Iranian Journal of Psychiatry and Behavioral Sciences
Volume:11 Issue: 2, Jun 2017

Context: We aimed to conduct a scientometric study by investigating published papers of Iranian researchers on autistic disorders.Evidence Acquisition: We conducted a systematic review of the literature to retrieve all relevant studies on autism that are published by Iranian researchers. Seven databases were searched, of which three were local Iranian databases (Magiran, SID and Irandoc), and four were widely used English language databases (PubMed, Scopus, ProQuest and PsycInfo). Bibliometric information of all papers was extracted. Two hundred and six (95 Persian and 111 English) papers published between 1979 and 2015 were retrieved. Comparison between subject areas showed that non-pharmacological intervention and biological studies had the largest number with 64 and 61 papers, respectively. Among universities, Tehran University of Medical Sciences with 81 articles was most productive, and among the research centers, psychiatry and psychology research center (Tehran University of Medical Sciences) with 32 articles was the most productive research center. The trends of research in the field of autism among Iranian researchers have the same patterns as the global trends. However, some important topics, such as prevalence, causes, services, and life span issues and the infrastructures have been studied less and should be considered in future studies. Moreover, it was revealed that we are faced with shortness of sources for research in this field, and the policy makers should consider this problem. We need to conduct researches that take into account our inner context, and the subject and quality of the research should be given more importance than the number.

Context: One the most prevalent endocrine disorders among females of the reproductive age is polycystic ovarian syndrome (PCOS). Studies have shown that a number of disorders are associated with PCOS, including depression, anxiety, impaired body image and body dissatisfaction, eating disorder, sexual dysfunction, and reduced quality of life. However, there is still a shadow of doubt regarding the etiology of these disorders in the literature. Based on a review of literature on PCOS symptoms and its disorder, it has been revealed that clinicians generally identify the physical symptoms of PCOS while the psychological aspects of PCOS have remained unexplored. The current study aimed at reviewing the psychosomatic aspects of PCOS.
Evidence Acquisition: The current study aimed at reviewing the research regarding PCOS published in various databases, including Google Scholar and more specifically PubMed, ProQuest, Ovid, web of science, Science direct, magiran, scientific information database (SID), and IranMedex. The keywords used for finding relevant research articles were polycystic ovarian syndrome, mood disorders or psychological issues, psychosocial problems, borderline personality disorder or personality disorder, stress, coping styles, physical symptoms, obesity, sexual dysfunction, and quality of life. Research articles published from 1983 to 2016 with relevant topics were selected for this study. Overall, 130 articles were searched. However, after a screening procedure was carried out by the researchers based on the summary of all articles, 53 full articles were considered for this study.
Based on researchers’ findings, 2 general categories emerged: (a) Psychosocial concerns related to PCOS (body dissatisfaction, body weight and body-image disturbances, sexual and relational functioning, femininity, fertility and sexuality concerns, health-related quality of life, stress, and coping responses); and (b) Psychiatric disorders (mood disorders, major depressive disorder, bipolar disorder, anxiety disorders, eating disorders, and borderline personality disorder).
Given the high prevalence and the serious psychiatric complications associated with PCOS in females, clinicians should pay considerable attention to this condition and ensure that patients receive adequate psychotherapeutic and pharmacologic treatments. Additionally, it is suggested that nurses and health care providers, through providing psychosocial education and support, should improve coping strategies of females with PCOS.

Context: Depression is a risk factor for vascular disease and vice versa. Identification of biological mechanisms common for depression and vascular pathology at microvascular level, and understanding their clinical significance may contribute to better treatment and prognosis of this combined physical/psychiatric disorder.
Evidence Acquisition: We searched the PubMed computer database for the following key words “Microvascular AND Depression” on the 28th of October, 2015 to obtain relevant articles, which were consequently summarized to facilitate further research in the field of psychiatry.
The majority of studies support the suggestion that microvascular abnormality is associated with depression even if several documents do not necessarily support this idea. It seems probable that microvascular abnormality is only relevant in particular subtypes of depression, for example depression due to a general medical condition, late-life depression, or pharmacoresistant depression. The biological mechanisms by which microvascular abnormality is interconnected with depression may cover genetics, epigenetics, endothelial dysfunction, inflammation or hyperhomocysteinemia.
Further research should be aimed at identifying biological mechanisms common in depression and microvascular pathology, including genetics and epigenetics, longitudinal studies of this subcategory of patients with depression, and possible pharmacotherapy overcoming the usual non-responsiveness. An active detection and aggressive treatment of physical diseases associated with microvascular pathology and depression, like hypertension, diabetes or inflammation, is warranted. This way, the patients experience less distress, their quality of life will increase, and societal cost of this vascular/psychiatric disorder will be reduced.

