Objective: The present study aimed to compare lapse and relapse-free survival between patients treated in Narcotics Anonymous (NA) groups and Methadone Maintenance Treatment (MMT) centers and to determine the relationship between social support scale and treatment outcome.

Method: This study was a prospective, 12-month cohort study using the random sampling method to select 100 newcomer patients treated by the NA Association as well as 100 patients in MMT centers. The data were collected using a demographic questionnaire and Social Support Appraisals (SSA) scale at the onset of the study along with follow-up phone calls every other week.

Results: All participants were male, aged between 18 and 65 with a mean (SD) age of 38.98 (± 10.85) years. Prevalence of relapse in 12 months was 60.5%. The lapses in the MMT group and relapses in the NA group were significantly higher (P < 0.001). The younger patients with lower levels of education are at greater risk of lapse/relapse. The mean score of SSA was significantly higher in the MMT group than the NA group in all subscales, including friends, family, and the others' support (P < 0.001). The mean scores of SSA subscales for the participants without relapse in the NA group was significantly higher in comparison to the MMT group.

Conclusion: Detection of factors related to drug abuse relapse/lapse may help addiction therapists to identify drug abuse patients with lapse/relapse and to develop treatment and policy guidelines to prevent relapse in addiction recovery.

Objective: Spironolactone (C24H32O4S), a potent mineralocorticoid receptor (MR) inhibitor, is a potassium-sparing diuretic that is traditionally used to treat fluid build-up in the body or for its anti-androgenic properties. This study is a double-blind, placebo-controlled, randomized clinical trial assessing the beneficial effects of spironolactone in addition to risperidone in improving negative symptoms of schizophrenia.

Method: 40 patients with chronic schizophrenia, aged 18–60 years, were assigned to two groups: risperidone + spironolactone or risperidone + placebo. Risperidone was administered to both the spironolactone and placebo groups with a dose up to 6 mg/day throughout the trial. Spironolactone (C24H32O4S) was ordered 100 mg/day for the full 8-week course of the study. Patients were rated on the Positive and Negative Syndrome Scale (PANSS) at four time points: baseline, weeks two, four, and eight. The PANSS negative subscale score was the main objective.

Results: PANSS negative, positive, and total scores showed significantly greater improvements in the spironolactone relative to the placebo group from baseline to the trial endpoint (P (Cohen’s d): 0.004 (0.96), 0.007 (0.90), and 0.042 (0.66), respectively). Similarly, ANOVA also presented significant time × treatment interaction effect for spironolactone on PANSS negative (F = 9.04; ηp2 = 0.19; df = 1.38; P = 0.002), positive (F = 3.43; ηp2 = 0.08; df = 2.72; P = 0.023), and total (F = 3.94; ηp2 = 0.09; df = 2.05; P = 0.022) scores. However, spironolactone did not cause significant decrease in the general psychiatric pathology score of PANSS.

Conclusion: Our findings suggest the efficacy and safety of spironolactone as an adjunctive therapy to risperidone in improving the symptoms of schizophrenia.

Objective: COVID-19 pandemic has influenced almost every country worldwide. Being in a pandemic situation can cause psychological distress to people, which can lead to sleep disorders. The present study aimed to assess prevalence of depression, anxiety, and insomnia among Iranian people and their relations with COVID-19 fear in the early stages of COVID-19 pandemic.

Method: A cross-sectional and population-based online study was designed. We created an online form and used Fear of COVID-19 scale (FCV-19), Generalized Anxiety Disorder 2 scale (GAD-2), Patient Health Questionnaire-2 (PHQ-2), and Insomnia Severity Index (ISI), to assess fear of COVID-19, anxiety, depression, and insomnia, respectively. We sent the link to the online survey to Iranians interested in participating in the study via social media, and 1223 Iranian completed the form.

Results: A total of 1223 individuals with a mean age of 39.82 ± 10.75 years participated in the study. Prevalence of insomnia, depression and anxiety among our participants were 55.2%, 61.5%, and 50.9%, respectively. The mean FCV-19 score among the participants was 19.70 ± 5.08. Insomnia was more common among those who were 50 years or older. Fear of COVID-19 was related to a more risk of progression toward depression, anxiety, and insomnia.

