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Background: According to the report of the World Health Organization, mental disorders are one of the 10 most important causes of disability in the world. This study was conducted with the aim of determining the number and frequency of latent classes of depression and its determinants in Isfahan university of medical students. Materials and Methods: A total of 1408 medical students from Isfahan University of Medical Sciences, Iran, were enrolled in the study in 2017. The symptoms and severity of depression were assessed using the standard Hospital Anxiety and Depression scale questionnaire. Latent class analysis was applied to seven symptoms of depression, all of which had four levels. Latent class subgroups were compared using the Chi-square test and analysis of variance test. The regression model was used to check the relationship between identified classes and related factors. Analyzes were done using SPSS-21 and Mplus7 software. Results: In this study, three latent classes were identified, that is, the group of healthy people, the group of borderline people, and the group of people suspected of depression. The prevalence of identified latent classes among medical students is 0.52, 0.32, and 0.16%, respectively. The regression results showed that compared to the healthy group, the factors affecting depression in the borderline and suspicious group were increasing age, female gender, interest in the field of study, physical activity, history of depression, and history of anxiety. Conclusion: The three classes that were identified based on the students' answers to the depression symptoms questions differed only based on severity. The history of depression and anxiety were the strongest predictors of latent classes of depression.

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Background: The aim of this study was to investigate the effect of Lieberman community return program on reducing positive and negative symptoms and improving social skills in people with schizophrenia. Materials and Methods: In this clinical trial study, 58 patients with schizophrenia were randomly allocated into two groups of 29. The first group received 16 sessions of Lieberman community return training and the second group received routine care as a control group. All patients were evaluated before intervention and 1 and 3 months after intervention using the Matson Social Skills Questionnaire and Negative and Positive Symptoms Assessment Scale and compared between the two groups. Results: Evaluation of negative symptoms showed that the dimensions of affective flattening, avolition, anhedonia-asociality, attention, and alogia in the intervention group decreased significantly over time (P < 0.05), but no significant difference was seen in the control group. The mean score of positive symptoms such as hallucinations, delusion, inappropriate affect, and formal thinking disorder in the intervention group were decreased significantly (P < 0.05), but no significant difference was seen in the control group. Appropriate social skills and overall skill score were increased significantly in the intervention group over time (P < 0.05). Conclusion: Lieberman community return program is likely to reduce the symptoms of schizophrenia and increase patients' social skills.

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Background: In this study, the purpose was to investigate the risk and protective factors affecting craving among patients with substance use disorders (SUDs) on buprenorphine, methadone, or opium maintenance treatment in Isfahan, Iran. Methods: In the current cross-section path analysis model, the statistical population was all SUD patients in Isfahan who were under treatment with Methadone or Buprenorphine in 2018. The study sample included 482 people who were on maintenance treatment in Isfahan who were selected by random sampling in two stages. The Franken, Hendriks, and Brink Opiate Craving Questionnaire (OCQ), Substance Related Beliefs Questionnaire (SRBQ), Cognitive Emotion Regulation Questionnaire (CERQ), Patient Health Questionnaire, Sixbey Family Resilience Assessment Scale (FRAS) and the Self-Resiliency Scale (SRS) were used to collect data. A path analysis method and PLS software were used to analyze the data. Results: The results showed that the direct impacts of self-resilience (ß=-0.147, p = 0.009) and uncompromising strategies (ß = 0.249, p = 0.0001) on depression are significant. Also, the direct effects of belief in drugs (ß = 0.518, p = 0.0001) and depression (ß = 0.219, p = 0.0001) on craving are significant. Conclusion: Substance-related beliefs play an essential role in craving both directly and indirectly. The results of the present study can be used to carry out educational and therapeutic interventions for drug SUD patients.

