Assessing Caregiving Burden in Family Caregivers of Depression and Schizophrenia in Pakistan.

BACKGROUND AND OBJECTIVE: Care for family members is a significant characteristic of families in South Asia. A family is one unit, and every other member is emotionally connected and expected to take care of each other. However, the provision of care to a family member with mental illness can be physically as well as emotionally exhausting and distressing for the Family Caregiver. The present study aimed to investigate the caregiving burden in family caregivers of depression and schizophrenia. METHOD: For this cross-sectional research, a purposive sample of 80 Family caregivers taking care of at least one family member with mental health problems of depression (n=40) and schizophrenia (n=40) were recruited for the present study. The age range of the sample was 15 to 60 years. All the respondents were literates who could read and write in Urdu. The scale used to measure the caregiving burden was Zarit Caregiving Burden Scale. The data was collected from the male (n=22) and female (n=58) family caregivers. To access data, family caregivers were approached at the psychological services clinics of Rawalpindi and Islamabad in private and public sector hospitals. RESULTS: The data were analyzed through descriptive and t-test analysis. Analyses of the data revealed that family caregivers of schizophrenia had a greater caregiving burden as compared to family caregivers of depression. Results also showed that females reported a higher caregiving burden as compared to male family caregivers. CONCLUSION: Family caregivers of schizophrenia undergo the severe burden of care and distress, and they may be considered a high-risk group for the development of mental health problems. Comprehensive intervention programs may be developed to involve them and safeguard their mental health.

The Implications of Sanctions on Civilian Mental Health and Quality of life Iranian: An overview.

BACKGROUND: The Islamic Republic of Iran has been under sanctions since 1979. These sanctions were further reinforced between the years 2005 and 2012. This study utilizes available data from Iran post-sanctions to review the impact of economic sanctions on both the mental health and the quality of life of Iranian citizens. METHODS: A comprehensive scoping review was conducted to identify studies examining the impact of sanctions on health in Iran. Searches were initiated in 2012 using PubMed/Medline, Embase, Web of Science, Scopus, and the Scientific Information Database (Iranian Database) with keywords such as sanctions, implications, mental health, quality of life, civilian mental health, and Iran. Subsequent to the screening process, secondary reports and letters to the editor were excluded. Only original studies-those collecting data via observation, interviews, surveys, experiments, or literature reviews-were retained for analysis. In addition to these search strategies, reference scanning was undertaken to identify additional articles pertinent to the scope of the current study. This thorough approach facilitated the discovery of relevant and significant articles exploring the effects of sanctions against Iran on the mental health and overall well-being of its civilian population. Following the search, duplicate articles were meticulously identified and removed by the authors. Data were subsequently extracted and summarized, focusing on study characteristics and the observed effects of sanctions on civilian mental health and quality of life in Iran. RESULT: Out of 165 items identified in the preliminary search, ten articles met the inclusion criteria. These selected articles highlighted the pronounced effects of sanctions on various health-related domains. CONCLUSION: Since 2012, Iran has been subject to intensified sanctions. There is evidence to suggest that the economic sanctions, imposed by Western nations, and have exerted a negative and detrimental impact on the health of individual Iranians.

The Use of Islamic Patterned Art Therapy: Healing of Psychological Problems Among University Students.

This study was designed to adopt art therapy from an Islamic perspective by adding/including shapes and designs of Islamic origin. This was basically color therapy and was designed to find its effectiveness in reducing depression, anxiety. Stress and enhancing psychological well-being of university students with high and low-religious levels from Islamabad and Rawalpindi. This study was carried out in two phases. The first phase was to develop Islamic adult coloring book with Islamic patterns and calligraphy. The second phase was the main study, and it was an experimental study which included screening out a sample, consisting of mild to moderate levels of depression, anxiety and stress and high and low-religiosity levels. A sample of 60 university students received Islamic patterned art therapy. On the basis of religiosity, two groups were formed as either a high-religious group or a low-religious group with individuals in both groups completing fourteen sessions. Pre- and post-test assessments were undertaken via the psychometric tools DASS-21, psychological well-being scale and religiosity scale. Statistics from the independent sample t-test and paired sample t-test and repeated measures ANOVA for within group and between group comparisons, revealed that there was a significant difference from pre-test to post-test assessments of depression anxiety and stress and psychological well-being, whereas there were nonsignificant gender differences on the bases of high and low-religiosity levels. Therefore, it could be concluded that Islamic patterned art therapy was found effective in reducing depression anxiety stress and increasing psychological well-being of university students.