Conclusion: Fear of COVID-19 has a considerable association with depression, anxiety, and insomnia in the pandemic, and strategies to reasonably decrease people’s fears can help to reduce incidence of psychological issues during the pandemic.Anxiety

Objective: Nurses exposed to COVID-19 could be psychologically stressed. The present study investigated the mental health and the resilience level in the nurses’ population.

Method: This cross-sectional study was performed on 432 nurses in 27 hospitals working in Guilan province, north of Iran, between April 29, to May 14, 2020. Mental health and resilience were measured using the 12-item General Health Questionnaire-12 (GHQ-12) and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Hierarchical multiple linear regression model was used to identify factors associated with mental health.

Results: The mean GHQ-12 and CD-RISC-10 scores were 15.72 (SD, 5.67) and 25.97 (SD, 6.88), respectively. Probable psychological distress (GHQ-12 score ≥ 15) was present in 57.2% of nurses. Among demographic and COVID-19-related variables, only educational level was significantly and negatively correlated with mental health. After controlling the variables, hierarchical regression analyses results showed that lower resilience was associated with poor mental health (β = -0.49; P < 0.001).

Conclusion: Regarding the nurses’ mental health, appropriate psychological/psychiatric intervention is necessary, and resilience can play a role as a mental health promoter.

Objective: Domestic violence is an important social problem and according to the DSM5 classification, this problem is considered from a clinical point of view. Factors that play a role in the occurrence of domestic violence may include the personality traits of couples and the ways in which couples manage each other's emotions. The purpose of the study was to investigate the role of personality dimension and relationship emotional schema in prediction of domestic violence.

Method: In this cross-sectional study, the study population included all men and women who referred to Sari forensic medicine in 2019 who were selected by convenience sampling. Data collection tools were Domestic Violence Scale, NEO Personality Questionnaire (NEO - FFI) and Relationship Emotional Schema (RESS). Data analysis was performed through correlation coefficients and regression analysis using SPSS 24 software.

Results: Based on the results of stepwise regression analysis, negative relationship emotional schemas (Guilt/shame, Control, Numbness, Rational, Duration, Rumination, and Blame) and positive relationship emotional schemas (Comprehensibility, Validation, Differentiation, Values, Consensus, Acceptance, Expression) are the best predictor variable (R = 0.65; adjusted R square = 0.41; F = 44.41; P = 0.001), and personality dimension was excluded from the model because it did not have a significant predictive power. And was not able to explain the variance of domestic violence.

Conclusion: According to the findings, the emotional schema of the relationship (negative/positive) and neuroticism play a key role in domestic violence. Therefore, by identifying the emotional schemas and personality traits of the couple's relationship, it is possible to provide more appropriate treatment outcomes for mental health professionals and effectively prevent the increase in domestic violence.

Objective: Previous research has shown a relationship between schizotypal personality traits and dissociative tendencies. The Inference-Based Approach (IBA) can explain this relationship to some extent. Purpose of this study was to investigate the mediating role of inferential confusion in relation to dissociative experiences and schizotypal personality traits.

Method: A total of 341 students from Shahed University participated in this cross-sectional study. Sampling was conducted randomly by the cluster sampling method. Data were collected using the Inferential Confusion Questionnaire (ICQ-EV), Schizotypal Personality Questionnaire-Brief (SPQ-B), and Dissociative Experiences Scale (DES-II). Data were analyzed using SPSS-22 software based on statistical methods including Pearson correlation, Baron and Kenny hierarchical regression and the Sobel test.

Results: There were significant positive relationships between dissociative experiences, schizotypal personality traits, and inferential confusion (P < 0.01). Findings showed that inferential confusion mediates the relationship between dissociative experiences and schizotypal personality traits (β = 0.29; P < 0.001).

Conclusion: According to the obtained results, the present study, considering role of inferential confusion, succeeded in explaining the relationship between dissociative experiences and schizotypal personality traits to some extent.

Objective: Although many studies have investigated the effect of maternal personality on internalizing and externalizing behaviors of a child, the role of both mother and child’s emotional mechanisms in these behaviors is little explored. The present study was focused on the relationship between the mother’s personality, and internalizing and externalizing behaviors of children with the mediating role of children’s alexithymia, mother’s alexithymia, and children’s emotion regulation (ER).