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OBJECTIVE: To evaluate the effect of a follow-up counseling program on oocyte donors' mental health. METHODS: A randomized controlled field trial conducted on 72 Iranian women who volunteered for oocyte donation. The intervention was designed based on the qualitative section of the study and review of the literature, as face-to-face counseling, an Instagram page, an educational pamphlet, and a briefing session for service providers. Mental health was assessed using the DASS-21 questionnaire in two stages before ovarian stimulation (T1) and ovum pick-up (T2). RESULTS: The scores of depression, anxiety, and stress after ovum pick-up in the intervention group were significantly lower than in the control group. Besides, after ovum pick-up, the satisfaction of participation in an assisted reproductive technique (P < 0.001) in the intervention group was significantly higher than the control group, respectively. In the intervention group, the mean scores of depression and stress were lower at T2 compared to T1 (P < 0.001). CONCLUSION: This study showed that the follow-up counseling program could influence these oocyte donors' mental health during participation in assisted reproductive techniques. Designing these programs in the cultural context of each country is recommended. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT20200617047811N1), Date of registration: 07/25/2020, Registry URL: https://www.irct.ir/trial/49196.

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To identify the perceptions of women oocyte donors this qualitative study was conducted on 30 oocyte donors using in-depth interview. The three main categories of decision-making challenge, the consequences of participation in assisted reproductive treatment, and the contrast between the self-image and social-image of the donor were inferred. Financial and altruistic motivation, social taboo, and the approval of trusted people were the sub-categories of the decision-making challenge. The results of the study showed that the decision for oocyte donation follows the effort of women to balance the financial and spiritual benefits of the donation against its cultural barriers.

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Assisted Reproductive Technology by means of oocyte donation is a very successful method leading to psychosocial consequences in donors. The aim of the present study was to conduct a systematic review of the existing literature on the psychosocial consequences of oocyte donation in the donors. The present study was conducted as a systematic review based on the PRISMA checklist. Searches were performed in PubMed, Web of Science, Scopus, and SID databases for the documents written between 2000 and 2020 regardless of the research methodology and the employed tools. English and Persian articles focusing on psychological and social issues of oocyte donation were reviewed. From 2,759 studies which were found, finally 14 related ones were selected. Psychosocial challenges of donors were obtained in three dimensions including short-term and long-term psychological reactions to treatment complications, emotional reactions to their function as an oocyte donor, and emotional reactions to the resulting offspring resulting and related social challenges. According to the existing studies, oocyte donation is a challenging process with short-term and long-term psychosocial consequences for donors. In order to prevent the feasible psychosocial hazards caused by the donation process, it is necessary to provide oocyte donors with psychosocial support, proper counseling, and awareness of the facts and possible issues ahead.

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OBJECTIVE: Addiction is a complex condition and a brain disease manifested by compulsive substance use despite its harmful consequence. Addicted individuals have an intense focus on using substances. This study aimed to investigate the effect of adding memantine to clonidine and buprenorphine in reducing withdrawal symptoms, compared with placebo, in drug-dependent patients (opium and heroin). MATERIALS AND METHODS: In this double-blind, randomized clinical trial study, 60 patients using opium or heroin were assigned to the intervention (n = 30) and control (n = 30) groups. Both groups were treated with buprenorphine and clonidine at the same dose in the detoxification process. The intervention group received memantine 10 mg daily for 10 days and then 20 mg daily for 21 days, and the control group received a placebo prepared in the same shape and size as memantine tablets. The severity of withdrawal symptoms was measured using the Short Opioid Withdrawal Scale over 3 weeks. Data analysis was performed using SPSS and descriptive and inferential tests. RESULTS: The results showed that despite memantine's superiority in controlling some withdrawal symptoms such as feeling sick, stomach pain, muscle spasm, and feeling cold, no significant difference was found between the 2 groups. There was also no statistically significant difference between the 2 groups in the total score of symptoms. CONCLUSIONS: No specific advantage of memantine was found for reducing the symptoms of withdrawal syndrome in the present study. However, this drug was well tolerated without any evidence of serious or significant adverse effects.

