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Brain and Neurological Disorders. This research studies the comparison of body image distortion in patients with depression and normal in Rafsanjan city, Iran. Method: This is a descriptive-analytical study with case and control group. The investigated population consists of all patients with depressive disorder who referred to psychiatric Children and Adolesce outpatient clinics of Rafsanjan City A city in southwest of Iran in Drawing test of 'Good enough - Harris' had been used in 40 depressed patients and 40 non-depressed as a control group. Chi-square test for data analyzing had been used. Results: The results showed that depressed patients in painting of the dummies were different in the most aspects as compared to control group. Conclusion: We suggest using 'dummy test Good enough- Harris ' in order to complementary diagnosis of depressed Persons. Major depressive disorder MDD , as one of the most prevalent psychiatric diagnoses, is characterized by the sense of depression and sadness, low self-confidence, and the lack of interest in any types of daily activity or enjoyment, which is also called 'psychological cold'. It is a set of different psychological states ranging from mild sense of dysphoria of silence and avoidance of routine activities \[1\]. In , Chai reported a significant difference between drawings of individuals with mania, mental retardation and schizophrenia with other patients \[6\]. Although there are a wide range of Draw-a-Man DAM tests \[9, 10\], all of them require a subject for drawing one or more men. Among drawing test, DAM is the oldest and the most reputable test. Since drawing tests are used as evaluative measures of mental functions, family personality and functions, emotions, fears and needs and for identification of gender roles, this study aim to compare the body image disorders in DAM of patients with MDD and healthy people. This is a descriptive-analytical study with case and control group. The investigated population consists of all patients with depressive disorder who went to psychiatric clinics of Rafsanjan city in The test was administered on 40 children with depressive disorder and 40 normal children that aged between 8 to 12 years old. In this study, non-probability convenience sampling method was used. Both groups case and control were matched in six variables, namely age, sex, education, marital status, and the lack of physical disorder. It is an easy administrable test. Make the very best picture that you can. Take your time and work very carefully. Try very hard and see what a good picture you can make '\[12\]. In the next step, the chronological age of the child is calculated. For example, if the subject is 10 years and 3 months old, we should multiply 10 by 12 and then add it with 3 number of months to obtain chronological age of the child. Subject's IQ is obtained by dividing the product of numerator and denominator and multiplying the output by , as follows:. After data collection, they were introduced to a computer as special codes and analyzed by SPSS Chi-square and T-square test tests were used to obtain descriptive statistics of tables and diagrams, and inferential statistics. In addition, p Results: In this study, 80 cases of depression and healthy Persons were collected that Frequency distribution of both groups healthy and depressed in various aspects of drawing are as follows:. Table 1: The frequency distribution removing members in drawing a person test among healthy subjects and depressed. As, you have observed in the table above Table 2: Frequency distribution local drawing of painting in healthy and depressed Persons. Table 3: Frequency distribution of geometric shapes in the drawing a person test in depressed and healthy Persons. The above results indicated that healthy persons had not used Table 4: Frequency distribution of incorrect replacement members in the drawing depressed and healthy persons. The table shows that only Table 5: Non-custom size distribution members in the drawing in the depressed and healthy persons. Table 6: Frequency distribution of deformation in the drawing depressed and healthy persons. As the table above observed in Table 7: Frequency distribution of replacement draw a person test Incorrect page depressed and healthy persons. Table 8: Frequency of members in the draw incorrect Fitness at healthy and depressed persons. As been observed in the table above, six cases Above normal person's depicted Also in healthy persons Results of this study showed that member omission, image transparency, using figures, wrong placement on the page, wrong member placement, deformation, wrong member symmetry, and the place of drawing on the page are significantly more frequent in depressed persons as compared to normal persons. These results correlate with the findings of other studies in the field. Regarding the member omission in draw-a-man test, results showed that member omission is more frequently observed in depressed persons. This correlated with the results reported by Key, Qaleiha et al \[13\]. This issue is further seen in patients. Member omission is in fact considered a kind of denial defensive mechanism. Like those suffering from schizophrenia, depressed persons omit the bigger part of the drawing. This can indicate unconscious personal conflicts. In fact, depressed persons may remove some parts of the drawing and or do not believe in that due to losing energy, not being in mood and even nihilistic delusions. It can also be inferred that depressed persons suffer from internal conflicts. Now, it can be said that the conflicts can be diagnosed using the psychological interpretation of drawing and based on the omitted member. Another finding is related to the place of drawing the image of body. Persons further tend to draw at the top of the page yet depressed ones at the bottom. In other words, most depressed persons in this study drew the man inappropriately. This disorder was observed in a few non-depressed persons. This correlates with the results of a study reported that wrong drawing placement on the page is farther in depressed persons. It must be noted that the middle of the page is the suitable place for drawing. Drawing the man at the corner of the page can explain the feeling of despair and worthlessness in the depressed Persons. The suitable place of the drawing almost indicates security and confidence. Normal persons usually draw the man in the middle of the page. Another reason can be low confidence and improper eye contact in depressed persons. Another finding was the wrong placement of the members in drawing. It was further observed among depressed persons as compared to the normal ones. This correlated with the results of other studies. The wrong placement of the members can be attributed to their cognitive problems, lack of focus, low temper, and low motivation. When bodies are disproportionate the improper symmetry of body and or members are not attached to the body and or some parts of the body are attached to the wrong places the wrong placement of body , distortion occurs. Mild distortions reflect a weak self-image, anxiety, and weak adjustment. Strong distortions are seen in children who have experienced severe emotional