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Background and Aim: Mood Bipolar Disorders(BD) are associated with unstabilities in patients' interpersonal interactions which in the long term may result in impairments in their social adjustment. Problem solving skills training, both in individual and group settings have been found effective on improving social adjustment. However, few studies have evaluated the efficacy of such approaches in social adjustment of patients with BD. This study was carried to assess the efficacy of problem solving skills training in the group setting on improvement of social adjustment in patients suffering BD. Method & Materials: Participants were 45 female patients with BD, aged 25-30 year old who were randomly selected among patients referred to rehabilitation centers of Isfahan in 2006. Participants were randomly assigned to two intervention and one control groups. In the first intervention group only patients received the education but in the second one along with patients, family members separately received the training too. No training was performed for control group. BD diagnosis was confirmed according to two psychiatrists' and the author's diagnostic interviews. In all three groups patients remained on their medications during the study. Wineland Social Adjustment Test were administered to the three groups before the intervention and then interventions groups received problem solving skills training by Hawthorn method in ten sessions. Wineland Social Adjustment test were again administered to patients of the 3 groups after the last intervention session and also later as a follow up post-test. Data were analyzed through SPSS-software using ANCOVA tests. Findings: After intervention, social adjustment mean scores were significantly higher in both intervention groups than in the control group (P Conclusion: Group problem solving skills training can improve social adjustment in patients with BD. This intervention can be considered as a part of these patients' treatment protocol in the long term.

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Aim and Background: This study aimed to assess the efficacy of psychoeducational group interventions in promoting quality of life and quality of relations in families of patients with bipolar disorder. Methods and Materials: This was a semi-experimental study with control group and random assignment. In this study, the experimental and control groups composed of 6 and 9 subjects, respectively. All participants were family members of patients with bipolar disorders who completed the World Health Organization's quality of life questionnaire and quality of relationship inventory. While the experimental group attended 12 sessions of psychoeducational group interventions, the control group received no intervention. Analysis of covariance was used for statistical analyses. Findings: The results of data analyses demonstrated significant increases in mean scores of quality of life and social support in the experimental group. However, the mean scores of conflict and depth of the relationship did not differ significantly between the two groups. Conclusions: These findings indicated that psychoeducational group interventions can promote quality of life and social support, but have little impact on conflict and depth of relationships.

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Abstract Aim and Background: Multidimensional and complex nature of bipolar disorder requires assessment and usage of modern treatments. The aim of this study was to investigate the efficacy of meta-cognitive therapy (MCT) compare to psycho &ndash; educational family therapy on Social performance in bipolar patients. Methods and Materials: This was a semi-empirical research with pretest-posttest design, using control group. From among the bipolar woman who had referred to psychological hospitals and clinics in Isfahan city in Iran, 24 patients were selected by purposeful sampling and were divided into three equal groups randomly. The first group received meta-cognitive therapy, second group received psycho-educational family therapy and the third group received drug therapy. The data were gathered using semi-structured interview based on diagnostic and statistical manual of mental disorders (4th edition) criteria and dysfunctional attitudes scale. The data were analyzed by descriptive statistics and covariance with SPSS 16 software. Findings: There wasn&rsquo;t difference significant between the mean scores of meta-cognitive therapy groups compared with psycho &ndash; educational family therapy (p<0.05). Also, there was difference significant between the mean scores of both group meta-cognitive therapy and psycho &ndash; educational family therapy compared with drug therapy. Conclusions: using meta-cognitive therapy and psycho &ndash; educational family therapy with the drug increases Social performance in bipolar patients. Therefore it is recommended family and therapists trained in this field.