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AIM: The aim of the study was psychometric properties of a questionnaire for assessing psychosocial dimensions associated with postpartum depression (PAPP). METHODS: Initial form of the questionnaire for assessing PAPP was developed based on the results of a qualitative study. Principal component analysis was used to determine the construct validity, as well as Cronbach's alpha and intraclass correlation coefficient to determine the reliability of the questionnaire. Construct validity, predictability of the questionnaire, and confirmatory factor analysis were evaluated in a longitudinal study on 303 pregnant women in the third trimester of pregnancy. Also, using Edinburgh postnatal depression scale, the level of depression was evaluated 6 weeks after childbirth. RESULTS: Exploratory factor analysis led to a 47-item questionnaire with five dimensions and confirmed that five factors determined 42.31% variance. Cronbach's alpha was 0.851 for the total score of questionnaire and for the factors, ranged from 0.84 to 0.92. ICC of total was 0.92 (95% confidence interval (CI): 0.69-0.93). Analyzing the confirmatory factor analysis showed that the 47 items questionnaire had a good construct validity (CMIN/DF = 2.01, p = 0.122). The level of the PAPP in women suffered from postpartum depression was higher than women without postpartum depression (odds ratio = 1.01, 95% CI: 1.01-1.02, p = 0.001). A cut-off score of 42 provided the best sensitivity (0.75) and specificity (0.50) for PAPP. CONCLUSION: The psychometric properties of the PAPP showed an appropriate validity and reliability, and it may applicable to predict of at risk pregnant women for postpartum depression who seeking antenatal care services.

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BACKGROUND: An unplanned pregnancy may be followed by increased depression and anxiety. The aim of the present study was to evaluate the mediating role of partner's emotional reaction to pregnancy (PERP) on the relationship between pregnancy planning and prenatal mental health. METHODS: This cross-sectional study was conducted on 303 healthy Iranian pregnant women during their third trimester. The levels of depression and anxiety were measured using the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory. The PERP score was also measured using a researcher-made questionnaire. The data were analyzed using the plug-in application PROCESS macro. RESULTS: The results showed that PERP score was reversely related to pregnancy planning and prenatal depression and anxiety. The direct effect of the pregnancy planning on depression (c = -.05) and anxiety levels (c = -.02) were not significant; but the indirect effect of pregnancy planning on depression (Point Estimate = -.379, CI: -.523 to -.250) and anxiety levels (Point Estimate = -.560, CI: -.741 to -.385) with the mediating role of PERP were significant. CONCLUSIONS: The results indicated that the effect of pregnancy planning on prenatal mental health is mediated by PERP, and in unplanned pregnancy women need to receive positive reaction of their partners toward pregnancy so that they can preserve their mental health.

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BACKGROUND: Increasing in elderly's population and their individual and social problems especially mental health problem in this group need special attention. The aim of this study was evaluation of health promotion behaviors training program efficacy on general health components in elderlies referring to health centers in Isfahan city. MATERIALS AND METHODS: This study was a tri phasic field trial in 2014 in which 72 elderlies allocated randomly in two case and control groups. Case group participated in 9 training sessions on stress management and interpersonal relationships and the control group participated in 2 sessions with a neutral discussion content. Data collection tools were demographic information questionnaire and general health questionnaire 28. Pretest, posttest, and 2-month follow-up were performed in two groups. Data were analyzed by t-test, analysis of variance with repeated measurement, least significant difference post hoc test, and SPSS 20 software. RESULTS: Findings of this study showed that the average of general health score in case and control groups had not significant difference before the intervention (P > 0.05). However, the mean difference of general health score after intervention and 2-month follow-up was statistically significant in two groups (P < 0.001). CONCLUSIONS: This study showed that interpersonal relationship and stress management training program are effective on promotion of mental health in elderlies. Hence, the findings of this study can be used in the field of treatment and care of the elderly by other health-care categories.