changes. Impulsive children do not pay attention to the symmetry of the drawing. Regarding the deformation of the drawings further seen in patients, it can be explained by the absence of mind, reduction of concentration, and reduction of patience. The same happened in Sayadi et al \[5\] study on schizophrenia patients. Similar results were also reported at a psychiatric ward of Farshchian Hospital, Hamedan. In this research, it was found out that the higher percentage of the depressed persons had improper symmetry of the drawing and a lower percentage had wrong placement of the drawing. Distortion included a change in the general design of the drawing deformation. This together with the addition of strange details to the drawing almost shows that the persons are not aware of realities. They are confused and unsettle. It can demonstrate psychosis. The higher percentage of depressed persons under study showed this disorder. The abnormal size of drawings was further frequent among depressed persons. This is similar to the results of other studies. These results do not correlate with the results reported by Holmes regarding the relationship between depression and the size of drawing. Rodenberg et al carried out a study on the painting of years old persons. They showed that the main symptoms of aggression in persons to draw-a-man test included drawing with large, big muscles, long arms and nails, etc. Since the signs of violence are also seen in some depressed persons, the issue can partially be attributed to depression. In this study, no significant difference was observed between depressed and normal persons in determining gender. Since the mental image of body is the image and feeling of a person from size and form of his own body and its constituent elements in the mind. It shows that individuals whether men or women, depressed or non-depressed further tend to demonstrate their feelings in terms of male sexuality. The last result of this study was related to Good enough test scores for both depressed and normal persons. Mean depressed children score was clearly lower as compared to the normal ones. Reviewing the history of Good Enough-Harris test shows that depressed children test score is lower than the normal persons score. Results are almost similar to the results of the previous studies. Like graphic texts, the analysis of the semantic levels of language, text, figure or painting is possible by the aids of the implications and theoretical principles of visual arts. Depressed children like, schizophrenia and mental retardation. The conscious concept of body image is a cortex-dependent process. The body image is also a part of perception and motion. Hence, it can be inferred that, in depressed Persons, cortex processes and perceptual processes have changed. Thus, using thus indirect evaluation technique and by the aids of demonstrative activity, it is possible to diagnose what a depressed person is not able to express. We thank all participants in this study. It is a manuscript-based thesis for achievement of doctoral degree in medicine. Also, its proposal is approved in psychiatric group and research committee in Moradi hospital, Rafsanjan City. RB had basic role in design and management of this study. All other participated authors helped to perform stages of study and wrote draft of article then RB revised the article and manuscript. Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. 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Drawing and Assessment Notes: Providing the child with a black pencil or an appropriate pen, as drawing with coloring pencils is difficult, making the identification of drawing's components problematic. Drawing with coloring pencil requires other conditions for evaluation. Different drawing results imply other disorders. In this case, the child should be referred to a psychologist or a psychotherapist Scoring System: A: Each component drawn by the child has 1 score as follows: Head presents Legs present Hands present one hand or both Trunk presents Length of the trunk is greater than the breadth Shoulder presents Both arms and legs attached to the trunk Legs and hands attached to the trunk at the correct points Neck presents Outline of the neck is attached to the head and trunk Eyes present Nose presents Mouth presents Two lips shown Nostril shown Hair shown partial Hairs shown completely Clothing presents signs of clothing Two articles of clothing All trunk covered by clothing Four articles of clothing definitely indicated ext. Then, and IQ is obtained using following equation For example, if the raw score of a test is 40, the corresponding raw score should be found in the conversion table Table 1 , and the mental age is extracted here it is This is the child mental age. Then, the obtained number is multiplied by 12 months of a year. In addition, p. In this study, 80 cases of depression and healthy Persons were collected that Frequency distribution of both groups healthy and depressed in various aspects of drawing are as follows: Table 1 : The frequency distribution removing a member in draw a person test Variable cases Removal of member P- value they have no removal members they have removal members Healthy Persons Variable cases Geometric shapes P- value they have no removal members they have removal members Healthy persons Variable cases Incorrect replacement members P- value no yes Healthy persons Variable cases Non-custom size distribution members P- value no yes Healthy persons Variable cases Deformation in the drawing P- value no yes Healthy persons It has financial support in Rafsanjan university of Medical Sciences. The initial complaints in depressed people. J PCPY. The epidemiological study of depression in the region of Kerman, Mahan. Medicine and purification. An epidemiological survey of psychiatric disorders in Iran. Clinical practice and epidemiology in mental health. Symptoms of aggression in Paintings Dummy test the 9-year-old boys. Journal of Fundamentals of Mental Health. Body image disorder in patients with schizophrenia and normal individuals. Journal of thought and behavior. Size and coloring of drawing a person test in adolescents with bipolar disorders. British Journal of Clinical Psychology. The Arts in Psychotherapy. What's in a picture? Comparing gender constructs of younger and older adults. The Journal of Men's Studies. Normalization's men scale drawing of dummy Goodenough - Harris on Bushehr children 6 to 11 years old. Journal of Psychology. Qualitative differences in human figure drawings according to schizophrenic subtype. Perceptual and motor skills. Psychological Assessment. Tehran, Roshd Publication; Comparison of the disturbance in mental image of the body in patients with major depression disorder and non-depressed persons. Journal of Birjand University of Medical Sciences. The scientific status of projective techniques. Psychological science in the public interest. View at Publisher View at Google Scholar. Mina Sherif Soliman Georgy. Anthony Kodzo-Grey Venyo. Gomez Barriga Maria Dolores. Maria Dolores Gomez Barriga. Dr Maria Dolores Gomez Barriga. Dr Maria Regina Penchyna Nieto. Table 1 : The frequency distribution removing a member in draw a person test.
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