Context: One of the serious global problems is the irrational prescribing of medicines that can be regarded as harmful or wasteful. Inappropriate use and overuse of medicines, waste resources and therefore lead to health and economic consequences in patients. The goal of this systematic review was to identify factors associated with irrational prescriptions of medicine.
Evidence Acquisition: We searched the Cochrane database of systematic reviews (via Cochrane library), PubMed, Medline, Scopus, Science Direct, BMC, Scholar Google, and SID from 1980 up to October of 2016.
Of the 594 papers, 26 papers were finally included. The combined results of the 26 papers indicated 24 factors for unnecessary prescriptions of medicine. Factors related to the patient were expectations, demand to prescribe, and poor medical knowledge. Factors related to the physician were inaccurate diagnosis, inadequate awareness and knowledge, low experience, information asymmetry, poor medical education, and the physician’s attitude. Factors related to the institutional and political issues were fee-for-service, out-of-pocket payment, financial incentives, insurance reimbursements, insurance coverage, medicine subside, medicine advertisement, ineffective monitoring programs, regulation on prescription, prescription supervision, clinical guidance, and medicines near-expiry dates or expired.
It can be concluded that the irrational/unnecessary prescription of medicine was influenced by many different factors, such as patient, physician, and institution. Thus to prevent irrational/unnecessary prescription, one needs to consider all the involved factors.

Opiate use on a stable methadone dose is a health concern in Iran (Persia). Cognitive-behavioral therapy (CBT) is a suggested treatment for this problem.
The study aimed to assess the CBT effectiveness in the treatment of regular opiate use on a stable methadone dose in Shiraz, near the Persian Gulf of Iran.
The study design was a multicenter randomized controlled trial. The study was conducted at two methadone clinics during 2015. Overall, 118 patients who were regular opiate users were selected. Participants were randomly assigned (1:1) to receive either CBT (n = 59) or remain in a control condition (n = 59). The Opiate Treatment Index, Contemplation Ladder and Severity of Dependence Scale were completed at baseline, post-treatment and a three-month follow-up. The primary outcome was the reduced mean score of regular opiate use. Other outcomes included an increased readiness to reduce opiate use and reduced severity of opiate dependence. Data were analyzed performing intentions-to-treat analyses, independent samples t-tests and Wilcoxon Rank-Sum tests.
CBT significantly reduced opiate use (z = 3.73, P = 0.01, d = 0.89) and the severity of opiate dependence (z = 7.36, P = 0.01, d = 0.64) after four weeks of treatment. Readiness to reduce opiate use significantly increased (t (116) = 9.55, P = 0.01, d = 0.81) over the same time. All study results remained stable at three-month follow-up while no significant change was found in the control group.
CBT can be used as an effective intervention to reduce regular opiate use on a stable methadone dose. A larger study with more Persian participants and a six-month follow-up is suggested.

Neurofeedback training is a promising area of research in cognitive performance. Although diverse patterns of frequency in improving memory performance have been studied, beta up-training and low alpha/high alpha ratio suppression have not yet been studied.
The present study aimed at examining the effect of 2 neurofeedback protocols “beta up-training” and “low alpha/ high alpha ratio suppression” on memory performance.
Thirty healthy participants, aged 20 to 40 years took part in this double-blind study. Participants performed ten 30-minute sessions of neurofeedback training. They were randomly assigned into 3 groups: (A) beta up-training and theta down-training, (B) low alpha/high alpha ratio suppression training, and (C) sham training. The Wechsler memory scale (WMS-R) was performed before and after the training period to examine memory performance. Data were analyzed using ANCOVA to compare memory performance changes among the 3 study groups.
No significant differences were obtained among the participants in age, gender, marital status, and psychological condition. Treatment groups (including beta up-training and theta down-training and low alpha/high alpha ratio suppression training) showed superior improvement in memory performance compared with the sham group.
Neurofeedback training can improve memory performance. Future studies should address the specificity of the neurofeedback training effects, taking into account various populations of patients with cognitive impairment.

Methamphetamine (MA) use disorder is a new health problem among female methadone patients in Iran. Some characteristics of women are likely to be associated with poor methadone treatment outcomes. However, there are few studies about the characteristics of this group.
The current study is the first research that aimed to investigate the demographic, drug use and treatment characteristics of a group of regular MA-using women in methadone treatment.
Methadone-maintained women who reported at least weekly MA use were recruited from four methadone treatment centres in Tehran. Participants’ drug use, severity of MA dependence, psychiatric distress, social functioning, criminality and high risk sexual behaviours were measured among the participants. Urinalysis was done to confirm MA use.
Between 28 July 2014 and 15 May 2015, 120 participants completed an interview. Mean duration of MA use was 5.4 (SD 2.1) years. Only 9.2% of the participants reported prior MA treatment. Psychiatric distress was high among all participants. Overall, 61 participants (50.8%) reported long duration of MA use (i.e. five years or more) while 59 participants (49.2%) reported less than five years of MA use. Severity of MA dependence (P = 0.38), psychiatric distress (P = 0.36), social functioning (P = 0.12) and criminality (P = 0.82) were not significantly associated with duration of MA use. However, participants who reported long duration of MA use were more likely to be engaged in high risk sexual behaviours (P = 0.01) compared with those reporting short duration of MA use.
The study results indicated that participants had multiple health problems. High risk sexual behaviours were considerable among participants with long duration of MA use despite being in methadone treatment. Participants had little or no previous treatment for MA use disorder. Treatment services should be expanded to address MA use disorder and its harms among this group.

