BACKGROUNDAcute myocardial infarction (AMI) is the leading cause of morbidity and disability among Iranian population. Pre-hospital delay is an important cause of increasing early and also late mortality in AMI. Thus the aim of the present study was to identify the factors influencing pre-hospital delay among patients with AMI in Iran.

METHODSBetween August 2010 and May 2011, a cross-sectional and single-center survey was conducted on 162 consecutive patients with ST-elevation myocardial infarction (STEMI) admitted to Cardiac Care Unit (CCU) of Dr. Heshmat Hospital, Rasht. All patients were interviewed by the third author within 7 days after admission by using a four-part questionnaire including socio-demographic, clinical, situational and cognitive factors. Data were analyzed by descriptive and Logistic regression model at P < 0.05 using SPSS 16.

RESULTSMean age was (60.11 ± 12.29) years in all patients. Majority of patients (65.4%) were male. The median of pre-hospital delay was 2 hours, with a mean delay of 7.4 hours (± 16.25 hours). Regression analysis showed that admission in weekend (P < 0.04, OR = 1.033, 95%CI = 1.187 - 2.006) and misinterpretation of symptoms as cardiac origin (P < 0.002, OR = 1.986, 95%CI = 1.254 - 3.155) and perceiving symptoms to not be so serious (P < 0.003, OR = 3.264, 95%CI = 1.492 - 7.142) were factors influencing pre-hospital delay > 2 hours.

CONCLUSIONSOur findings highlight the importance of cognitive factors on decision-making process and pre-hospital delays. Health care providers can educate the public on AMI to enable them recognize the signs and symptoms of AMI correctly and realize the benefits of early treatment.

Acute Disease ; psychology ; Aged ; Cross-Sectional Studies ; Decision Making ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; psychology ; Time Factors

Objectives: Obsessive-compulsive disorder is one of the most common psychiatric disorders that cost a lot for the patient and the community. An important factor that is supposed to be associated with severity of OCD symptoms is emotion dysregulation. Thus, the purpose of this study was to examine different aspects of emotion dysregulation on the severity of OCD symptoms.. Methods: It was a descriptive-correlational study. 477 students of universities of Tehran were selected and completed Difficulties in Emotion Regulation Scale (DERS), Acceptance and Action Questionnaire (AAQ-II), Perseverative Thinking Questionnaire (PTQ), Obsessive-Compulsive Inventory Revised (OCI-R), Generalized Anxiety Disorder assessment (GAD-7) and negative affect subscale of (PANAS). Data was analysed by Pearson correlation, multiple hierarchical regression analysis and ANOVA. Results: The result shows that among different aspects of emotional regulation, impulse control difficulties and experiential avoidance predict the severity of OCD even after elimination of high levels of GAD and controlling of negative affect. In addition, participants with heightened GAD symptoms had significantly higher scores on Goal-directed behaviour and limited access to emotion regulation strategies than participants with heightened OCD symptoms. Conclusion: Our findings suggested that emotion dysregulation explains partial contribution of the psychopathology of OC symptoms in nonclinical people. However, in clinical condition it would be a considerable factor that mediates levels of severity, likewise other, emotion disorders. Future research will be needed to examine preventive and therapeutic role of emotion regulation in obsessive–compulsive symptom dimensions.