Belief Salience, Religious Activities, Frequency of Prayer Offering, Religious Offering Preference and Mental Health: A Study of Religiosity Among Muslim Students.

To investigate role of belief salience, participation in religious activities, religious offering preference and prayer offering positively predicts mental health among university students. It is a cross-sectional research design carried out in International Islamic University Islamabad, February 2018 to August 2018. Demographic variables were assessed by collecting information about age, education, marital status, family income and socioeconomic status. Mental Health Inventory-38 was used to measure mental health of the students, and in order to measure religiosity, Religiosity Measure Scale tapping belief salience, religious activities, frequency of prayer offering and religious offering preference was used. The results of the present study were analyzed through SPSS 21v. For computation of the findings, regression analysis and t test were applied. Study found that involvement in religious activities, prayer offering and belief salience positively predicts mental health among university students. Along with that, female students were also found to be highly involved in prayer offerings, religious offering preference and belief salience. However, there were no significant gender differences on participation in religious activities and mental health. It is recommended that development and enhancement of belief salience and religiosity in treatment of Muslim clients with psychological issues may boost their mental health. Therefore, these may be incorporated in treatment models.

Smartphone addiction and its associated factors among students in twin cities of Pakistan.

OBJECTIVE: To determine the prevalence and indicators of smartphone addiction in local population. METHODS: The cross-sectional study was conducted in the twin cities of Islamabad and Rawalpindi, Pakistan, from August 2017 to August 2018, and comprised school, college and university students of either gender aged 12-19 years. Data was collected using Smartphone Addiction Scale-Short Version with a cut-off score of 31 for boys and 33 for girls. Data was analysed using SPSS 23. RESULTS: Of the 702 subjects screened, 422(60%) had smartphone addiction; 242(57.3%) males and 180(42.6%) females. Social networking applications were significant indicators of the addiction (p<0.05). CONCLUSIONS: Smartphone addiction was found to be high among Pakistani adolescents.

A systematic review of prevalence of Depression in Iranian patients.

BACKGROUND: Depression is a common mental health disorder which has become a global public health issue. It constitutes around 35 to 45% of mental health problems in Iran and covers 8% to 20% of population of Iran. Therefore, the present study aimed to determine the prevalence of depression among the Iranian patients through systematic review and meta-analysis. METHOD: For the present study information were searched in Web of Science, Scopus, PubMed, Google Scholar, and in Iranian databases including Iran Medex, SID, MedLib, Scientific Information Database, MagIran, using the following keywords: "depression", "prevalence" and Iran. The data from these databases were analyzed through meta-analysis (random effects model). Heterogeneity among the results of the studies was examined by I2 index. Beck Depression Inventory (BDI), Depression Anxiety and Stress Scale-21 (DASS-21), General Health Questionnaire-28 (GHQ-28), and Geriatric Depression Scale (GDS) were used in this study, and statistical analyses were performed using STATA Ver.16. RESULTS: A total of 46 studies conducted in Iran based on a sample size of 2960 individuals was found during the time period of 2010 and 2018. Prevalence of depression among Iranian patients was estimated to be 34.26 (95% CI, 24.12% - 44.10%). Thus, the findings indicated that there exists a moderate prevalence of depression which is continuously growing. CONCLUSION: The prevalence of depression in Iran is moderate and growing which is alarming as it may turn out to be a massive increase in incidence rate of depression in coming years. This indicates a greater risk for Iranian population and calls for effective measures to be taken to control the mental health problems among Iranian patients.

Religiosity and Death Anxiety: A Study of Muslim Dars Attendees.