Methamphetamine as one of the most prevalent drugs can reduce the efficacy of interventions designed to reduce HIV prevalence such as opioid substitution therapy and other harm reduction interventions. Harm reduction facilities and interventions have mainly been designed for opioid users, but due to the high prevalence of methamphetamine use among the clients, these settings could be appropriate entry points for providing methamphetamine focused harm reduction interventions.
The present study aimed at examining the effects of the integration of a methamphetamine harm reduction intervention into opioid harm reduction services of drop in centers (DICs) on the high- risk behaviors of the participants.
This prospective study was conducted to evaluate changes in high- risk behaviors associated with methamphetamine use among regular methamphetamine user clients of 10 DICs located in provincial capitals of Iran from September 2014 to March 2015. Participants were evaluated before and after a manual based psychoeducation intervention.
In total, 357 clients (18.5% females, and 81.5% males) entered the study; of whom, 60.3% of males and 83.3% of females were daily methamphetamine users at initial assessment. The prevalence of injection in the last 3 months was 8% and 1.6% among male and female participants, respectively. The frequency of sexual intercourse among participants had a significant reduction after intervention. The use of a condom in the last intercourse was increased significantly, moreover, having sexual intercourses without condom under the influence of methamphetamine was reduced, especially among females.
The results of the present study provide provisional data on the effectiveness of stimulant harm reduction among clients of DICs in Iran. In addition, our findings revealed that service providers believe that this integration is feasible and the clients found it acceptable. Conducting studies with more rigorous design and longer follow-up is highly recommended.

Alcohol use is a health concern in Iran, the most populated Persian Gulf country. However, alcohol use disorder treatment is a new issue in Iran, which needs consideration.
In this article, we present a study protocol that aims to investigate the feasibility and effectiveness of integration of outpatient alcohol use disorder treatment in drug treatment centers in Iran.
The study design is a prospective cohort and multi-center research, which will be conducted in major cities of Iran in 2016 - 2017. Overall, 750 participants with psychiatric diagnosis of hazardous alcohol drinking or dependence will be recruited. The settings will be 150 outpatient drug treatment centers. This project will be implemented in 3 phases. Phase I will be the preparation phase, Phase II will focus on training treatment providers and Phase III will be the main phase of the study and will evaluate the feasibility and effectiveness of integration of alcohol use disorder treatment services within outpatient network of drug treatment centers. Five questionnaires will be used to assess the study outcomes. Completing the study questionnaires at baseline, weeks 4, 12, 24, and 52 will assess participants. Data analyses, including descriptive statistics, regression models, and repeated measures of ANOVA will be performed using SPSS version 22.
This is the first study to investigate the feasibility and effectiveness of integration of outpatient alcohol use disorder treatment in drug treatment centers in Iran. If found effective, the results of this study will be useful for applying in Iran and other countries in Western and Central Asia.

Therapeutic community program (TCP) is a developed drug treatment modality in Iran (i.e. the most populated Persian Gulf country). In recent years, TCP has been developed for women in Iran. However, there are few studies of women on TCP and their treatment needs.
The current study is the first research that aimed to explore the treatment needs of drug-dependent women on TCP in Tehran and Karaj cities in Iran.
A qualitative study was designed and conducted in 2011. The study sites included Chitgar, Shahriyar and Hesarak centers in Tehran city, Iran and Shahr-e-Ghods center in Karaj city. Qualitative methodology was selected as the main method of conducting the study. Overall, 20 women were individually interviewed and nine key experts were interviewed in three focus group discussions. Atlas-ti software was used for qualitative data analysis.
The median age of the women was 32 years. The median year of education was nine years. The study findings indicated that continued professional staff training, considering treatment needs of special female groups, extended treatment duration with special services and family support and education were the most frequently reported treatment needs of women.
The therapeutic community program for women needs especial attention to the treatment needs of this group of illicit drug users. The reported treatment needs should be considered in designing and implementing effective women-only TCP in Iran.