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Abstract Aim and Background: Correct diagnostic of bipolar disorders by psychologists requires a high level of proficiency and experience.  Moreover, in many cases, similar symptoms may lead to misdiagnosis which can worsen the disease. The purpose of this research work is design of an automatic system for effective diagnosis of this disease using brain signals. Such a system can be used as an auxiliary system for the psychologists. Methods and Materials: This study is done on 12 subjects with bipolar disorders and 12 healthy subjects. Signals from sixteen EEG electrodes are recorded according to the standard 10-20 system. Based on the other studies, we use signals from the channels located at F 3 , F 4 , P 3 , P 4 , T 3 , T 4 , O 1 and O 2 area. A set of features including the total signal power, frequency bands power, center frequency, maximum frequency, AR coefficients and Hjorth descriptors are extracted from the signals. The classification task (healthy/bipolar disorders) is then performed using the back propagation and Radial Basis Function (RBF) neural network classifiers. Findings: Our investigations show that among the adopted features, the maximum frequency, theta power, activity and AR coefficients are suitable references for separating the healthy subjects from the diseased ones. Also, the back propagation neural network outperforms the RBF one. Conclusions: In the proposed automatic detection process, the radial basis function neural network classifier leads to a correct diagnosis rate of more than 87%. The back propagation neural network classifier has a correct diagnosis rate of more than 94%.  These results confirm that the proposed system can be considered as an auxiliary tool for detecting the bipolar disorders.  

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Abstract Aim and Background: the aim of this study was to evaluate effectiveness of schema therapy in reducing symptoms and adjusting early maladaptive schemas in patients with bipolar disorder. The purpose was to identify patient’s maladaptive schemas and attempt to modify or change them. Methods and Materials: Subjects included 30 patients, 10 men and 20 women that were chosen by convenience sampling from visitors of Nour Medical Center, two mental health clinics in Isfahan and Baran ‘e’ Mehr counselling center in Shahin Shahr. They were diagnosed with bipolar disorder (type I or II) by a psychiatrist using DSM-IV-TR and receiving medical treatment, were randomly put in two groups. Test group received medical treatment with schema therapy and the control group received only medical treatment. Young mania rating scale (YMRS), bipolar depression rating scale (BDRS) and Young schema questionnaire (YSQ3) were used before and after treatment. Data were analyzed by multivariate analysis of variance and covariance using SPSS 18.0. Findings: Controlling the covariate variable, differences between two groups after the intervention were significant for all three variables of symptoms of mania and depression and early maladaptive schemas (P<0.01). Conclusions: schema therapy as an adjuvant psychological treatment with medication can be effective in reducing symptoms and adjusting the early maladaptive schemas in patients with bipolar disorder, therefore providing regular protocols for schema therapy and adding it to medical treatment is suggested.  

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Abstract Aim and Background: Indeed, Family caregivers of mental patients are the backbone of the Health - therapeutic care systems. To care patients with mental disorders is responsible for family members to have a lot of stress. The purpose of the present study was to evaluate the efficacy of group psycho educational interventions on depression, anxiety and burden experienced (stress) in families of patients with mood disorders. Methods and Materials: This research was a semi-experimental study with control group and random assignment. In this study, the experimental group composed 6 subjects and control group 9 subjects. All participants were family members of patients with mood disorders who were hospitalized in 1390 at the Psychiatric Hospital Ibn Sina. Subjects completed family burden interview scale, Beck depression inventory, Beck anxiety inventory. Experimental group attend in 12 sessions of group psycho educational interventions, but the control group received no intervention at this time. Analysis of covariance was used for statistical analyses. Findings: The findings showed that both groups are different significantly in terms of depression, anxiety and burden. Conclusions: These findings indicated that group psycho educational interventions can decrease levels of burden, anxiety and depression.  

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Aim and Background: The aim of present study was investigating the efficacy of acceptance and commitment therapy (ACT) for couples on marital adjustment in men with bipolar II Disorder. Methods and Materials: Participants (3 couples) were selected using purposeful sampling. Nonconcurrent multiple baseline experimental single subject study was used as the method. The efficacy of couples’ ACT protocol was carried out in three phases of intervention (baseline, 12-session treatment and 3-month follow-up) by using dyadic adjustment scale (DAS). Data were analyzed by visuals analysis and percentage of non-overlapping data (PND) and percentage of overlapping data (POD) strategies. Findings: There was a significant difference between the mean values of the baseline and intervention scores. The effectiveness of couples-based ACT in men with bipolar II disorder was validated to improve the marital adjustment. Conclusions: ACT for couples can improve the marital adjustment in men with bipolar II disorder and decrease the rate of divorce.

