International Mental Health ResearchKlinik für Psychosomatische Medizin und Psychotherapie

Since October 2010 the cities of Freiburg and Isfahan have established a town twinning project, which has led to numerous contacts on the administrative level and an intense cultural exchange between the partners (for further information click here). On 16th of October 2003 the Albert-Ludwigs University and the Isfahan University ratified a Memorandum of Understanding, a declaration of intent to cooperate in scientific research and in the training of human resources. Based on this MoU, former University Rector, Prof. Dr. Jäger, visited Isfahan University together with Dr. M. Salavati, the initiator of the town twinning project, in 2008 and ratified the cooperation between Freiburg University and the Isfahan University for Medical Sciences.

Following up on this MoU, Prof. Dr. med. Carl Eduard Scheidt was invited to take part in the 2nd International Conference for Psychosomatic Medicine in Isfahan in spring 2008. During this event the postgraduate curriculum in psychosomatic medicine and psychotherapy was introduced to the Iranian medical doctors and it was mutually decided to establish and adapt this curriculum to the Iranian context and needs. Based on these fruitful discussions and ideas a conjoint project proposal was developed and introduced to the German Academic Exchange Service (DAAD) for Funding. The consent for funding was given in 2009 and the first project phase of curriculum development and exchange of experiences started in January 2010.

The aim of the cooperation during this phase was to develop and improve the already existing cooperation and dialogue between the Isfahan University of Medical Sciences, Iran and the Albert-Ludwigs-University, Freiburg by focusing on an interdisciplinary cooperation project dealing with issues of globalization and health.

The term globalization refers to the fact that the growing exchange of goods and ideas worldwide leads to a rapid change of social structures in developing countries. Globalization also affects health care and medicine. The increase of migration requires a more detailed understanding of how cultural differences shape illness behaviour and mechanisms of coping. Doctor patient communication is substantially influenced by roles in the medical setting, which differ between cultures and societies.

Illnesses, in which the influence of culture specific factors are most obvious are psychiatric and psychosomatic disorders such as depression, eating disorders, somatoform disorders etc. In close cooperation between the IUMS and Freiburg University, a transcultural and interdisciplinary dialogue and perspective has been developed, in order to describe and compare socio-cultural factors of health and disease in the two countries, Iran and Germany. In particular the project is focusing on sociocultural aspects of the manifestation and treatment of psychiatric and psychosomatic disorders because in these conditions social and cultural factors are most directly reflected.

Since the beginning, the dialogue has addressed medical staff (doctors and medical students) as well as to other health related professions, such as clinical.

The project aimed to realize a reciprocal process of discussion of the participating institutions and staff members and to attain a maximum of sustainability. In order to guarantee sustainability as one line of the project a curriculum on psychosocial skills and psychosomatics was developed, adjusted to the Iranian culture and demands of medical treatment. A core group of Iranian experts was involved in the discussion of the curriculum and trained to teach the curriculum in their own country.  This core group and the jointly developed curriculum have been the basis for all subsequent and future project phases.

The project consisted of three parts, which interact and reinforce each other, and establishes an intensive and effective dialogue.

With the venue alternating between Isfahan and Freiburg 3 Summer Schools have been hosted by IUMS and Freiburg University. The schools lasted for two weeks each and focussed on the following topics:

1. Globalization and psychiatric/psychosomatic illnesses
2. Gender specific aspects of psychiatric/psychosomatic illness and their treatment.
3. Patient participation and treatment planning in the medical setting

The participant group consisted of 30 to 50 medical doctors, clinical psychologists and social scientists both from Iran and Germany.

Voices from the Summer Schools

Exchange of students and scientists (research grants)

Throughout the 4 years of the first project phase several research projects could be initiated and supported, such as:

• Regressions of Cognitive, Personality and Family Variables in Iranian and German Patients with Migraine Headache

• Biopsychosocial versus biomedical reasoning: a cognitive approach
• Breaking bad news

These research projects have been transcultural and interdisciplinary in design.

Curriculum on Psychosocial skills (psychosomatic medicine and psychotherapy)

The curriculum on psychosocial skills for medical doctors and clinical psychologists has been developed through biannual workshops hosted in Isfahan, Iran.
Topics have been:

• Depression
• Psychosomatic aspects of pain
• Family Medicine and Therapy
• Trauma and loss
• Psycho-oncology
• Family and Couple Therapy

Obsessive Compulsive Disorders For the purpose of training and curriculum development, experts in psychosomatic medicine from well-known German centers have been invited to join the faculty, such as …?

Over the past 20 years, the Iranian government has made substantial efforts to improve psychosocial and mental health care for the Iranian population through the integration of appropriate services into the primary care system. A crucial step in this development will be the inclusion of basic mental health training into the curriculum for Family Medicine.

In a joint project between the Isfahan University for Medical Sciences, Isfahan, and the Department for Psychotherapy and Psychosomatic Medicine, Freiburg, a training module for mental health will be developed and implemented with the goal of being incorporated into the program for Family Medicine by the Iranian government.

The training of general practitioners in psychosomatic basic care has been standard practice in Germany for many years. A certified and evaluated curriculum exists, which provides primary care doctors with basic knowledge in the clinical assessment of mental disorders and communication skills in interactions with patients. In cooperation with Iranian general practitioners, psychiatrists and psychotherapists, this curriculum will be adapted to the socio-cultural context of the Islamic Republic of Iran. In doing so, we can draw back on preliminary work in Iran focusing on culture-bound aspects of mental and psychosomatic disorders.

Throughout the course of three years, the project will be realized through the following steps:

1. A one-year project phase for the development and adaptation of the curricular content and teaching formats, including teaching tools for web-based learning.
2. A practice phase, in which the curriculum is implemented by Iranian and German experts in co-moderation
3. A follow-up practice phase II for the implementation of the curriculum under Iranian management with German supervision.

The project is supported by the DAAD and the Federal Foreign Office.