Method: 162 mothers and elementary school-aged children were recruited regarding their demographics and completed the NEO personality inventory, Child behavior checklist, Toronto alexithymia scale, Children’s alexithymia measure, and Children’s emotion regulation checklist. Data were analyzed using SPSS (ver.23), and AMOS (ver.23).

Results: Structural equations modeling demonstrated an acceptable model fit to data (CMIN/DF = 1.233, RSME = 0.038, GFI = 0.962). Mother’s alexithymia predicted internalizing problems whereas it didn’t predict externalizing problems in children. Also, the bootstrap results indicated that the mother and children’s alexithymia and children’s ER had mediating roles between mother’s personality and externalizing and internalizing problems.

Conclusion: The present results demonstrated that mother’s personality can indirectly, through mother and children’s alexithymia and children’s ER act as an important factor in development of mental problems. In other words, findings indicated that children’s emotional development is not a one-way road, but it is a mutual process that involves both the mother and the child.

Objective: The present study evaluated the model of mediating variables concerning effectiveness of mindfulness in improving women's marital satisfaction.

Method: This study was quasi-experimental with pre-test, post-test and control groups. The statistical population included every married woman in Tehran in the year 1396 (2017). The research sample was composed of 60 married women with moderate marital satisfaction. They were chosen using the convenient sampling technique and were randomly assigned to control and experimental groups. The experimental group attended 8 sessions of Mindfulness-Based Stress Reduction (MBSR) and the control group was on a waiting list. Both groups answered the Five Facet Mindfulness Questionnaire (FFMQ), the Depression, Anxiety, and Stress Scale (DASS), Difficulties in Emotion Regulation Scale (DERS), Interpersonal Reactivity Inventory (IRI), Needs for Intimacy Questionnaire of Bagarozi, Positive and Negative Affect Scale (PANAS) and the Couple Satisfaction Index (CSI) before and at end of intervention. The data were analyzed by Structural Equation Modeling (SEM) using PLS-22 and SPSS-23.

Results: In the initial hypothetical model, which included the direct effect of mindfulness on marital satisfaction and its indirect effects through psychological distress, emotion regulation, empathy, marital intimacy and positive emotion on marital satisfaction, coefficients of all model paths were significant at 95% level except direct path of mindfulness to marital satisfaction (t = 1.14), marital intimacy to marital satisfaction (t = 0.48) and positive affection to marital satisfaction (t = 1.75). After removing the non-significant paths, the model was tested again and the model fit index (GOF = 0.47) was a very good fit for the modified overall model.

Conclusion: The results identified mindfulness-based stress reduction intervention was effective in enhancing marital satisfaction through reducing psychological distress and improving emotion regulation and empathy.

Objective: Effective rehabilitation and better quality of life among stroke patients are functions of several factors such as quality and pattern of sleep. The present study aimed to evaluate sleep quality and related determinants in such patients.

Method: The present cross-sectional study was performed from October to December 2019 among stroke patients who were admitted to Sina Hospital, Hamadan, Iran. We used the Pittsburgh Sleep Quality Index (PSQI) questionnaire to determine sleep quality in these patients. Significant determinants of the global score of PSQI were identified via multivariable linear regression.

Results: A total of 97 stroke patients (age 67±79 years, 55.7% male) were enrolled into the study. Prevalence of poor sleep was 0.84 (95% CI: 0.75, 0.91) in stroke patients. Patients with nervous tension and those with surgical treatment and with Non-hemorrhagic CT scan had a predicted increase of 1.65, 2.91 and 3.25 in the mean of the global PSQI score (P ≤ 0.05), respectively.

Conclusion: Nervous tension, treatment method, results of CT scan and cardiac problems may be associated with post-stroke sleep disorder.

Objective: Chronic METH use results in neurodegenerative alternations in the human brain. The present study aimed to assess the long-term METH impact on brain metabolite concentrations in cases meeting the DSM-5 criteria regarding METH use.