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Aim and Background: The purpose of this study was to investigate the relationship between defense mechanisms with the formal elements of art therapy. Methods and Materials: Descriptive-correlational research method was used in this study. The studied population consisted of all patients referred to Modares Martyr Psychiatric Hospital of Isfahan and Mental Ills Center of Parasto, Iran. Among attendees, 60 individuals including 30 patients with bipolar disorder (14 men and 16 women) and 30 patients with schizophrenia disorder (13 men and 17 women) were selected with available sampling method. Defense styles questionnaire (DSQ), the person picking an apple from a tree (PPAT) painting test and formal elements art therapy scale (FEATS) were used in this study. Pearson correlation, Student's independent t-test and analysis of variance (ANOVA) were used to analyze the data using SPSS software. Findings: There was a significant positive correlation between defense mechanisms of humor, sublimation, suppression, undoing, reaction formation and rationalization with formal elements of integration, developmental level, line quality, logic, rotation, details of object and environment, and color fit. Also, there was a significant negative correlation between defense mechanisms of projection, acting out, isolation, denial, displacement, and somatization with formal elements of integration, realism, problem-solving, developmental level, details of object and environment, line quality, prominence of color and logic. On the other hand, tow patients groups of bipolar and schizophrenia disorders were different in all of the FEATS with the exception of the rotation element. In addition, sex difference was observed in three elements of integration, developmental level, and line quality. Conclusions: FEATS is able to identify the patients' defense mechanisms. Also, it seems that this measure is able to screen and diagnose the mental disorders.

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Aim and Background: The main component of nonverbal communication is recognition of face expressions of emotions, and defect in this ability is associated with weakness in social communication. Bipolar disorder is a kind of disorder that is characterized by this defect. Thus, this study aimed to investigate the effect of psychodrama on emotional rehabilitation of patients with bipolar disorder. Methods and Materials: This experimental study was carried out through pre- and post-test by control group. Using purposeful sampling method, 20 subjects were selected who were diagnosed with bipolar disorder by the psychiatrist according to Diagnostic and Statistical Manual of Mental Disorders-5 th Edition (DSM-5). Then, subjects were randomly assigned to two groups; experimental and control. The experimental group received 8 sessions of psychodrama treatment. The scores of the emotional rehabilitation questionnaire of both groups were collected before and after the intervention and in the follow-up period of 6 months, and then were analyzed by repeated measures of analysis of variance (ANOVA). Findings:  A significant increase in the scores of post-test and follow-up in comparison with that of pre-test in experimental group (F (2,36) = 49.87, P < 0.001, h 2 = 0.73). Also, the between-group results showed a significant difference between the experimental and control groups (F (1,18) = 5.32, P < 0.050, h 2 = 0.58). Conclusions: It seems that psychodrama is effective in increasing the emotional rehabilitation of patients with bipolar disorder; so, it is recommended as an effective treatment for these patients.

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Aim and Background: The research aimed to investigate the effectiveness of emotional schema therapy on the mood symptoms and impulsivity of women with bipolar disorder (I, II).

Methods and Materials: Present research was semi-experimental study with pretest-posttest design and follow-up with control group that was performed on 30 female patients with bipolar disorder referring to the Farabi hospital in Isfahan in 2016. Participants were selected by available sampling, then they were randomly assigned to experimental (n=15) and control group (n=15). Participants responded to Barratt Impulsiveness Scale (2004), Hamilton Questionnaire and Young Mania Scale in three steps pretest, posttest and follow-up. Experimental group in addition to medication, they received emotional schema therapy in group method during 14, 90-minute sessions while the control group did not received any cognitive intervention. Descriptive statistics methods and analysis of multivariate Covariance and were used for analyzing the data

Findings: Findings showed that emotional schema therapy had impact on the dimensions of impulsivity and mood symptoms (depression and mania) of bipolar patients and this effectiveness continued to be sustained in fallow up 3 months later.