Drug abuse is a general health problem that threatens all groups in human societies. While youths are vulnerable to drug interests, the amplification of their powers along with creating all protective factors in their living environment is helpful in confronting this problem. This study has been performed with the aim of determining the factors related to the tendency towards drug abuse based on positive youth development model among high school students of Isfahan.
This study has been performed with the aim of determining the factors related to the tendency towards drug abuse based on positive youth development model among high school students of Isfahan.
This sectional study has been performed with the participation of 252 male and female high school second graders in Isfahan. The sampling method was a multi-stage cluster. The data-gathering tool was a researcher-made questionnaire in three parts whose validity and reliability were confirmed. The gathered data were analyzed by SPSS 18 software, Pearson correlation tests, and Regression analysis.
The mean and the standard deviation of the age of the participants were 15.82 ± 0.66. Among the structures of the model of positive youth development, those of social competence, emotional competence, social norms, and self-efficacy were predicted 30.8% of changing the tendency towards drug abuse, and the structure of the attitude toward drugs could predict 35% of behavior changes (R2 = 0.308, P

Dietary intake is important for physical and mental health.
The purpose of the study was to investigate the effect of dietary behaviors on psychological well-being and mental distress in a large cross-national sample of university students from five ASEAN countries (Indonesia, Malaysia, Myanmar, Thailand, and Vietnam)
In this cross-sectional survey, 3357 university students (Mean age = 20.5 years, SD = 1.6), who were randomly selected, responded to a questionnaire including measures of dietary behaviors, psychological well-being, and mental distress.
In analysis of covariance, adjusted for age, sex, subjective socioeconomic status, country, body mass index (BMI), and physical activity, positive dietary behaviors (fruit and vegetable consumption, daily breakfast, fat avoidance, and eating foods high in fiber) were associated with happiness, life satisfaction, and self-reported health. Fruit consumption and regular breakfast were negatively associated with depression and traumatic stress symptoms. Unhealthy dietary behaviors (soft drinks, fast foods, and eating snacks) were associated with unhappiness, low life satisfaction, and depression symptoms.
Overall, the study found some evidence indicating that healthier dietary behaviors were associated with higher psychological well-being and lower mental distress, suggesting that a diet intervention may be helpful in preventing or alleviating mental distress in this ASEAN university student population.

Depression is a widespread disorder that affects all aspects of a person’s life. Various psychological and medical interventions have been proposed to help treat depressive symptoms. One effective treatment is object relation therapy based on transference and potential space.
In the current study, we focus on how clients who suffer depressive disorder understand this type of therapy.
This qualitative research was conducted in 2015 - 2016 using a content analysis with 18 Iranian participants who were diagnosed with depressive disorder based on the structured clinical interview for DSM-IV, the clinician version (SCID-I/C V) and who had received object relation therapy based on transference and potential space. The study was carried out in an outpatient clinic of the school of behavioral sciences and mental health (formerly Tehran Institute of psychiatry). The data were collected through conducting in-depth semi-structured interviews, which continued until data saturation was achieved. The data were analyzed with the induction method.
The analysis of the data resulted in the identification of 2 main categories and 4 subcategories. “Gradual formation of therapeutic alliance” and “use of non-interpretative techniques” were the subcategories of “analytic dyad formation” as the main category; and “in-depth examination of client experience” and “client’s emotional expression” were listed under “development of self-awareness and self-expression”.
Gradual formation of therapeutic alliance is consistent with literature that emphasizes the necessity of new relational experiences and creation of a safe attachment base in therapy. The findings showed that the exploration and awareness of patterns in the context of a secure relationship and transference and extra-transference can produce therapeutic changes. In addition, such safe space can provide a suitable context for releasing built-up emotions.

Despite the importance of stigma in psychiatric disorders and due to the important role of nurses in caring and supporting such illnesses, it is not considered in nursing educations.
The current study aimed at comparing the effect of Contact-based education and acceptance and commitment-based training on stigma toward psychiatric disorders among nursing students.
It was a clinical study and 111 nursing students of the 4th semester passing mental health training course 1 in Ibne-Sina Psychiatric hospital of Mashhad, Iran, were selected by cluster and quota sampling methods. They were divided into 3 groups of contact-based education (interpersonal contact among individuals with improved mental illnesses), acceptance and commitment-based training and control group. In order to obtain data, The opening mind scales for Health Care Providers was used; and it was completed in 3 levels of pretest, posttest and 1-month follow-up sessions. Data analysis was carried out by repeated measurements of ANOVA.
There was no significant difference between the contact-based education and acceptance and commitment-based training groups in reducing the average score of stigma and subscales of social distance and diagnostic overshadowing (P > 0.05). On the other hand, in terms of mean changes, there was no significant difference among the 3 groups in the score of disclosure subscale (P = 0.09). However, contact-based education group demonstrated significant reduction in the mean of recovery and social responsibility subscales, compared to acceptance and commitment-based training group (P

Prevalence of body image disorder in postpartum period, especially in primiparous women is relatively high. This study aimed to determine the effectiveness of cognitive behavioral group therapy based on the cash’s eight-step model in body image of primiparous women.
This study aimed to determine the effectiveness of cognitive behavioral group therapy based on the cash’s eight-step model in body image of primiparous women.
This research was a pretest-posttest quasi-experimental study in which, 61 primiparous women referring to health centers in Zahedan were selected according to convenience sampling method and randomly assigned into intervention and control groups. The multidimensional body-self relations questionnaire (MBSRQ) was used to collect data. The intervention group received group cognitive behavioral body image therapy based on the Cash model and the control group remained pending. After six weeks, both groups completed the MBSRQ again. Data analysis was performed using descriptive statistics and analysis of covariance in SPSS 22.
Analysis of covariance showed that the mean scores on appearance evaluation (P = 0.0001), body areas satisfaction (P = 0.0001), and the total score of body image (P = 0.0001) in the intervention group were significantly higher than those in the control group. However, in terms of appearance orientation, fitness evaluation, fitness orientation, and subjective weight, there was no significant difference between the two groups (P > 0.05).
Due to the effectiveness of cognitive behavioral therapy based on Cash model in primiparous women’s body image, it is recommended to use this method of consultation in health care programs after child birth to improve the women’s body image and prevent subsequent psychological problems.

