of more than 11 (OR = 4.14) increased the risk of poor sleep quality considerably. Promoting sleep hygiene education of elders in primary health care services are recommended.
    International Journal of Geriatric Psychiatry 04/2009; 24(11):1201-8. · 3.09 Impact Factor
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    ABSTRACT: Aim of this study was to evaluate the prevalence of suicide ideation and behavior in a community sample of an Iranian city, Karaj. Study sample consisted of 2,300 subjects, chosen randomly from the community. The WHO/SUPRE-MISS survey questionnaire, used in this study. Lifetime prevalence for suicide thoughts, plans and attempts were 12.7, 6.2 and 3.3%, respectively and for the previous year they were 5.7, 2.9 and 1%, respectively. Although it is not possible to generalize the results to the country, but in some area of Iran, the prevalence of suicide ideation, plan and attempt appeared to be similar to that of many developed countries.
    Community Mental Health Journal 01/2009; 45(1):37-41. · 1.03 Impact Factor
  • European Psychiatry - EUR PSYCHIAT. 01/2009; 24.