فهرست مطالب فیروزه رئیسی

The inability of couples to resolve conflicts and deal with them appropriately may lead people to divorce. This study was conducted with the aim of determining factors affecting divorce in Iran during the last 10 years.

In this study, a systematic review was done. All the articles in the last decade (2010 to 2020) about the causes of divorce in Iran in Persian and English and in the databases PubMed, Scopus, Web of Science, Google Scholar and Megiran, ISC, SID were indexed using Persian and English keywords. From all the articles found, following the data entry and exit criteria, 27 articles were finally extracted and analyzed using the PRISMA guidelines.

The obtained results can be classified in several categories. These classes include demographic factors, economic factors, cultural-social factors, personality factors, factors related to incompatibility between couples, family factors and biological-psychological factors. In addition, 20 of the most important causes of divorce in the last 10 years were: male unemployment, lack of moral understanding, infertility, cultural and religious differences, involvement of family members, mental illnesses, drug and alcohol addiction, financial problems and insufficient income, from forced and forced marriage, sexual dissatisfaction, domestic violence, indifference to spouse, infidelity, remarriage, physical diseases, unrealistic expectations, immorality, foul language and obscenity, legal and judicial problems, lack of trust in each other, and moral corruption and illicit pleasures.

The findings of this research can help health policy makers to reduce divorce as a serious social harm by developing detailed programs.

Patients with severe mental illnesses are more prone to experience sexual health problems. Herein, we developed a "Safe Sex Knowledge and Behavior Questionnaire for Patients with Severe Mental Illnesses"(SSKBQ-SMI).

The present study was conducted in the form of methodological research in 4 stages. In the first stage, items of the questionnaire were selected and the item pool was formed by using similar studies and experts' opinions. During the next steps, the psychometric properties of the questionnaire were assessed using content validity, face validity, reliability and construct validity. The content validity was tested using the Content Validity Index and Content Validity Ratio. The charts of content validity were given to 13 specialists expert in sexual health including psychiatrists, clinical psychologists, gynecologists, urologists, and infectious disease specialists. The reliability was tested by using the test-retest method in 70 patients with two-week intervals. The construct validity was tested using exploratory factor analysis in 265 patients. The internal consistency was calculated by using Cronbach's alpha index.

After determining the content and face validity, a tool was obtained with 16 True/False items in the knowledge section (with one score for each correct answer and the total score range from 0 to 16) and 16 five-point Likert scale items in the behavior section (with each question score range from 0 to 3 and the total behavior score range from 0 to 48, the lower score defined safer behavior). The correlation coefficient of the scale scores in the test-retest method was calculated to be 0.880 (P<0.001) and 0.951 (P<0.001) in the sections of knowledge and behavior, respectively. The Cronbach's alpha coefficient was 0.809 for the section of knowledge, 0.756 for the section of behavior, and 0.782 for the whole questionnaire. Exploratory factor analysis confirmed the existence of 4 factors in the knowledge section and 3 factors in the behavior section.

The present 32-item questionnaire was designed based on experts' opinions and important statements of patients about sexual health, simple scoring, good reliability and validity, is a suitable tool for assessing the safe sex knowledge and behavior in patients with severe mental illnesses.

Sexual addiction is a growing disorder which is accompanied with many personal and social consequences. The current fundamental study aims to investigate and discover the factors affecting the development of sexual addiction, with a qualitative view at the experience, thoughts and feelings of patients with sex addiction. Using a qualitative method, 13 patients with sex addiction (10 male and 3 female) aged 21–50 were selected by purposeful sampling and interviewed in 2019 in Tehran with a semi-structured interview. Then, the data was analyzed by using a seven-step Colaizzi method. The results were categorized into three main categories including personal issues, family inefficiency and inattentiveness of the society about sex education, and further categorized into 11 subcategories. Our findings provide invaluable insights into sex addiction for physicians and other mental health providers. Given the lack of community planning and policy regarding the sex education for teachers, parents and youth, we emphasize the responsibility of parents in teaching healthy sexual behaviors to their children and adolescents.

Numerous studies have addressed the impact of cognitive-behavioral therapy and treatment based on acceptance and commitment to depression. However, there is a research gap between comparing the effectiveness of cognitive-behavioral therapy and treatment based on acceptance and commitment to depression and increased sexual activity behavior of patients with sexual addiction.

The aim of the present study is to compare the effectiveness of cognitive-behavioral therapy and acceptance-based therapy. Depression and hyperactive sexual behavior of patients with sexual addiction.