A change in behavior is one of the most important components of readiness for drug use treatment in Iran.
The aim of this study was to determine ones willingness to change and continue treatment amongst patients receiving opium tincture (OT) maintenance treatment in Tehran, Iran.
This longitudinal study was conducted in 2014. Overall, 140 participants were selected from clients who were referred by a non-governmental organization providing OT, Congress 60, to four drug use treatment centers. At the start of the study, the questionnaire; stages of change readiness and Treatment Eagerness Scale were completed. After three months, participants were divided into two groups of retention and relapse. Data was analyzed using SPSS version 21 and by performing an independent t-test.
There was no significant difference between the retention group and relapse group regarding demographic characteristics (P > 0.05). Motivation for change was higher in the retention group compared to the relapse group and their differences were significant (P

Sexuality is an aspect of quality of life that is important for many patients and their partners, but may be adversely affected by a cardiac event. Therefore, it is necessary that cardiologists assess sexual issues among cardiovascular patients. However, most health professionals avoid talking about sex issues due to some barriers. The recognition of these barriers leads to new information that is helpful for future planning and intervention in Iran.
The aim of the present study was to identify the barriers to discussing sexual issues among cardiovascular patients and to discover cardiologists’ reasons for not addressing sexual issues.
Using a self-made questionnaire, a cross-sectional descriptive study was carried out at the seventeenth national congress on cardiovascular update which was held in 2015, and cardiologists’ answers were gathered and analyzed.
The study population consisted of 138 cardiologists (87 male and 51 female) with a mean age of 45.42 years. Analysis of data showed that most of the barriers for discussing sexual issues were “Patient discomfort for discussing about sexual issues,” “Religious and cultural reasons”, “Not having enough time,” “Presence of other person” and “Lack of knowledge and skill in dealing with sexual issues.” Among the demographic characteristics, cardiologists’ gender showed a significant relationship with “Cardiologist discomfort for discussing sexual issues” (P value = 0.005). Female cardiologists had more discomfort than male cardiologists.
From the opinion of cardiologists, patients’ uncomfortable feelings, cultural-religious issues and time restrictions were the most important when discussing sexual issues with cardiovascular patients, so these barriers need more attention in the delivery of public health interventions.

Some studies have investigated the relationship between vitamin D and total antioxidant capacity (TAC) with psychiatric disorders. However, it seems that results were contradictory and also studies on stress and anxiety, as two common symptoms of psychiatric disorders, were limited.
The current study aimed to investigate the relationship between stress and anxiety with serum vitamin D and TAC.
This case-control study was conducted on 45 non-depressed female students with some degrees of stress and anxiety and 45 controls with no measurable depression, stress or anxiety as the control group at Jundishapur University dorms from April to June 2014. Self-administered questionnaires including food frequency and depression, anxiety and stress scales (DASS-21) were used to assess the dietary patterns and psychological assessment, respectively. Serum 25-hydroxy vitamin D and total antioxidant capacity (TAC) were also measured.
Serum concentrations of vitamin D were significantly higher in the control group (P = 0.002) and increasing each unit of vitamin could reduce the risk of stress and anxiety for 3.33%. TAC levels showed no significant differences between the groups. Consumption of hydrogenated fats increased the risk of stress and anxiety (odds ratio (OR) = 1.53, P = 0.019).
Low vitamin D levels may be associated with higher stress and anxiety. Consumption of hydrogenated fats is associated with higher scores of stress/anxiety. No relationship was observed between total antioxidant concentrations with mood disorders in young female students.

Length of hospitalization is an important indicator for optimal management and to reduce and save the costs.
Considering the limited hospital capacity as a referral center for psychiatric patients, the high prevalence of the disease, and the high expense of the treatment, this study aimed to identify the factors associated with psychiatric patients’ length of hospitalization.
The data were obtained from the records of all patients hospitalized for the first time since the April 2007 to the March 2012. The data collection tool was a checklist comprising of demographic variables, variables related to the socioeconomic status, psychiatric disorders, and the related variables such as length of hospitalization and a previous history.
In the present study, 2397 (72.8% males and 27.2% females) medical documentations were investigated. Median length of stay was 25 days. Using the Cox model, the variables including age, educational level, material status, employment, the insurance status, the history of hospitalization at psychiatric center, type of treatment and disorder, duration of disorder, the referral source , and hospitalization during religious months (Ramadan and Muharram) and agricultural seasons had a significant relationship with the length of hospitalization (P value