Dars is usually considered a religious lecture or activity where attendees spend much time in search of Islamic information, which often keeps the attendees away from negative thinking. Religious directions, belief salience, spiritual activities and practices are significant assets for dealing with difficult situations and odds of life. Death anxiety can increase the vulnerability of development of any psychological illness. Therefore, it is vital to study whether religiosity can serve as a buffering agent to death anxiety. The objective of our study was to examine the relationship between religiosity and death anxiety among Muslim dars attendees. We also aimed to investigate the gender-based differences in religiosity and death anxiety among Muslim dars attendees. A purposive sample of 200 adults (male n = 100 and female n = 100) with the age range of 20-60 years participated in the present study. The sample was collected from informal religious gatherings (dars) from Islamabad and Rawalpindi. The information was gathered through self-reporting questionnaires, death anxiety scale and index of religiosity. The questionnaires were in Urdu (native language) for ease and convenience of the respondents. Variable correlation analysis and t test was applied statistically through SPSS 21 version. The findings of the study indicate that there is a significant negative relationship between religiosity and death anxiety. Results also revealed that there is insignificant difference in religiosity between male and female Muslim adults. Results also specified that the level of death anxiety is higher in female than in male Muslim adults. Religiosity has a significant inverse relationship with death anxiety, and this can be helpful in reducing the anxiety-related features. Being a trans-diagnostic construct, measures can be taken to control death anxiety in order to enhance the mental well-being of masses. The present research also puts forward that the development of religious beliefs and interventions can help people to better adjust in life.

An Urdu adaptation of smartphone addiction scale-short version (SAS-SV).

OBJECTIVE: To adapt the English version of Smartphone Addiction Scale-Short Version into Urdu language. METHODS: The cross-sectional study was conducted from October 2017 to January 2018 at the International Islamic University, Islamabad, Pakistan. In the first stage, Smartphone Addiction Scale-Short Version was translated by 8 experts. In stage 2, the translated version was pilot-tested on 30 university students aged 18-19. Finally, the version was tested on the actual subjects who were students aged 11-30 years at schools, colleges and universities within Rawalpindi and Islamabad. SPSS 22 was used for data analysis. RESULTS: Of the 348 subjects, 216(62%) were males. Overall, 194(55.7%) students were above the addiction cutoff value. Inter-item reliability of the translated version was good (α = 0.81); the construct validity was adequate (P<0.001); Comparative Fit Index = 0.95; Tucker Lewis Index= 0.93; Normative Fit Index= 0.92; and Root Mean Squared Error Approximation = 0.05. CONCLUSIONS: Smartphone Addiction Scale-Short Version can be used as a screening tool for assessment and identification of smartphone addiction in Pakistan..

Negative repercussions of caregiving burden: Poor psychological well-being and depression.

OBJECTIVES: To compare depression and psychological well-being between caregivers of schizophrenic patients and non-caregivers and to study the burden of caregiving as a relative risk for depression and psychological well-being. METHODS: This cross sectional comparative study was conducted at International Islamic university Islamabad from January to September 2017. Fifty informal caregivers of schizophrenic patients from 19 to 55 years of age were included in the study. The control group consisted of age and socio-economic status matched healthy volunteers who did not have any psychological or medical patient at home needing care and assistance. For measurement of study variables i.e., burden of caregiving, depression and psychological well-being, instruments used were Zarit Burden Interview (ZBI), The Beck Depression Inventory (BDI) and Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) respectively. RESULTS: Results were analyzed using MANOVA followed by One-Way ANOVA. Findings indicated that informal caregivers of schizophrenia have greater depression and poor psychological well-being in comparison to the non-caregiver controls. Association of caregiving burden with psychological well-being and depression was calculated using Chi Square test and relative risk. CONCLUSION: Caregiving adversely affects informal caregivers' mental health and wellbeing. Informal caregiving is a burden for the caregivers; health status of family members involved in caregiving should be routinely assessed to enhance their health-related quality of life.

Role of Religiosity in Psychological Well-Being Among Medical and Non-medical Students.

