Volume 35, Issue 136 (July 2022)                   IJN 2022, 35(136): 150-161 | Back to browse issues page


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Alvandi S, Mardani-Hamooleh M, Ghasemi F, Esmaeeli N, Haghani S. Mental Pain in People With Bipolar Disorder Hospitalized in a Psychiatric Hospital in Tehran, Iran. IJN 2022; 35 (136) :150-161
URL: http://ijn.iums.ac.ir/article-1-3525-en.html
1- Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran.
2- Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran. , mardanihamoole.m@iums.ac.ir
3- Department of Psychiatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
4- Department of Psychology, Iran Psychiatric Hospital, Iran University of Medical Sciences, Tehran, Iran.
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Introduction
One of the most important mental disorders is bipolar disorder, which is characterized by episodes of mania and depression. This disorder can be associated with negative emotions and mental pain. Mental pain is caused by a person’s failure to meet and satisfy their needs, which can lead to tension and negative emotions such as feelings of shame, guilt, despair, humiliation, sadness, and anger. Mental pain is seen in patients with mental disorders such as anxiety, eating disorders, personality disorders, schizophrenia, and bipolar disorder, but is more common in patients with bipolar disorder. It can be associated with the symptoms of psychosis. This pain has a big role in the pathology of depression and is directly related to the severity of depression in patients with depressive disorder. Mental pain can cause self-harm and is one of the predictors of suicide attempt in patients with the depressive episode of bipolar disorder. When the mental pain becomes severe and annoying, a person commits suicide to get rid of it. With low mental pain, the patients with psychological disorders respond better to psychotherapy. This study aims to determine the mental pain of people with bipolar disorder in Tehran, Iran.
Materials & Methods 
This is a descriptive study. Participants were 153 people with bipolar disorder admitted to Iran Psychiatry Hospital in Tehran, Iran who were selected by a continuous sampling method. Inclusion criteria were: Having a diagnosed bipolar disorder based on medical records, age 18-60 years, being literate, and not having visual and hearing impairments. A demographic form and Orbach Mikulincer Mental Pain (OMMP) Scale were used to collect data. The demographic form was used to survey the age, gender, marital status, educational level, employment status, economic status, history of suicide, and history of previous hospitalization in the psychiatric ward. The OMMP scale was designed by Orbach et al. (2003) [24] and has 44 items rated on a 5-point Likert scale as 1=Strongly disagree, 2=Disagree, 3=Somewhat agree, 4=Agree, and 5=Strongly Agree. The total score ranges from 44 to 220.  Data analysis was performed in SPSS software version 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (Pearson correlation test, independent t-test, and analysis of variance). P<0.05 was statistically significant. 
Results 
The freezing dimension of mental pain had the lowest score, while the emotional flooding dimension had the highest score. Comparison of mental pain scores based on demographic characteristics showed that the statistically significant relationship of history of suicide attempt (P<0.001), economic status (P=0.002), and employment status (P=0.02) with mental pain. Those with a history of suicide attempt, those with poor financial status, and unemployed patients had higher mental pain.
Discussion
The results of the present study emphasize the need for psychological interventions to reduce mental pain in patients with bipolar disorder. It seems that having a history of suicide attempt increases their mental pain due to creating mental preoccupation. In addition, having a poor economic status, which can be due to unemployment, can increase the severity of mental pain in patients with bipolar disorder. More studies are needed to generalize the results to all patients with bipolar disorder in Iran.

Ethical Considerations
Compliance with ethical guidelines

This study was approved by the ethical committee of the Iran University of Medical Sciences (Code: IR.IUMS.REC.1399.602). All ethical principles are considered in this article.

Funding
This study is taken from the Master's thesis of Samira Alwandi, Department of Psychiatry, Faculty of Nursing and Midwifery, Iran University of Medical Sciences.

Authors' contributions
Conceptualization: Samira Elwandi and Marjan Mardani Hamouleh; Research: Marjan Mardani Hamouleh, Nazanin Esmaili and Fariba Ghasemi, Analysis: Shima Haqqani; Project management: Marjan Mardani Hamouleh; Compilation and finalization: Marjan Mardani Hamouleh.

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
The researchers are thankful to all of the participants.
 
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Type of Study: Research | Subject: nursing
Received: 2022/01/17 | Accepted: 2022/06/22 | Published: 2022/07/1

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