The present study was a quasi-experimental study with a pretest-posttest-follow-up design with a control group The statistical population of this study was men over 18 years of age with sexual addiction living in Tehran in 2019. Thirty patients were selected as a sample by snowball method and were randomly assigned to two experimental groups and one control group (10 patients). The tools of the present study are: Behavioral Cognitive Therapy Sessions (Location, 2014), Acceptance and Commitment Therapy Sessions (Crossbow, 2011), Beck Depression Questionnaire (Beck et al., 1961) and Sexual Increase Sexual Questionnaire (Reid et al., 2011). ). Data analysis was performed by mixed variance analysis methods with repeated measurement, multivariate analysis of variance, Bonfroni test and Toki test.

Cognitive-behavioral therapy and treatment based on acceptance and commitment were effective in reducing depression and increased sexual activity in these patients (P< 0/05). there was no significant difference between the two treatment methods.

Patients who participated in cognitive-behavioral and acceptance therapy sessions based on acceptance and commitment had fewer depressive symptoms and increased sexual activity

Detecting influential factors of sexual dysfunction could be essential in preventive and intervention strategies. The aim of this qualitative study was to explore the women’s understanding of the origin of their sexual problems. Fifteen married women with sexual dysfunction aged 21-42 were interviewed in person as they were referred to Tehran University outpatient sexual health clinics to receive care and treatment. Sexual dysfunction approved by clinician judgment and standard questionnaires. Appling directed content analysis, we applied from previous known themes of physiological, psychological, interpersonal and socio-cultural determinants of sexual dysfunction However, categories that constitute main themes were in some aspects different with those found in Western contexts specifically, in socio-cultural issues. In addition, the greatest focus of our participants was on socio-cultural related factors such as financial pressures, life stressors and fatigue, lack of sexual knowledge, erroneous sexual beliefs and perfectionism. These findings revealed also some new attributing factors of sexual problems such as filiarchy. Our results suggest that socio-cultural determinants and theirs impacts need to be taken into account in delivering culturally sensitive interventions for treatment of women sexual problems.

Sex reassignment surgery has been done as a therapeutic option in people with gender dysphoria in Iran and other countries that has not been determined. The impact of related factors including age at surgery, duration of past surgery and the individual complaints on quality of life, so this study has been completed with the aimed to assess quality of life aspects in male to female gender dysphoria in terms of sex reassignment surgery.
This cross-sectional study has been done in 2013 on 46 male to female gender dysphoria. To evaluate the samples’ quality of life, the demographic information was collected at first step and then quality of life standardized questionnaire (SF36) was utilized.
Base on ANOVA analysis, there was not a significant relationship between duration of past surgery and cosmetic surgery. However, there was a significant relationship between age of people at the time of surgery and satisfaction with the apparent characteristics (p It is necessary to have consultations with a team of experts including psychiatrist and psychologist that can choose suitable person for surgery with a view to considering age factor and follow-up of persons for reduction of difficulties after surgery.

The sexual health is a major factor in the stability of marriage. High prevalence of sexual dysfunction and an undeniable effect on individual diseases, family conflicts and social problems, which led to the increase of divorce in the society therefore prevention of these disorders, is necessary. Iranian traditional medicine as a holistic medicine has specific recommendation in this area. The purpose of this study is to evaluate sexual health opinion from the perspective of traditional medicine in Iran.
In this narrative-descriptive study, authentic texts of traditional medicine, such as "Kamelossanaeh", Canon of Ibn-Sina, Hefzol-sehhe Naseri ... were searched in sex problems with the key words "Bah", "intercourse" and "Mobahi" and then sexual health measures as classified has been provided.
The studies of traditional medicine in the field of sexual health show the important relationship between normal sexual activity and mental and physical health, and correct sexual activity lead to an increase in the physical force and resolved mental illness. Sexual recommendations are including sexual intercourse only with a real desire and in proper time and avoid intercourse in improper time. Other recommendation in this area is the appropriate amount of cohabitation due to the strength of the body, age, season, sex and also use of effective composition for the sexual enhancement.
Discussion & Iranian traditional medicine sexual health education can be an effective step to improve public health and family strength and reduce the incidence of divorce as a social problem.

