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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.

BackgroundStigma of mental disorders causes a reduction in seeking help from the health care professionals and is evident across the world.ObjectivesThe current study aimed to compare medical students’ attitude towards mental illness after two different psychiatry clerkships in terms of the level of clinical exposure to patients with mental illness.Patients and MethodsThrough a quasi-experimental study, all of the 4th-year medical students were invited to enroll this study conducted in Tehran University of Medical Sciences (TUMS). They were non-randomly assigned into two different psychiatry clerkships from January 2009 to January 2010. One group was enrolled in the traditional lecture-based course (low-exposure) while the second group participated in a novel method with increased hours of patient exposure (high-exposure). Attitude towards mental illness (AMI) was measured by a 22-item questionnaire before and after the clerkship and data were compared between the two groups in terms of changing attitude towards mental illness in five different categories.ResultsA total of 211 participants were enrolled in the study (115 female) of which 115 students (54.5%) were in low-exposure group and 96 students (45.5%) in the high-exposure group. Generally, AMI scores did not differ between the two groups and did not show any significant changes before and after the psychiatry clerkship. The only exceptions to this were AMI4 category (the concept of etiology of the mental illness), which significantly improved after the clerkship in the low-exposure (P = 0.011) and the high-exposure groups (P = 0.024), respectively.ConclusionsExposure of medical students to patients with mental illness did not improve attitude towards mental illness and psychiatric conditions.

Feasibility and sustainability of the program are affected by a number of factors. Low referral rate of clinicians, limited resources of the hospital, issues related to stigma and logistic issues are barriers in implementation of these services. Administrators' and clinicians' understanding of the importance of patient and family psychoeducation seems to be crucial in sustainability of such programs in routine service delivery.

Background: One in four families has at least one member with a mental disorder and families are the main caregivers in most patients in low and middle-income countries. Caregivers experience disruption in their routine lives, increased responsibilities, increased need for support, and changes in their network. The role of personal support networks in the health and burden of the caregivers is complex and depends on the context, cultural and socioeconomical variables. In this study, we aimed to investigate the personal support network of caregivers of patients with severe mental illness in Iran. Methods: By using a mixed-methods design, we focused on the structure and composition of caregiver networks, as well as self-perceived caregiver support. Results: We found that the support network of caregivers was mostly composed of immediate family members whom themselves were selectively chosen as a result of the multidimensional process of interaction between stigma, availability, and the perceived needs of caregivers. The participants mentioned economic and instrumental supports more frequently than emotional support, probably reflecting their unmet basic needs. Advocacy for providing formal systemic supports to caregivers, as well as interventions that expand caregivers personal support network is recommended. Conclusions: Most participants of the study were relatively isolated and had a small network of support, mostly composed of immediate family members. Stigma was a serious source of family distress for caregivers and a limiting factor in social relationships.

Acute treatment response of first-episode psychosis in a clinical sample of a developing country seems to be higher than that of developed countries. However, predictors of response are comparable.

In Iran, inpatient group psychotherapy has been limited to transient practices for research purposes or fulfilling personal interest of therapists. The goal of this paper is to share and explain the experience of developing an inpatient group psychotherapy program in Roozbeh Psychiatric Hospital, Tehran, Iran. After theoretical delineation and preparation of a draft of the program guideline, two pilot sessions were held. Based on this initial experience a final treatment guideline was prepared. Afterwards, the program was continued for more than 1 year in a female ward at Roozbeh Psychiatric Hospital. The output of this exercise was a guideline that covers important topics in development of inpatient group psychotherapy. It is concluded that inpatient group psychotherapy has its unique challenges. Of the most important challenges that can be mentioned in this regard are the participation of patients with significant differences in levels of psychopathology and psychiatric signs and symptoms, and high comorbidity with specific personality traits or disorders. Other challenges relevant to the structure of the group include items such as very limited time for working through and inevitable out-of-group contacts.

Thematic analysis of personal networks involves identifying regularities in network structure and content, and grouping networks into types/clusters, to allow for a holistic understanding of social complexities. We propose an inductive approach to network thematic analysis, applying the learnings from qualitative coding, fused mixed-methods analysis, and typology development. It involves framing (changing focus by magnifying, aggregating, and graphical configuration), pattern detection (identification of underlying dimensions, sorting, and clustering), labeling, and triangulating (confirmation and fine-tuning using quantitative and qualitative approaches); applied repeatedly and emergently. We describe this approach utilized in two cases of studying support networks of caregivers.