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Article
ACUTE MYOCARDIAL INFARCTION AND DEPRESSION
احتشاء عضلة القلب الحاد والكأبة النفسية

Authors: ALIAS A. HUSSIN الياس حسين --- SABRI K. SHAIKHOW صبري شيخو
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2008 Volume: 2 Issue: 1 Pages: 5-16
Publisher: University of Dohuk جامعة دهوك

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Background Depression found to be common after acute myocardial infarction AMI, its recognition and treatment may be important to reduce its consequences. Objectives To clarify the effect of depression following AMI. Patients and Methods Prospective study was conducted at the coronary care unit (CCU) at Ibn-Sena ,Mosul teaching hospital . Two hundred cases with AMI ages 25 years up to 75 years were included. Results Depression was prevalent after AMI, with a higher incidence in females, 57% vs 43% for males. P value < 0.05 and odds ratio: 2.85, this study found that higher percentage of depression was among those with low educational and socioeconomic state and discovered that patients with depression following AMI developed more cardiac complications such as recurrent angina, recurrent AMI, arrhythmia, congestive cardiac failure (CCF) and death more than non depressed patients, 38% of the depressed group needed coronary angiogram vs 23% of non depressed. Conclusion Patients who developed depression following (AMI) are more prone to complications.

خلفية البحث: تحدث الكآبة النفسية بشكل واسع بعد أحتشاء عضلة القلب الحاد. تشخيص الحالة و معالجتها ضروري جداً لأن الكآبة النفسية تؤدي الى اختلاطات قلبية كبيرة.الهدف: بيان تأثير الكآبة النفسية بعد احتشاء عضلة القلب الحاد. المرضى و طرق البحث: اجرت دراسة مستقبلية فى المستشفى العام شعبة العناية القلبية فى الموصل لمئتان مريض مصابون باحتشاء عضلة القلب الحاد رجالا ونسساء تتراوح اعمارهم بين 25-75 سنة.النتائج: بيينت الدراسة حدوث حالات كأبة حادة بين هؤلاء المرضى وبنسبة اكثر بين النساء عن الرجال 57 % الى 43% (P value 0.05 O.R 2.85). وثبتت الدراسة ان الكأبة النفسية بعد احتشاء عضلة القلب الحاد اكثر بين بين اللذين لديهم مشاكل عائلية وزوجية والطبقات الاقل ثقافة. نتائج الدراسة بيينت ان ان المرضى الذين يعانون من الكأبة النفسية بعد احتشاء عضلة القلب تحدث لديهم مخالطات قلبية مثل تكرار ذبحة صدرية واحتشاء عضلة القلب واضطرابات لضربات القلب والوفيات بنسبة اكثر من الذين لايعانون من الكأبة النفسية. الاستنتاج: التشخيص المبكر للكأبة النفسية بعد احتشاء عضلة القلب الحاد ومعالجتها ضرورى لمنع حدوث المخالطتات المذكورة .


Article
Assessment of Postpartum Depression among Mothers Attending Primary Health Care Centers in Hawler City
تقييم اكتئاب ما بعد الولادة بين الأمهات اللائي يراجعون مراكز الرعاية الصحية الأولية في مدينة هولير

Authors: Twana Abdulrahman Rahim --- Sawza Hamid Ramadan Albotany
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2012 Volume: 16 Issue: 1 Pages: 58-64
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Background and objectives: Postpartum depression is a global, life-threatening disorder which affects particular mothers in their post-natal periods. It’s regarded to be one of the major disabling conditions of motherhood. We aimed to study the rate of, as well as assessing a group of psycho-obstetrical risk factors behind postpartum depression.Methods: 98 newly gave-birth mothers were recruited with mean age of 27.07 year between the periods of November 2009 to February 2010. Edinburg Post-natal Depression Scale was adopted by authors for the assessment of postpartum depression. Comparisons on groups of demographic, obstetrical, and psychological data were done between both positive and negative mothers for the disorder.Results: 39.8% of mothers were diagnosed as postpartum depression. For which, no particular demographic factors were significantly predictive for. Depressed mothers were of significant higher mean number of gestation with p value of 0.0472. However, no other obstetrical factors revealed back statistical significant differences. Past history of depres-sive disorders, whether post-natal or not, was significant predictor for current postpartum depression with p value of 0.02 for history of previous postpartum depression, and p value of 0.042 for non postpartum depressive disorders.Conclusion: Postpartum depression is highly prevalent in our society. History of depres-sive disorders is a strong predictor for future postpartum disorder. However, there were no clear correlation between postpartum depression and other demographic and obstetrical data apart from the mean number of gestation.