Happiness is one of the 6 important senses and is associated with stress, anxiety, depression, and life satisfaction. These elements relate to risk behaviours.
This study aimed at investigating happiness and its correlation with risk behaviours and environmental factors in freshman students.
Overall, 1056 new students were selected randomly from Khorramabad universities in 2015. Oxford happiness questionnaire (OHQ) was completed by the students. Independent t test, chi-square, and correlation coefficient with a significance level of 5% were used.
Happiness score was 4.09 ± 0.71 with no significant difference between genders or universities (P ≥ 0.05). Among females, happiness was associated with physical activities (P = 0.001). Hookah smoking was associated with decreased happiness in all students (P = 0.001). Among males, smoking had an inverse relationship with happiness (P = 0.037).
Although the happiness score among students of various universities was high and comparable at the beginning of their academic course, the current study will be continued to investigate changes in students’ happiness and also affecting factors throughout their education.

Cigarette smoking is one of the most important public health problems.
This study determined the personal and environmental predictors of transition across smoking stages using cross sectional data.
In this cross sectional study, 4 853 students (14 to 19 years) completed a self-administered multiple-choice anonymous questionnaire. We used a probabilistic discrete event system (PDES) for estimating the transitional probabilities in smoking stages in terms of sex, peer and family smoking, attitude towards smoking, general risk taking behavior, and the socio-economic status.
The results showed factors such as being a boy (OR = 8.9 (7.9 - 10.0)), having a positive attitude towards smoking (OR = 8.2 (6.5 - 10.5)), and having a smoker friend (OR = 5.2 (3.6 - 7.6)) were highly associated with the initiation of smoking. In contrast, having a smoker friend is the most important factor that prevents one from quitting smoking (OR = 0.08 (0.07 - 0.09)). Also, this factor is important in the adolescents’ relapse from being an ex-smoker to a current smoker.
Prevention efforts will need to be mentioned for reducing the smoking initiation risk factors and the quitting of smoking. The programs aimed at smoking prevention and intervention should focus on the protective factors to reduce the probability of smoking initiation and relapsing.

It is proven that perceived social support and family function are important in the treatment and prevention of lapse or relapse in drug use disorders, but the role of these factors, especially when added together, are less evaluated in primary prevention of drug dependence.
The current study aimed to investigate the relationship between perceived social support and family functioning in the student's tendency toward illicit drug use.
The study had a cross-sectional design. A total of 156 students of Allameh Tabatabaei University were selected in the 2013 - 2014 academic year in Tehran, Iran, and the required information was obtained from them by three questionnaires: perceived social support, family functioning, and students’ tendency toward illicit drug use. Data were analyzed with the Pearson correlation coefficient and multiple regression coefficients, by SPSS version 21.
There was a significant relationship (P

Fear of success is a stressful factor that is derived from achievement. A few children and adults have a fear of success and as a result restrict their contributions despite their skills.
The present paper aimed at investigating the relationship between attribution styles and metacognitive skills and fear of success.
This was a descriptive cross sectional study conducted on a statistical population of all students of 3 universities of National, Azad, and Payam-e Noor of Bojnourd, Iran, in the first 6 months of 2015. In the present study, 385 students were selected through clustering random sampling, and 3 questionnaires of Zukerman and Ellison’s Fear of Success, Peterson and Seligman’s Attribution Styles, and Wells’ MetaCognition were distributed among the students. The obtained data were analyzed using SPSS software version 20.
Results of the regression revealed that in the best model of prediction, cognitive confidence, positive attributions, uncontrollability, and risk are able to predict the fear of success variable (P ≤ 0.05.01). With respect to Pearson’s correlation coefficient, a significant negative relationship was obtained between positive attribution style and fear of success (P ≤ 0.0005), and only negative stable attributions had a significant relationship with fear of success (P ≤ 0.01). In addition, a significant relationship was detected between cognitive confidence, uncontrollability, and risk (P ≤ 0.0005), positive beliefs about concern, and fear of success.
The results of the present research, conforming to that of the other studies, revealed that attribution styles and metacognitive skills are able to predict the fear of success variable.

Implicit mental rotation has been studied in patients with schizophrenia; however, no research has examined it in relatives of the patients.
This study compared the performances of schizophrenia patients with their unaffected relatives to shed further light on the nature of cognitive functioning in schizophrenia relatives.
We examined mental rotation in 25 schizophrenia patients, 25 of their first-degree relatives and 25 controls, using the Hand Rotation Task. In this task, the participants had to determine the laterality of hands showed in various orientations.
The results of this study revealed that the mean error rate of the relatives was significantly different between patients and healthy controls (all P