Conclusions: Applying emotional schema therapy along with drug therapy can be effective intervention for treatment of mood symptoms and impulsivity in patients with bipolar disorder.

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Aim and Background: Understanding the predictors and vulnerabilities of bipolar disorder is very important because the prevalence and recurrence rate of this disease is high and even after treatment, patients still experience mild symptoms and functional impairments. Therefore, the present study aimed to investigate the mediating role of behavioral activation system–relevant cognitive styles in the relationship between traumatic childhood experiences with bipolar disorder syndrome in patients with bipolar disorder.
Methods and Materials: The present study was a descriptive correlational study. The statistical population consisted of all patients with bipolar disorder admitted to Shahid Hayinejad Hospital in Babol. The sample size was 379 people who were selected by available sampling method in a period of 18 months. In order to collect the research data have used  from the Child Trauma Questionnaire, Beck Depression Inventory- II,  Mania Self-Report Scale and 3 Questionnaires of behavioral activation system–relevant cognitive styles (Perfectionism / Performance Evaluation subscale of Dysfunctional Attitudes Scale, Self-Criticism subscale of Depression Experiences Scale, and Autonomy subscale of Autonomy - Community orientation Scale). The research data were analyzed using SPSS and LISREL software and structural equation modeling.
Findings: The results showed that traumatic childhood experiences have an effect on behavioral activation system–relevant cognitive styles and symptoms (depression and mania) of bipolar disorder (p <0.05). Behavioral activation system–relevant cognitive styles have an effect on symptoms (depression and mania) (p <0.05). In addition, the results showed that the behavioral activation system–relevant cognitive styles mediate the relationship between traumatic childhood experiences and symptoms (depression and mania) of bipolar disorder.
Conclusions: The results of the present study support the hypothesis behavioral activation system–relevant cognitive styles mediate the relationship between traumatic childhood experiences and symptoms (depression and mania) of bipolar disorder.

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Aim and Background: Research has increasingly shown a relation between childhood maltreatment and the dysregulated behaviors observed in individuals, yet the mediating factors in this relationship have received little attention. Thus, the primary aim of this study is to explore the role of cognitive processes as mediators in the relationship between childhood maltreatment and the dysregulated behaviors of individuals with bipolar disorder.
Methods and Materials: This study employed a descriptive and correlational research design. The statistical population consisted of all individuals with bipolar disorder who were hospitalized at Razi Psychiatric Hospital during the years 2023-2024. A total of two hundred individuals were selected for the research sample using convenience sampling. Data collection tools included the following: the Binge Eating Severity Scale (Gormally et al., 1982), the Deliberate Self-Harm Inventory (Gratz, 2001), the Alcohol Use Disorders Identification Test (Saunders et al., 1989), the Childhood Trauma Questionnaire (CTQ), the Cognitive Abilities Questionnaire (Nejati, 2013), the Difficulties in Emotion Regulation Scale- Short Form (Kaufman et al., 2016), the Acceptance and Action Questionnaire (Bond et al., 2011), and the Levels of Self-Criticism Scale (Thompson & Zuroff, 2004). Data analysis was conducted using SPSS and LISREL software, employing Pearson correlation and structural equation modeling techniques.
Findings: The study's results indicated that cognitive processes—including cognitive ability, self-criticism, experiential avoidance, and difficulties in emotion regulation—play a mediating role in the relationship between childhood maltreatment and dysregulated behaviors, such as alcohol consumption, binge eating, and non-suicidal self-injury, in individuals with bipolar disorder. The statistical fit of the model was strong, with the following indices: CFI= 0.96, NNFI= 0.95, IFI= 0.96, GFI= 0.92, and RMSEA= 0.072.
Conclusions: People with bipolar disorder who experienced childhood maltreatment often exhibit dysregulated behaviors due to cognitive processes. Therefore, clinical interventions focusing on cognitive processes are essential in preventing maladaptive behaviors in this population.