Article
Depression and anxiety in women with breast cancer in Erbil city: a case-control study
الاكتئاب والقلق لدى النساء المصابات بسرطان الثدي في مدينة أربيل: دراسة الحالات والشواهد

Authors: Baran K. Barzinji --- Diyar H. Tahir --- Kameran H. Ismail
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2012 Volume: 16 Issue: 1 Pages: 65-70
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Background and objectives: Breast cancer has specific challenges for women. This study was carried out to identify the frequency of depression and anxiety in women with breast cancer..Methods: A hospital based case-control study was carried out in Erbil city from August, 15th to November, 1st 2010. The convenient sample included 100 cases of diagnosed breast cancer for the last three years attending Maternity and Nanakali hospitals and two hundred age-matched (± 5 years) non-cancer women attending the Maternity hospital for gynaecological conditions were taken as a control group.Results: The mean ± SD ages of cases and controls were 45.51 ± 8.87.4 and 44.57 ± 8.59 years, respectively (P=0.378). The proportion of depression among cases (69%) was higher than that among controls (17.5%) (P<0.001), and the proportion of anxiety among cases (56%) was higher than that among controls (16%) (P<0.001). Multiple logistic re-gression analysis of risk factors for depression revealed that breast cancer (OR=10.531), owned home (OR=0.463), and years of formal education (OR=0.917) have a statistically significant association with depression. While breast cancer (OR=8.735) and parity (OR=1.167) have a statistically significant association with anxiety and borderline anxiety.Conclusion: Increased levels of depression and anxiety after a diagnosis of breast cancer highlight the need for dedicated psychiatric service provision.


Article
Depression among Patients Attending Physiotherapy Clinics in Erbil City
الاكتئاب بين المرضى الذين يراجعون عيادات العلاج الطبيعي في مدينة أربيل

Authors: Diyar H. Tahir --- Jwan M. Zangana --- Sirwan K. Ali
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2009 Volume: 13 Issue: 2 Pages: 22-27
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Background and Objectives: Depression is a condition that worsens the prognosis of patients undergoing physiotherapy treatment; it is underestimated and under-recognized. The objectives of this study were to detect the prevalence, severity and type of depressive disorder among patients attending the physiotherapy clinic, and analysis the factors that influencing the occurrence of depression and its severity.Methods: Cross sectional study was carried out with (200) patients attending physiotherapy clinic in Hawler and Rizgary Teaching Hospitals in Erbil City from 2nd January -2nd march 2009. Data about demographic characteristics of the sample, utilization of health services, and type of physical diseases were obtained by direct questioning the patients. Depression was assessed by means of the Patient Health Questionnaire (PHQ-9).Results: Point prevalence of depression was estimated to be 56% (27% mild, 20.5% moderate and 8.5% sever) among this population of patients attending an outpatient physical therapy clinic. Female gender, old age and married patients were suffering from sever depressive disorders .Conclusions: The high prevalence of depression in patients attending physiotherapy clinics suggests that consideration should be given to screen the psychological.