Religion has been generally considered as a protective factor for the psychological health of the people. As many studies have publicized a high prevalence of psychological morbidities among the medical students during their academic stages of medical schools, it is significant to investigate whether religiosity functions as a protective factor, to explore religiosity as a predictor of psychological well-being in a sample of medical students, and to compare the results of medical students as well as non-medical students with respect to religiosity and psychological well-being. The study is carried out in Federal Medical and Dental College and International Islamic University, Islamabad. The present study examined a sample of 120 medical students from Federal Medical and Dental College and 120 non-medical students from International Islamic University, Islamabad. Purposive sampling was used. The respondents completed religious orientation scale and scale of psychological well-being scale along with a demographic data sheet. In order to measure the study variables, linear regression and t test were used. The findings revealed that religiosity is a strong predictor of psychological well-being. Extrinsic and intrinsic religiosity predicts psychological well-being among the students. The results indicated a significant difference in psychological well-being between medical and non-medical students. No significant difference was found in religiosity of medical and non-medical students. The gender differences in religiosity and psychological well-being were found to be insignificant. The results emphasize that psychological well-being is prophesied by religiosity. The present research suggests further investigations and also endows with trends for psychological evaluation, development of religious beliefs, and interventions for augmenting psychological well-being among the medical students.

The effectiveness of the community reinforcement approach (CRA) in the context of quality of life and happiness among people using drugs.

Introduction: The Community Reinforcement Approach is an evidence-based treatment modality for alcohol and drug addiction treatment with proven efficacy and cost-effectiveness. The present study investigated the effectiveness of the Community Reinforcement Approach (CRA) in the context of quality of life among drug addicts. Materials and methods: A total of 60 inpatient substance abusers post detoxification in Fountain House, Lahore, Pakistan, participated in this study. Fountain House was selected as the Minnesota model is primarily used there. Therefore, a new treatment approach was introduced to investigate its effectiveness for individuals with substance abuse. A randomized 12-week trial was conducted as a substance use disorders (SUDs) treatment program. Persons with SUD (i.e., identified patients) enrolled in a residential treatment program were randomized into the integrated model of the Community Reinforcement Approach (CRA) and traditional Minnesota model treatment (n = 30), and traditional Minnesota model treatment only (TMM; n = 30). All the participants in the experimental group attended the group therapy sessions and other activities in the facility in addition to the treatment conditions. The participants attended the individual therapeutic sessions, which were conducted according to the CRA guidelines used in the experimental group. In this study, each individual in the CRA treatment group received 12 one-to-one sessions ranging from 45 min to 1 h. The WHOQOL-BREF scale and Happiness Scale (1) were used for data collection. Result: The results showed a significant increase in the quality of life of participants in the treatment group with CRA compared with the control group with TMM. The findings also indicated that the individuals in the treatment group with CRA had improved levels of happiness compared with individuals with TMM. Discussion: The CRA is an effective and adaptable treatment approach that works well in combination with other treatment approaches. The proven efficacy, compatibility, and cost-effectiveness distinguish it from other treatment methods. Implications: The CRA should be adapted, assessed, and evaluated further, especially in Pakistan, where there is a pressing need to adopt an effective treatment strategy for addiction problems.

Filicide in South Asia: Demography, risk factors, psychiatric, and legal aspects.

Background & Objective: Filicide is an act of killing a child up to the age of 18 years committed by his or her parent(s) or parental figure(s), including guardians and stepparents. There is absence of data and research regarding filicide in South Asia. The present study aimed to address the empirical lacuna in South Asia and to expand the literature in order to broaden the understanding of filicide. Method: The search was conducted in the databases of PubMed, PubMed Central, Scopus, and Google Scholar. The original articles, quantitative studies, case studies, and full-length articles were included for the present review. Publications in only the English language, which clarified that the child was killed by parent(s) in eight South Asian countries from 2000 to 2020 were included. Results: A total of 13 reports of filicide were found in the eight South Asian countries; 12 from India and 1 from Pakistan. The most common method of filicide was by administering poisonous substances and burning by parents, depression was responsible for 7 cases of filicide, schizophrenia was responsible for one case. Conclusion: The review identified that there is a scarcity of research on filicide in South Asia. Rigorous research and investment for the compilation of data on filicide are needed to reduce it in South Asia. This may further help in the protection of lives of children as well as for taking steps for rehabilitation of parents and society.

Assessing the effectiveness of animal-assisted therapy on alleviation of anxiety in pre-school children: A randomized controlled trial.