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BACKGROUND: Studies showed that decreased marital satisfaction and increased risk of depression and anxiety were mutually related. Therefore, this study was conducted to evaluate the effect of communication skills training with a couple focused approach on marital satisfaction and psychological symptoms among pregnant women. METHODS: This experimental study was performed on 60 pregnant women with low marital satisfaction who were divided into two groups of intervention and control. The women in the intervention group and their husbands participated in a communication training program based on the couple focused approach. The levels of anxiety, depression, and marital satisfaction were evaluated before and then one and three months after the intervention using valid questionnaires. RESULTS: The results indicated that after the intervention, compared to the pre-intervention period, the levels of marital satisfaction increased while the levels of depression and anxiety decreased significantly in the intervention group (p < 0.05). The comparison of the groups revealed significant differences in the scores of marital satisfaction, depression, and anxiety in the intervention and control groups at the intervals of one month and three months after the intervention (p < 0.05). CONCLUSIONS: The research findings indicated that communication skills training program based on the couple focused approach and an emphasis on the needs of pregnant women during the pregnancy can improve the marital satisfaction and psychological health of pregnant women. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT2017012932264N2, Date of registration: 2017-06-28 Retrospectively registered.

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BACKGROUND: Oocyte donation is one of the assisted reproductive techniques that can undermine the mental health of the women donor. As such, the aim of this study is to design a mental health promotion program for oocyte donors. METHODS: This is an exploratory mixed methods study (qualitative-quantitative) that consists of three phases. In the first phase, a qualitative study will be conducted to identify the needs and strategies of the mental health promotion program for the women donors. In this phase, the participants will be selected using purposeful sampling method and the data will be collected through semi-structured interviews. In the second phase, the initial draft of the program is designed and validated in the panel of experts and using the classic Delphi technique and, then, the program is finalized. In the third phase, the designed program will be implemented as a quasi-experimental study in two groups of program recipients (intervention) and control, and the effectiveness of the intervention program will be evaluated. DISCUSSION: In order to design a documentation-based mental health promotion program for the oocyte donors, their experience during the process of oocyte donation should be evaluated. Doing so, the program will be developed based on the specific circumstances of the target population and their social and cultural context and, hence, will have the highest impact.

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BACKGROUND: Achieving a rapid onset and durable methods of treatment for major depressive disorders is an issue pursuing in psychiatry. This study was designed to assess the therapeutic efficacy of intravenous (IV) ketamine injection in controlling depressive symptoms in comparison with electroconvulsive therapy (ECT) in major depressed disordered patients. MATERIALS AND METHODS: Thirty-two patients over 18 years of age who were candidates for ECT were enrolled in the study. They were allocated into two groups using block design randomization. Sixteen patients received IV infusion of 0.5-mg/kg ketamine and 16 patients underwent a bitemporal ECT. To evaluate the changes in depression severity, researchers administered Hamilton Depression Rating Scale (HDRS) at baseline, before each treatment session, and four time points posttreatment (week 1 and months 1, 2, and 3). The Wechsler Memory Scale was used to evaluate the cognitive state of patients in week 1, month 1, and month 3 of the treatment. RESULTS: The HDRS showed improvement in depressive symptoms in both the groups with no statistically significant difference. Cognitive state was more favorable (but not significant) in the ketamine group (P > 0.5). CONCLUSION: Treatment with IV ketamine in depressed people has the same antidepressant effects as ECT treatment without any memory deficiency.