Article
DEPRESSION IN A GROUP OF PATIENTS WITH CHRONIC RENAL FAILURE ATTENDING HEAMODIALYSIS UNIT IN TEACHING HOSPITAL IN BAGHDAD

Authors: Makhoola H Kassim --- Uday AJ Khalid عدي عبد الجبار خالد
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2012 Volume: 10 Issue: 1 Pages: 55-59
Publisher: Al-Nahrain University جامعة النهرين

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BackgroundDepression is the most common psychopathological condition among patients with chronic renal disease yet it is still under recognized and underestimated. Depression adversely affects the already disturbed quality of life of patients with chronic renal disease.ObjectivesTo determine the rate of depression in a sample of chronic renal failure patients attending haemodialysis unit in teaching hospital in Baghdad and examine the sociodemographic variables of such patients.MethodsThis is a cross-sectional study done at Al-Kadhimiya Teaching Hospital, during a period of 2 months from 4th of January 2009 to 4th of March 2009. The total of 50 random cases with chronic renal failure coming for haemodialysis were interviewed by semi structured schedule for psychiatric diagnosis. Results were reviewed by simple descriptive and inferential statistical measures.ResultsThe rate of depression in this sample of patients with chronic renal failure was 40%.There was no statistically significant relation between any of the demographic variables and depression.ConclusionThe rate of depression in this study is high. Results were compared with other studies in light of circumstances of this study.Key wordsDepression, chronic renal failure, haemodialysis


Article
Poststroke Depression In Relation To Different Brain Lesions
اكتئاب ما بعد السكته ( الصدمة الدماغية ) وعلاقتها بأضرار الدماغ المختلفة

Authors: Dr.Hayder . M.Ali, د. حيدر مخلف علي --- Dr.Hussein Hlail Wda"a AL-Sayyad د. حسين هليل وداعة
Journal: Thi-Qar Medical Journal مجلة ذي قار الطبية ISSN: 19929218 Year: 2010 Volume: 4 Issue: 2 Pages: 59-73
Publisher: Thi-Qar University جامعة ذي قار

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ABSTRACTObjectives: This study is aimed at the pathoanatomic correlates of depression in the postacute stage of patients with stroke. Methods: Of a consecutive series of 47 stroke patients, with single demarcated unilateral lesions was selected. Clinical examination, neuroradiological, CT scan examination, and psychiatric assessment were performed within a 2-month period after the acute stroke. Depression was assessed with the Beck Inventory Scale ( BIS ) and DSM-IV-R criteria. The neuroradiological examination of all patients was performed on the same scanner, lesion location, lesion volume, and ventricle-to-brain ratio were analyzed. Results : We found no significant differences in depression scores between patients with left and right hemisphere lesions and no correlation between the severity of depression and the anteriority and or the volume of lesion or brain atrophy. Major depressive disorders were only found in nine patients with left hemisphere lesions, all involving the basal ganglia, whereas none of the patients with right hemisphere stroke exhibited major depression. Conclusions: Lesions in the vicinity of the left hemisphere basal ganglia tend to play a crucial role in the development of major depression after the acute stage of stroke. The pathophysiological implications of this finding are discussed.

الملخص : الأهداف: تهدف الدراسة الى تحديد العلاقة بين الاضرار التشريحية المرضية والاكتئاب لمرضى السكتة ( الصدمة ) الدماغية الطرق: تم أنتخاب (47) مريض بصورة متوالية مصابين بضرر محدد أحادي الجانب . وأجري لهم الفحص السريري , الفحص الشعاعي بمفراس الدماغ , والتقويم النفسي ,خلال شهرين مابعد السكتة الدماغية . تم تقويم الاكتئاب بمقياس بيك , ومعايير الاكتئاب للمصنف الامريكي الرابع. علما أن الفحص الشعاعي العصبي ( مفراس الدماغ ) لجميع المرضى تم بنفس التقنية موقع الضرر , حجم الضرر ونسبة البطين – الى – الدماغ تم تحليلها جميعاًالنتائج: لم يتم أستخراج أختلاف واضح في معدل درجات الاكتئاب بين المرضى المصابين في الفص الايسر والمرضى المصابين في الفص الايمن , ولاتوجد علاقة بين شدة الاكتئاب وامامية (الفص الامامي ) او حجم الضرر او ضمور الدماغ .اضطرابات الاكتئاب العظمى موجودة لدى تسعة مرضى فقط كان لديهم ضرر الفص الايسر للدماغ . معظم المرضى كان لديهم ضرر في العقدة القاعدية , بينما لا يوجد أي مريض مصاب بضرر الفص الايمن للدماغ يعاني من نوبة اكتئاب عظمى . الأستنتاج: الاضرار المجاورة الى العقدة القاعدية للفص الايسر للدماغ تلعب دورا حاسما في نشوء نوبات الاكتئاب العظمى بعد السكتة (الصدمة ) الدماغية .