Objective & background: Human-animal interactions are considered as being valuable and beneficial for the psychological health. Recently Animal-Assisted Therapy (AAT) has been included for client-therapist interaction. The purpose of the present study was to assess the effectiveness of animal-assisted therapy in alleviation of anxiety in pre-school children. Method: The study was carried out as a randomized controlled trail with pre-test and post-test design and control group. The trial was registered in the Chinese Clinical Trial Registry with the registration id of ChiCTR2000034145. The study consisted of 33 anxious 5-7years old children (participated in a welfare anxiety screening plan held by Counseling Center, Tehran-Iran) between 2018 and 2019. The participants took part in the study voluntarily. The subjects were randomly divided into experimental and control groups (10 in each group). The experimental group was exposed to 8 sessions of animal therapy. The research instrument used in the present study was Spence Preschool Anxiety Scale (Parent Form) and the data were analyzed on SPSS 21 software. Results: The results showed that animal therapy had a significant effect on general anxiety after adjusting for post-test assessments (f = 32.49 and p = 0.001) with the effect equal to 0.70. In addition, the effect of animal therapy on anxiety of separation (f = 5.63, p = 0.03), generalized anxiety disorder (f = 8.56, p = 0.01), social phobia (f = 14.58, p = 0.002) and specific anxiety (f = 11.63, p = 0.005) was significant with effects equal to 0.30, 0.40, 0.53, and 0.47, respectively. The results also showed that the effect of animal therapy on obsession was not significant (p > 0.05). Conclusion: Therefore, it can be concluded that Animal therapy is effective in alleviating anxiety in children. It supports for the inclusion of AAT in therapeutic practice with children having anxiety.

A rare phenomenon of pregorexia in Pakistani women: need to understand the related behaviors.

BACKGROUND: In Pakistan, for a decade or so, there has been a huge increase in body ideals, and thinness and eating disorders reported during pregnancy. The purpose of the present research was to study the lived experiences and behaviors characterized by pregorexia in Pakistani young women. METHOD: A phenomenological approach was used to study eating disorder-related behaviors among pregnant women. A criterion sample of 15 women (22-34 years of age) having difficulty with their body image, the decline in caloric intake, skipping meals, and extensive exercise from a private gynae clinic of Islamabad was selected. The participants were screened on the DSM-5 criteria of anorexia nervosa. They were also asked questions about their diet intake, behaviors executed to lose or maintain weight, use of any medical or chemical substance to control weight, any social activities/behaviors, type of exercise if any, duration or frequency of exercise, and behaviors that made them feel better. RESULTS: The findings revealed that 93.33% of women met the complete criteria of Anorexia nervosa. 86.6% had never been diagnosed or treated with anorexia nervosa, however, 13.33% were diagnosed with anorexia nervosa comorbid with depression. Results indicated a likelihood of having anorexic tendencies in 40% of women and the other 60% developed the symptoms during pregnancy only. Behaviors related to pregorexia were found to be: skipping meals, eating small portions, control on calorie intake, following diet plans available on YouTube, taking fat burn tea, avoiding the presence of elders of the family while taking meals, eating alone to limit food portion, taking laxatives or medicine to control weight, induced vomiting after eating, eating to match the norm of eating (supervised eating by elders) being pregnant and later self-induced vomiting, or eating slowly and consuming more time, pretending to eat the suitable amount of food. Women also engaged in fast walking, light exercise, and intensive cardio to control weight and stay in body shape. Around 86% reported that controlling weight, calorie intake, and exercising made them feel better. CONCLUSION: There is a need to understand and differentiate pregorexia from other eating behaviors and problems among pregnant women with respect to cultural context.

Pregorexia is a term used to describe a condition where an individual displays a heightened fear of pregnancy-related weight gain. The present study is the first to examine this eating disorder in Pakistan. Some behaviors related to pregorexia were commonly identified to include skipping meals, eating small portions, following diet plans available on YouTube, eating alone to limit food portion, taking laxatives or medicine to control weight, induced vomiting after eating, and pretending to eat the suitable amount of food. We recommend clinicians interacting with pregnant women to screen for these behaviors when taking histories to provide better support, education and increased awareness.

Suicide prevention in Bangladesh: The role of family.