High and low levels of anger, tension, rage, pathological anxiety and depression are the most common psychological disorders which occur during pregnancy, and can lead to undesirable outcomes.
The present study was conducted in order to investigate the relationship between household socioeconomic status and mental health in women during pregnancy in 2014 - 2015.
The present cross-sectional study was conducted on 400 pregnant women from 24th to 32nd weeks of gestation in Tehran with random sampling. Data was collected using a demographic and obstetrics questionnaire, a household socioeconomic status (HSES) scale, the Perceived Social Support Scale and the short-form version of the Depression, Anxiety, and stress scales (DASS-21) and, then was analyzed using SPSS-22 and Lisrel-8.8 by statistical path analysis.
According to the path diagram, among the direct paths, social support had the greatest negative effect (B = -0.29), however household size had the greatest positive effect (B = 0.18) on maternal mental health as per the DASS; among the indirect paths, paternal education and income had the greatest negative effects (B = -0.053; B = -0.035) and maternal education the greatest positive effect (B = 0.002) on maternal mental health.
The financial deprivations and socioeconomic inequities such as poor nutrition, poverty, poor housing and poor income is contributed significantly to the incidence of chronic diseases and mental health by way of psychosocial factors, lifestyle behaviors and physiopathological changes. Counseling interventions aimed at improving maternal mental health through alleviating socioeconomic damages and increasing family support are recommended.

Severe mental illnesses, such as schizophrenia and affective disorders, have considerable effects on the life of not only patients, but also their caregivers.
The aim of this study was to develop a self-administered quality of life (QoL) questionnaire for the assessment of QoL in caregivers of patients with schizophrenia and affective disorders.
Based on a mixed method approach and purposive sampling method, a sample consisting of 196 caregivers was recruited from 2 psychiatric hospitals in Tehran and Kerman, Iran, as well as a charity center in Kerman during 2015 - 16. A 67-item questionnaire was developed in the qualitative phase of the study, consisting of semi-structured interviews with 45 caregivers, comments of an expert panel, and some items from other relevant questionnaires. The item reduction in the quantitative phase was based on item distribution, missing data per item, inter-item correlation, and factor analysis. The reliability coefficient (Cronbach’s alpha) was calculated for all the dimensions. Convergent validity was assessed by Pearson’s correlation coefficient test, and discriminant validity was analyzed, using student’s t test and analysis of variance (ANOVA).
The final version of the questionnaire included 21 items and 7 dimensions: emotional burden (5 items); dealing with patient symptoms (3 items); relationship with the therapeutic team (3 items); relationship with family (2 items); financial burden (3 items); relationship with the extended family and friends (2 items); and latent worry (3 items). The 7 dimensions could explain 78.45% of the total variance. Item internal consistency was satisfactory for all the dimensions, ranging from 0.77 to 0.96 for each item. Cronbach’s alpha coefficient ranged from 0.74 to 0.89 in the whole sample. The SAC-QoL index was significantly correlated with all the dimensions of the world health organization QoL-BREF (WHOQoL-BREF) scale (r, 0.32 - 0.65). Also, the predefined hypotheses confirmed the discriminant validity (P

One of the most important adverse effects of a psychosocial process is burnout. There are 2 versions of the Maslach burnout inventory which have been standardized and used in different studies in Iran, with each focusing on a specific population.
The present study aimed at standardizing the third version of this tool.
In this cross sectional study, 331 Iranian staff was included in the final analysis using multistage sampling method in 2011. Exploratory factor analysis using SPSS Version 17 and confirmatory factor analysis using the Lisrel 8.8 were used to assess the domain structure of the Maslach burnout inventory- general survey (MBI-GS). Internal consistency reliability was assessed with Cronbach’s alpha. The CVI and CVR were used to assess content validity.
The item total correlation and internal consistency (total alpha) were 0.79, 0.85, and 0.87, respectively. The interclass correlation coefficient was 0.87, which indicated good test retest reliability (r = 0.87, P

Aging is an inevitable biological phenomenon. Today, the elderly have a more active life, better life expectancy, and health status than in the past in Iran. However, there are still a lot of related hidden problems such as the elderly abuse.
The current study aimed at determining different types of the elder abuse in Shiraz, Iran.
The current cross sectional study was conducted in 2012. The study population included the elderly in Shiraz, Iran. A sample of 226 elderly was randomly selected from 7 urban health centers. Data were collected using domestic elder abuse questionnaire. Data were analyzed by performing descriptive statistics (mean, frequency percentage, and standard deviation), the Pearson correlation, and the Mann-Whitney test by SPSS.
Overall, 226 elderly, 72.6% females and 27.4% males, were recruited. The mean± SD age of the sample was 68.55 ± 6.28 years. The incidence rates of abuse for the elderly participants were as follows: emotional negligence (43.8%), psychological abuse (41.2%), negligence in healthcare (31.9%), financial abuse (23%), and curtailment of personal autonomy (20.8%), as well as financial negligence (28.8%), physical abuse (7%), and abandonment (4%). According to the results of the current study, there were significant relationships between financial negligence and occupation (P value = 0.02), financial negligence and gender (P value = 0.06); between negligence in healthcare and gender (P value = 0.04); and between financial abuse and gender (P value = 0.04). According to the results of the study, there was a significant relationship between financial negligence and Occupational negligence, gender and negligence in healthcare, and financial abuse and gender.
The results of the study indicated that a high percentage of the elderly participants were abused differently. Therefore, recognizing the prevalence and types of abuse is important to inform the health policy makers and legal authorities, especially families. In this way, better and more desirable care can be provided to the elderly and measures can be taken to improve their lives.