Article
Anxiety and Depression among Couples Attending The Infertility Clinic Center in AL-Hilla
القلق والاكتئاب بين الازواج الذين يحضرون عيادة العقم في الحلة

Authors: Nibras H. Abdel-Hussein --- SajaH. Mohamed
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2015 Volume: 5 Issue: 3 Pages: 249-256
Publisher: University of Kufa جامعة الكوفة

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Objective: -A descriptive study utilizing a study approach was carried out to assess the level of anxiety and depression for infertile couples in AL-Hilla city, Babylon Governorate- Iraq.Methodology: -A purposive (non-probability) sample of (50) infertile couple ((50) infertile wives and the other (50) infertile husbands) was selected from the center of infertility in BabylonGovernorate. The data had been carried out from February 17th 2015 to March 22nd 2015. Data were collected through the use of the questionnaire, the application of the interview technique, and review of the infertile couples' records. Data were analyzed through application of descriptive statistics analysis which include; frequency, percentage, mean and the inferential data analysis approach (Pearson correlation coefficient, standard deviation, Chi-square and t-test).Results:-The results of the study indicatedthat a significant differences between males and females with level of anxiety.Conclusion: The study concluded that is a highsignificant relationship betweenanxiety and depression. Recommendation:- The study recommended that a competent counselor nurse to assist the infertile couples during attending the center and follow them by home visiting to found any solution for their psychosocial problems.Raising awareness among gynecologists about the prevalence of psychiatric and personality disorder among infertile couples and their psychiatrists for proper management.

الهدف :- دراسة وصفية أجريت لأجل تقييم مستوى القلق والاكتئاب للأزواج الذين يعانون من العقم في مدينة الحلة, محافظة بابل- العراق.المنهجية :- شملت العينة الغرضية ( غير احتمالية) 50 زوج عقيم ( 50 امرأة عقيمة و50 رجل عقيم ). تم اختيارهم من مركز العقم في محافظة بابل. تم جمع العينة في 17 شباط 2015 ولغاية 22 اذار 2015. جُمعت البيانات من خلال الاستبانة ومن خلال عملية المقابلة ومراجعة سجلات الازواج. تم تحليل البيانات من خلال التحليل الاحصائي الوصفي }( التكرار , النسبة المئوية , وكذلك التحليل الاحصائي الاستنتاجي ( معامل الثقة, انحراف قياسي, أختبار مربع كاي){.النتائج :- أشارت نتائج الدراسة الى أن هناك فروق ذات دلالة إحصائية بين الذكور والإناث مع مستوى القلق.الاستنتاج: استنتجت الدراسة إلى أن هناك ارتباط معنوي قوي بين القلق والاكتئاب.التوصيات:- توصي الدراسة بتزويد هذه المراكز بممرض مستشار مختص لمساعدة الأزواج الذين يعانون من العقم خلال حضور المركز ومتابعتهم من قبل الزيارات المنزلية ليتم العثور على حل لمشاكلهم النفسية بالإضافة الى رفع الوعي لدى أطباء أمراض النساء إزاء انتشار الاضطراب النفسي لدى الأزواج الذين يعانون من العقم والأطباء النفسيين من أجل الإدارة السليمة.