Considering the high prevalence of sexual dysfunction in females with OCD and its impact on marital satisfaction, the purpose of this study was to investigate the relationship between sexual function and marital satisfaction in a group of female OCD patients.
In this cross-sectional study, 36 females with OCD, referred to the clinic of Roozbeh Psychiatric Hospital (related to Tehran University of Medical Sciences) and 3 private offices in Tehran, were selected by random sampling and completed questionnaires including: demographic FSFI, BDI-II, MOCI, OCI-R and researcher-developed marital satisfaction questionnaire.
80.6% of women reported sexual dysfunction. The results of studying sexual function questionnaire subscales was as following: 50 % low sexual desire, 58.3 % low sexual arousal, 36.1 % decreased lubrication, 44 % orgasmic disorder, 52.8 % sexual pain disorder and 41.7 % sexual dissatisfaction. Furthermore, statistically significant correlation was found between sexual dysfunction (total score and arousal, lubrication, pain and satisfaction subscales) and marital dissatisfaction. Studying the relation between obession(MOCI questionnaire) and marital satisfaction revealed that the correlation between washing subscale of MOCI and marital dissatisfaction was also significant while there were not any significant correlation between obsession (OCJ-R, MOCI) and sexual function (FSFI).
High prevalence of sexual dysfunction in OCD patients, significant relationship between obsession and marital satisfaction, and sexual function and marital satisfaction could demonstrate relationship between sexual function, OCD and marital satisfaction.

Concurrent depression has been mentioned as a possible factor which might reinforces relationship between OCD and sexual dysfunction. The aim of this study was to evaluate sexual function in OCD patients with and without depressive symptoms.
subjects were 56 married OCD patients referred to outpatient clinic of Roozbeh psychiatric hospital and three private psychiatric clinics in Tehran from 2011 to 2013. Participants completed demographic questionnaire, OCI-R, MOCI, BDI-II, IIEF, FSFI.
80.6% of women and 25% of men had sexual dysfunction and 82% of patients had depressive symptoms. Comparing sexual dysfunction in OCD patients with and without depressive symptoms demonstrated that mean index of IIEF in erection and satisfaction subscales of men without depressive symptoms (BDI-II index= Regarding to possible role of depressive symptoms on sexual function, sexual assessment in all OCD patients should be considered.

Although sexual dysfunction is a common problem in patients with obsessive-compulsive disorder (OCD), there are sparse clinical research on the study of the correlation between OCD subtypes and different phases of sexual response cycle. This study was undertaken to assess sexual function and its different phases in a group of Iranian patients with OCD. This was a descriptive cross-sectional study. The subjects consisted of 56 married OCD patients (36 female, 20 male) who suffered from OCD according to a psychiatric interview and DSM-IV questionnaire based on structured clinical interview for DSM (SCID). Patients were between 18 to 50 year age that had been referred to the outpatient clinic of Roozbeh Psychiatric Hospital and three private psychiatric clinics in Tehran (from September 2011 to February 2013). Five Questionnaires were used in this study: Iranian validated form of Female Sexual Function Index (FSFI), International Index of Erectile Function (IIEF), Maudsley Obsessional Compulsive Inventory (MOCI), Obsessive Compulsive Inventory-Revised (OCI-R) and a questionnaire which has provided demographic data and other relevant information regarding sexual function and OCD. The prevalence of sexual dysfunction among female was 80.6% and the frequency of disorders in different subscales of FSFI including sexual desire, sexual arousal, lubrication, orgasm, satisfaction and sexual pain were 50%, 58.3%, 36.1%, 44.4%, 41.7% and 52.8% respectively. Sexual disorder is reported in 25% of male OCD patients which subscale's evaluation of IIEF shows low sexual desire in 10%, erectile disorder in 20%, orgasmic disorder in 25%, sexual dissatisfaction in 40% and 50% decreased in the total sore of IIEF. Moreover, the correlation coefficients between the total score of OCI-R with erectile and satisfaction subscales of IIEF were statistically significant. The score of washing subscale in OCI-R and sexual satisfaction was significantly correlated. High prevalence of sexual dysfunction in OCD women and significant correlation between male sexual dysfunction and OCD (r= -481.0 between total score of OCI-R with erectile dysfunction and r= -458.0 between total score of OCI-R and sexual satisfaction) could confirm a relation between OCD and sexual disorders. So, evaluation of sexual function in all patients with OCD is recommended.

The ultimate goal of this study is one of the discourse fields analysis, i.e. Grice's cooperative principles.

In this comparative and case - control study, two groups of normal individuals and schizophrenic patients were selected by simple method from sample of convenience and interviewed based on the spontaneous part of Persian Aphasia Test. All the answers were analyzed with respect to the percent rate of errors in the 4 "cooperative maxims", and the errors were collected. Data were analyzed by Independent T Test, ANOVA, Kruskal Wallis and Mann Whitney.

There were significant differences between two groups in respect to all the Grice’s cooperative principles (P<0.001), maxim of quantity (P<0.001), maxim of relevance (P<0.001) and maxim of manner (P=0.02), but in maxim of quality there was no significant differeance (P=0.07). The mean percent of errors in the course of illness, education and age varieties were not significant.

Schizophrenic patients have incoherence speech and this problem exists in the discourse field and social interactions, thus the patients frequently fail in observing the Gricean cooperative principles.