Marital satisfaction is defined as a mental state reflecting the pressures and benefits perceived by the couple in their life. Several factors seem to contribute to marital satisfaction and success including having children.
The present study aimed at evaluating the effect of the number and gender composition of children (having only sons, only daughters, and children of both genders) on marital satisfaction in women of childbearing age in Tehran.
This descriptive correlational study was conducted on 213 married females aged 15 to 45 years presenting to health centers in Tehran, Iran, in 2015. The demographic questionnaire, the ENRICH marital satisfaction scale, and a researcher-made childbearing questionnaire were used for data collection. Data were analyzed using descriptive statistics (mean and standard deviation) and ANOVA in SPSS version 17. The level of statistical significance was set at P The results of the present study revealed a significant correlation between the mean score of marital satisfaction and the number of children (P = 0.005); for instance, women’s marital satisfaction reduced with an increase in the number of children. The results also revealed a greater marital satisfaction in women with children of the same gender than in those with children of both genders. Moreover, the mean score of marital satisfaction was significantly higher in women with only sons than in those with either only daughters or with children of both genders (P = 0.013).
Women’s marital satisfaction decreased with an increase in the number of children. Children’s gender affected marital satisfaction. Women with only sons had a greater marital satisfaction than those women with only daughters, or with children of both genders.

Sexual dysfunction, which may occur after lower extremity trauma, is a main physical problem with negative mental health impacts.
This study aimed at comparing male sexual dysfunction before and after lower extremity trauma.
In this cross sectional study, all patients with lower extremity trauma who were admitted to Kowsar hospital in Semnan, Iran, were recruited and assessed. Two main questionnaires were administered: a questionnaire including demographic and incident variables and the international index of erectile dysfunction (IIEF). Sampling was done from June 2014 to August 2015. Statistical analyses were performed using Friedman and Wilcoxon's test in SPSS Version 19.
Overall, 153 male patients participated in the study. The changes of sexual dysfunctions were significantly different before and after the incident in 1 and 3 months after the incident in all the IIEF subscales (P = 0

Based on some suggestions, emotional intelligence can affect job motivation and job performance.
The current study aims at examining the relationship between emotional intelligence and job motivation among faculty staff of Mazandaran University of Medical Sciences, Iran, in 2015.
The present descriptive correlational study was conducted on 120 faculty staff of Mazandaran University of Medical Sciences using stratified random sampling method. The data collection tools included the job motivation levels questionnaire and the standard emotional intelligence questionnaire.
The mean ± standard deviation (SD) overall score of job motivation was 173.76 ± 25.62 (confidence interval (CI) 95%: 172.03 - 175.1) and that of emotional intelligence was 116.52 ± 7.91 (CI 95%: 115.6 - 117.69). The results of the present study suggested that the overall score of emotional intelligence was significantly correlated with that of job motivation as well as with all the variables examined in the job motivation levels questionnaire (P

The focus of recent research has significantly shifted from explaining the causes and symptoms of autism to investigating issues related to the parents of autistic children.
This study aimed to investigate health-related quality of life (HRQOL), depression, and associated factors among parents of autistic children in Kermanshah, Iran.
In this cross sectional study performed in 2015, a total of 97 male and female parents of autistic children completed 3 questionnaires: background/demographic checklist, 36-item short-form health survey (SF-36), and beck’s depression inventory. Data were analyzed using SPSS version 18.
Analysis of the general physical health domain of HRQOL demonstrated no significant difference between men and women (P > 0.05). On the other hand, in all subdomains of mental health, women’s scores were higher in comparison with men, and there was a significant difference in the mental health domain. Also, analysis of depression level revealed that 25.8% of the subjects had severe depression.
Given the low level of QOL and depressive symptoms in more than two-thirds of parents of autistic children, psychological empowerment of this group is recommended.

Adolescents’ addiction to internet is a serious problem worldwide, especially in the developing countries.
The current study aimed at estimating the prevalence of internet addiction (IA) and its relationship with interpersonal communication skills (ICS) and socio-educational factors among high school students in Tabriz, Northwest of Iran.
In the current cross sectional study, a total of 2416 students were selected as a study sample size in 2010. The data were collected using a valid and reliable self-administered questionnaire. The direct standardization method was employed to calculate IA prevalence.
The prevalence of IA was 52.1% in males and 37.0% in females. The standardized prevalence of IA among the study sample was 45.8%. The results of logistic regression analysis suggested the association of the gender (odd ratios = 1.91) and ICS scores (OR = 0.97) with IA.
The prevalence of IA among adolescents in the Northwest of Iran was high. Males were at higher risk of IA than their female counterparts. Improvements of ICS may prevent IA in adolescents.