Article
Depression status in relation to caries experience and salivary physiochemical characteristics among 15 years old students in Al-Swera city – Wassit Governorate-Iraq

Authors: Huda S. Khiala --- Ban S. Diab
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2015 Volume: 27 Issue: 2 Pages: 158-162
Publisher: Baghdad University جامعة بغداد

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Background: Depression is a common mental disorder that presents with depressed mood;it can become chronic orrecurrent and affect dental health .Thus this research aimed to assess the prevalence and severity of dental cariesamong students with different grade of depression in relation to physicochemical characteristics of stimulated wholesaliva.Materials and methods: The total sample involved for depression status assessment is composed of 800 students forboth gender aged 15 years old that were selected randomly , This was performed using children depressioninventory (CDI) index that divided the students into four groups of depression(low or average grade, high averagegrade, elevated grade and very elevated grade). The diagnosis and recording of dental caries was by using decay,Missing, Filled surface index (DMFs); and according to the criteria ofManji et al (1989), Salivary samples was collectedfrom 30 student with very elevated grade of depression and 30 from low or average grade under standardizedconditions, then analyzed for measuring salivary flow rate and viscosity, in addition to estimation salivary elementsthat includes total protein, zinc, copper, chromium and Lithium.Results: the data of the present study showed that the percentage of Caries free students was higher among veryelevated grade (8.60%) followed by low or average grade (8.52%), the less was among elevated grade ofdepression (5.04%).Concerning caries experience, the highest result was among elevated grade of depressionfollowed by low or average grade, the lower result was among high average grade. While the sever grade of dentalcaries (D4) was found to be highly significant differ among different grade of depression, The data analysis of salivaryelements found that the protein was higher in very elevated grade than low or average grade while other elementsshow the opposite result with significant concerning copper and zinc among very elevated grade that showsignificant difference. DMFs correlated negatively with salivary flow rate among low or average grade and veryelevated grade; while concerning salivary viscosity, the correlation was direct with DMFs. With highly significant invery elevated grade, Salivary elements show positive relation with not significant except copper that show negativerelation with significant.Conclusion: The results of the current research revealed that depression status had an adverse effect on salivaryphysicochemical characteristics and dental status including caries experience


Article
Depression InType2 Diabetic Patients In Al-Diwaniyah Teaching Hospital
مرضى السكري من النوع الثاني في مستشفى الديوانية التعليمي

Authors: Adil Hammadi عادل حمادي --- Abdulzahra Mohammed Alkhafaji عبد الزهرة محمد الخفاجي --- Aqeel Raheem Hassan عقيل رحيم حسن
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2016 Volume: 12 Issue: 22 Pages: 1-11
Publisher: Al-Qadisiyah University جامعة القادسية

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Objectives: Depression is commonly found as a comorbid condition in chronic medical illnesses in general, and diabetes mellitus (DM) in particular. Patients with diabetes are twice as likely to suffer from depression as compared to the general population. The aims of the study were to estimate: the prevalence of depression in type 2diabetic patients and its severity, the rate of depression in type 2 diabetes in relation to socio-demographic variables, and to find out the correlation of depression with some diabetes variablesMethods:100 Iraqi patients with type 2 DM compared with 100 persons from general population as control group participated in across sectional study. Participants were interviewed using: a semi-structured interview schedule based on ICD-10, diagnostic criteria for depression ,Beck depression inventory II for severity of depression and socio demographic questionnaire.Results: The prevalence rate of depression in type 2 diabetes was 44%. The rate of depression was higher for females, married, housewife ,those of secondary level education, in age group(50-59),those of poor glycemic control, with long duration of diabetes, in patients on insulin and those with cardiovascular complication. Conclusions: Depression is more common in type2 diabetic patients than in normal individuals. This will necessitate the need for more attention and screening for such conditions, which plays a role in the patients state physically and mentally.