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BACKGROUND: A successful aging pattern indicates a change in attitudes toward aging and life quality improvement, which include the components of general health and life satisfaction. The current study aimed to evaluate the effects of an educational program on successful aging components in the elders. MATERIALS AND METHODS: A three-stage empirical study was conducted on 72 individuals of 60-75 years old who were randomly divided into two experimental and control groups. A 9-session educational program presenting health-related behaviors, including stress management and interpersonal relationships, was held for the experimental group. Two sessions of neutral topics group discussion were held for the control group. A Demographic Information Questionnaire, General Health Questionare-28 (GHQ-28), Diener's Satisfaction with Life Scale (SWLS) were used and completed before, immediately after, and two months after the intervention. Independent t-test was used for analysis of obtained data via SPSS software. RESULTS: The mean (SD) score of general health in the two groups had no significant differences before the intervention [32.40 (14.70) vs. 30.8 (10.04)] (p = 0.60). The mean (SD) scores of general health immediately after intervention and two months later in the experimental group [20.2 (8.8) and 24.1 (8.05)] were significantly lower than control group [31 (9.8) and 30.9 (9.8)] (p < 0.05). The mean (SD) scores of life satisfaction in the both groups showed no significant difference before the intervention [16.8 (5.8) vs. 17.3 (5.5)] (p = 0.39), but were significantly different immediately after [20.4 (5.1) vs. 17.03 (5.1)] and two months after [19.8 (5.1) vs. 17.1 (5.1)] (p = 0.004). CONCLUSIONS: This study confirmed the effectiveness of health-related educational programs in improving elders 'general health and life satisfaction'.

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The aim of this study was to investigate the relationship between marital quality and mental health during pregnancy. This cross-sectional study was conducted on 300 Iranian pregnant women. The ENRICH marital satisfaction subscales, levels of domestic violence, perceived social support, as well as depression and anxiety levels were assessed using a questionnaire. AMOS path analysis was used to explore the causal relationship and the mediating effect of social support among the variables of marital quality subscales and mental health. The results showed that, adjusted for age, the history of infertility and level of anxiety were related to marital satisfaction, marital relationships and level of depression which were related to the level of domestic violence. Sexual satisfaction and the level of perceived social support had a mediating role in such relationships. The study confirmed that marital quality is an important predictor of mental health. Improving the marital quality may lead to improvement in mental health.

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BACKGROUND AND AIM: Prenatal mental health has been shown to be related with postpartum depression. However, the role of mental and psychological factors in postpartum depression requires especial attention. Furthermore, the relationship between demographic factors and postpartum depression is contradictory. The study was aimed to identify role of prenatal anxiety and depression and demographic factors with postpartum depression. MATERIALS AND METHODS: A prospective cohort study was conducted with 303 pregnant women who have gestational age from 28 to 36 weeks and referred to health-care centers in Isfahan city and follow-up for 6-12 weeks after postpartum. Data were collected using the demographic form, Edinburgh depression, and anxiety Spielberger questionnaire during pregnancy and Edinburgh depression inventory in the 6th and 12th weeks after childbirth. Descriptive statistics and linear logistic regression were used to analyze the data. In demographic factors, data were analyzed using the Student's t-test, Chi-square, Pearson and Spearman test and after the meaningfulness of regression was used. RESULTS: Results showed that the 6 and 12 weeks after childbirth, 61 patients (20/1%) and 33 patients (10/9%) had postpartum depression. The most important risk factors for depression in the first 6 weeks were history of infertility (confidence interval [CI]: 0.56-0.767) (P = 0.018) and history of depression (CI: 1.155-1.369) (P = 0.000) and in 12 weeks, postpartum were history of depression (CI: 0.072-1.305) (P = 0.001). CONCLUSION: Infertility and history of depression during pregnancy were two risk factors of postpartum depression which should be taken into consideration during prenatal care.

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Postpartum depression is a debilitating mental disorder with a high prevalence. The aim of this study was review of the related studies. In this narrative review, we report studies that investigated risk factors of postpartum depression by searching the database, Scopus, PubMed, ScienceDirect, Uptodate, Proquest in the period 2000-2015 published articles about the factors associated with postpartum depression were assessed in Farsi and English. The search strategy included a combination of keywords include postpartum depression and risk factors or obstetrical history, social factors, or biological factors. Literature review showed that risk factors for postpartum depression in the area of economic and social factors, obstetrical history, and biological factors, lifestyle and history of mental illness detected. Data from this study can use for designing a screening tools for high-risk pregnant women and for designing a prevention programs.