Method: We recruited 42 METH users meeting the DSM-5 criteria and 21 healthy controls. Psychotic signs were measured using the Positive and Negative Syndrome Scale (PANSS). Proton magnetic resonance spectroscopy (1HMRS) evaluating Myo-inositol (Ml), Choline (Cho), Glutamine plus Glutamate (Glx), N-acetyl aspartate (NAA), and Creatine (Cre) were obtained in the dopaminergic pathway (Frontal Cortex, Substantia nigra, Ventral Tegmental Area (VTA), Nucleus Accumbens (NAc), Hippocampus, Striatum,) the subjects. All participants collected urine specimens for 24 hours to measure presence of specific metabolites including METH metabolite level, 5-Hydroxy indoleacetic acid metabolite (for serotonin level monitoring), and metanephrine metabolite (for dopamine level monitoring).

Results: Dopamine and Serotonin increased in the METH group (P < 0.001). METH caused an increase in the Cre (P < 0.001) and a decline in the Glx (P < 0.001), NAA (P = 0.008), and MI (P < 0.001) metabolite concentrations of dopamine circuits in METH users in comparison with healthy subjects. We found no change in Cho metabolite concentration. Psychological data and the neurometabolite concentrations in the studied area of the brain were significantly correlated.

Conclusion: There is an association between METH use and active neurodegeneration in the dopamine circuit, and it causes serious mental illness. 1HMRS can detect patient’s deterioration and progression of disease as well as follow-up management in patients with METH use disorder.

Objective: After accidents and disasters, people suffer from mental disorders due to physical, economic and social injuries. These include anxiety, stress, depression, suicidal ideation, and suicide attempts. Due to the fact that some of these measures can endanger a person’s life, as a result, it is important to pay attention to these psychological factors. Accordingly, the present study was conducted to investigate the prevalence of suicidal ideation and suicide attempt after disaster in the world.

Methods: The present study was a systematic review and meta-analysis of the prevalence of suicidal ideation and suicide attempt after disaster in the world. Accordingly, all English-language articles published from the beginning of 2000 to the end of 2019 were extracted through searches in the databases of Scopus, Web of Science, PubMed, Cochrane Library, Science Direct and Google scholar and then evaluated. Statistical analysis of data was performed using fixed and random effects model in meta-analysis, Cochran test and meta-regression.

Results: A total of 33 studies with a sample size of 61,180 people entered the meta-analysis process. Accordingly, the prevalence of suicidal ideation was estimated at 12.9% (CI95%: 10.3% -15.5%) in the whole population, 5.2% (CI95%: 2.9% - 7.4%) in male and 15.8% (CI95%: 10.0% - 21.6%) in female. Moreover, the prevalence of suicide attempt after disasters was estimated at 8.8% (CI95%: 6.6% - 11.0%).

Conclusion: Based on the findings of the present study, the prevalence of ​​ suicidal ideation and suicide attempt after disaster is high. Due to the fact that many people in the world are exposed to disasters every year, relatively many people deal with suicidal ideation or suicide attempts.

Objective: To cope with the COVID-19 pandemic, national health authorities temporarily closed cultural, religious, and educational institutions such as universities and schools. Children and adolescents with ADHD were challenged with the restrictions caused by the Covid-19 pandemic such as homeschooling and reduced physical activity. The present narrative review aimed to summarize the state-of-the-art regarding associations between COVID-19-related social restrictions and possible psychological and behavioral issues in children and adolescents with ADHD. Additionally, we discussed the underlying possible reasons of the association focusing on the role of parental influence and physical activity, vulnerabilities of individuals with ADHD to Covid-19 infection and to school closure and remote learning. Method: To collect data for the present narrative review, recent publications on these topics between February 1st, 2020 and January 10th, 2021 were retrieved from the most popular search engines (PubMed; Scopus; Google Scholar; Psych Info; Embase) through a comprehensive search using relevant keywords.

Results: During confinement, children and adolescents with ADHD reported increased behavioral and ADHD-related symptoms and overall decreased psychological well-being. Factors negatively impacting children’s and adolescents’ behavioral symptoms and well-being were: less physical activity, adverse parental behavior, difficulties in coping with preventive guidelines, and school closure and remote learning consequences.

Conclusion: Children and adolescents with ADHD and their caregivers faced both specific and general psychological issues related to the school lockdowns and homeschooling. Additionally, Individuals with ADHD seem to be more vulnerable to Covid-19 infection which highlights the need for better healthcare adaptation.