الخلفيةالاكتئاب يوجد عاده كحاله مرضيه في أمراض صحية مزمنة بشكل عام ، وداء السكري بشكل خاص. المرضى الذين يعانون من مرض السكري هم أكثر احتمالا بمعدل الضعف للمعاناة من الاكتئاب بالمقارنة مع السكان عموما. وقد قيل ان العلاقة بين الاكتئاب والسكري ثنائية الاتجاه أساسا. ان علاج الاكتئاب ليس فقط يحسن أعراض الاكتئاب، ولكن قد يكون له أيضا تأثيرأيجابي على السيطرة على نسبة السكر بالدم. وبالتالي،فإنه من المفيد بالنسبة للأطباء التعرف وعلاج الاكتئاب على نحو كاف في مريض السكري.أهداف الدراسة1. لتقدير معدل أنتشارالأكتئاب في مرضى السكري النوع الثاني في مستشفى الديوانية التعليمي.2. قياس شدة الاكتئاب في هؤلاء المرضى.3. لتقدير معدل الاكتئاب في مرضى السكري النوع الثاني في ما يتعلق ببعض المتغيرات الأجتماعيه والديموغرافية (العمر،الجنس، الحالة الاجتماعية،المستوى التعليمي، المهنة والإقامة).4. لمعرفة العلاقة بين الاكتئاب وبعض متغيرات السكري (مدة المرض، السيطرة على نسبة السكر في الدم، نوع العلاج وبعض مضاعفات مرض السكري).المرضى والطرق.شارك 100 مريض عراقي مصاب بداء السكري النوع الثاني مقارنة مع 100 شخص من عامة السكان كمجموعة تحكم في دراسة مقطعيه خلال الفترة من 20 يونيو 2014 إلى10 فبراير 2015 في عيادة السكري في مستشفى الديوانية التعليمي, المشاركون بعمر 20 عاما و أكثر ، وأجريت مقابلات معهم باستخدام:1. جدول المقابلة شبه المنظمة على أساسICD-10 (النظام العالمي لتصنيف الأمراض العاشر) المعاييرالتشخيصية للأكتئاب (النسخة العربية التي ترجمت وكانت تستخدم في السابق من قبل باحثين آخرين). الملحق الأول.2. مقياس بيك الثاني لقياس شدة الأكتئاب. والتقييم هو تقييم ذاتي ويقع في ثلاث فئات: الأول 10-18= خفيف والثاني 19-29 = متوسط والثالث 30 - 63= شديد . الملحق الثاني.3. الاستبيان الاجتماعي والديموغرافي. الملحق الثالث.والبيانات تم تفسيرها وتحليلها باستخدام الحزمة الإحصائية للعلوم الاجتماعية النسخة 18النتائجأظهرت النتائج ان معدل انتشارالأكتئاب في مرضى السكري النوع الثاني كان 44٪ مقارنة مع 16٪ في المجموعة الضابطة وكانت هذه النتائج ذات دلالة إحصائية. وكان معدل الاكتئاب أعلى بين الإناث،المتزوجات، ربات المنزل،الذي كانوا في المرحلة الثانوية من التعليم ،وضمن الفئة العمرية (50-59)،المرضى الغير مسيطرين على نسبة السكر في الدم،والمرضى المصابين لمدة طويلة والمرضى على علاج الأنسولين والمرضى الذين يعانون من مضاعفات القلب والأوعية الدموية. وكان معظمهم يعيشون في المناطق الحضرية،مع شدة متوسطة من الاكتئاب.الاستنتاجات الأكتئاب هو أكثر شيوعا في مرضى السكري النوع الثاني من الأفراد العاديين. وهذا يشير إلى الحاجة إلى المزيد من الاهتمام والكشف عن هذه الحالات التي تلعب دورا في حالة المريض جسديا وعقليا.


Article
Suicidal ideation among a group of depressed outpatients
التفكير في الانتحار بين مجموعة من المرضى الخارجيين المكتئبين

Author: Banaz Adnan Saeed
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2017 Volume: 21 Issue: 3 Pages: 1907-1914
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Suicide is a common problem worldwide; the suicidal ideation is a predictor of suicide. This study aimed to shed light on the demographic as well as clinical risk factors for suicidal ideation among depressed outpatients.Methods: A total of 100 depressed patients who visited the psychiatric outpatient department of Hawler Teaching Hospital from August 2015 to January 2016 were assessed for the suicidal ideation and risk factors of suicidal ideation by adopting standardized diagnostic and symptoms rating scales.Results: Suicidal ideation was present in 64% of patients; significant predictors for suicidal ideations were previous suicide attempt, the severity of depression and hopelessness.Conclusion: Suicidal ideation is highly prevalent among psychiatric outpatients with major depression. Those patients discovered to have risk factors are in great need of help to prevent future suicide.

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