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Oocyte-donation is generally safe but may exacerbate psychiatric symptoms in some women. In this prospective study 63 oocyte-donating women and, as a control group, 63 women providing their own oocytes for in vitro fertilization (in couples with male infertility) were evaluated pre- and post-ovulation-induction in regard to hypochondriasis, anxiety, social impairment, and depression. The mean hypochondriasis score for oocyte-donators was significantly lower than for women providing their own oocytes, prior to ovulation-induction (5.03 vs. 6.59). However, after ovulation-induction and oocyte retrieval this score rose to 6.66 among oocyte-donators, whereas it remained essentially unchanged among women providing their own oocytes (6.66). The mean anxiety score for oocyte-donating women also rose following this procedure, from 5.87 to 7.65. Depression scores for both groups remained similar, before and after the procedure. Results showed that at the beginning of the ARP donating women have the same conditions as own oocyte women regarding depression and anxiety but after the egg harvesting they would suffer more damages regarding hypochondriasis and anxiety aspects.

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BACKGROUND: Mothers got stressed when they are informed about the occurrence of stillbirth. Many researchers believe that the failure to provide the required care by health teams during this hard time is the main determinant of maternal mental health in the future. In other words, psychosocial support by medical care providers can significantly improve mental outcomes of mother after stillbirth. OBJECTIVES: This study aimed to explore stillborn mothers' suggested strategies to provide maternal mental health in the experience of stillbirth. PATIENTS AND METHODS: Twenty women who had experienced stillbirths participated in this qualitative content analysis study. They were selected through purposeful sampling method. Data were gathered by individual interviews recorded on audiotapes, transcripted and then analyzed. Then, transcriptions were coded and classified. Finally, 3 main categories and 9 subcategories were emerged. RESULTS: Analysis of participants' viewpoints and their opinions about strategies to provide maternal mental health in the experience of stillbirth lead to development of 3 main categories: "before delivery strategies" with 3 subcategories, "during labor strategies" with 3 subcategories, and "postpartum strategies" with 3 subcategories. Analyses of findings showed that, health care providers can mitigate some of the long-term negative mental outcomes of stillborn mothers by spending extra time with grieving mothers, facilitating bonding, and validating their emotional expressions. CONCLUSIONS: According to the results, revision and modification of the care plan in the experience of stillbirth seems necessary to improve mental health in these mothers. According to suggested strategies, midwives and health care providers are health professionals who can effectively and properly care for stillborn mothers.

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BACKGROUND: Stillbirth is one of the deepest losses that can inflict a broad range of cognitive, mental, spiritual, and physical turmoil. Many researchers believe that the failure to provide the care required by health teams during the hard times is the main determinant of maternal mental health in the future. In other words, social support can significantly improve the mental health outcomes of mothers after stillbirth. This study aimed to explore social support to aid mothers in adaptation after the experience of stillbirth. MATERIALS AND METHODS: This was a qualitative content analysis in which 15 women who had experienced stillbirth participated. They were selected through purposeful sampling method. Data were gathered by individual interviews recorded on audiotapes, transcribed, and analyzed. Interview transcriptions were coded and then classified. Finally, two main categories and five subcategories emerged. RESULTS: Analysis of participants' viewpoints and their statements about social support led to the emergence of the two main categories of support from relatives and support from social support systems with two and three subcategories, respectively. Analysis of findings showed that mothers experiencing stillbirth need the support of their spouse and family and friends through sympathizing, in performing everyday activities and to escape loneliness. These women require support from a peer group to exchange experiences and from trauma counseling centers to meet their needs. CONCLUSIONS: It seems necessary to revise and modify the care plan in the experience of stillbirth using these results and, of course, to be considered by a panel of experts in order to provide social support to these women. Thus, midwives and healthcare provider can act, based on the development and strengthening of social protection of women experiencing stillbirth, to provide these women with effective and appropriate care.