BACKGROUND: Suicide is a public health problem that gets little attention in Bangladesh especially in prevention aspects. Recent studies revealed that a significant portion of risk factors is closely related to family events. However, potential prevention strategies considering the family structure and involving family dynamics of Bangladesh have not been discussed. OBJECTIVES: We aim to highlight areas of family vulnerability and resilience when the threat of suicide is present, as well as the potential roles of family in suicide prevention in Bangladesh. METHODS: We conducted a thorough narrative and focused literature search and synthesized evidence based on available articles discussing suicidality and family dynamics in Bangladesh. RESULTS: Risk factors for suicide prevailing in the family have been organized, and several strategies for coping with family risk factors, including marital discord and family conflict have been proposed for testing empirically. CONCLUSIONS: The family has an important role to play in suicide prevention in Bangladesh. However, potential prevention strategies and their effectiveness have been untapped in the country. Studies are warranted to test the effectiveness of the proposed strategies.

Depression and suicidal behavior in South Asia: a systematic review and meta-analysis.

Background: Estimates of depression in suicidal behavior in South Asia would help to formulate suicide prevention strategies in the region that hasn't been assessed yet. Objectives: We aimed to systematically assess the prevalence of depression in fatal and non-fatal attempts of suicide in eight South Asian countries. Methods: We searched Medline, Embase, and PsychINFO by specific search terms to identify articles assessing depression in fatal and non-fatal attempts of suicide in South Asian countries published between 2001 and 2020. Two separate meta-analyses were conducted for fatal and non-fatal attempts. Due to the high heterogeneity of studies (96-98%), random-effects models were used to calculate pooled prevalence rates. Results: A total of 38 studies was identified from five south Asian countries (India [27], Pakistan [6], Sri Lanka [3], Nepal [1], and Bangladesh [1]). The majority of studies (n = 27) were published after 2010. Twenty-two studies reported non-fatal attempts, and sixteen reported suicide. The prevalence of depression among non-fatal attempts ranged from 14% to 78% where the pooled prevalence rate was 32.7% [95% CI 26-39.3%]. The prevalence of depression among suicides ranged from 8% to 79% where the pooled prevalence estimate was 37.3% [95% CI 26.9-47.6%]. Conclusions: This review revealed the pooled prevalence of depression among fatal and non-fatal suicidal attempts in South Asian countries, which seems to be lower when comparedto the Western countries. However, a cautious interpretation is warranted due to the heterogeneity of study methods, sample size, and measurement of depression.

Review of psychological trauma: theory, practice, policy and research.

We present a concise state-of-the-art review of psychological trauma and post-traumatic stress disorder (PTSD) for mental health practitioners. This article is also set to present the nature of traumatic incidents, their common presentation, their disruptions to normal psychological and biological functioning, and the negative health care impact of untreated incidents. Originally, the trauma response to extreme life events and PTSD was conceptualized as normal responses to overwhelming situations. However, in the last few years, there has been an increase in the acceptance of the idea that exposure to a traumatic situation/stimulus may not be sufficient to explain the development of PTSD. In addition, the individual vulnerability factors play a significant role in understanding this condition. In principle, this paper also focuses on the associative relationship between social support and psychological trauma because of methodological review. Hence, due to the paucity of such types of studies, this review starts with the findings and different aspects considered on the nature of social support, and then the general outcomes of this association. Furthermore, the relationship between support and human physiology is also presented. To further strengthen the objectives in review, the methodological issues and limitations are discussed in each section. Finally, this review article concludes the evaluation of the research specific to psychological trauma and social support in the field of combat, sexual abuse, and battering.

Indigenously adapted cognitive-behavioral therapy for excessive smartphone use (IACBT-ESU): A randomized controlled trial.

This study aims to assess whether 12 sessions of indigenously adapted cognitive-behavioral therapy for excessive smartphone use (IACBT-ESU) would reduce excessive smartphone use. A single-blind randomized controlled trial was conducted in students (12 to 19 years of age) to examine the potential beneficial effects of IACBT-ESU (n = 62) compared with brief educational data alone (n = 62). Symptoms of depression, anxiety, stress, and peer relations were also compared between the two groups. The IACBT-ESU group demonstrated significant reductions in excessive smartphone use, with reduced symptoms of depression, anxiety, stress, hyperactivity, and emotional difficulties at both trial end and at 3-month follow-up (p < .01) compared with control participants. IACBT-ESU was associated with reduced excessive smartphone use and improved psychological well-being, with beneficial findings maintained 3 months after the trial's end. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Suicide methods in South Asia over two decades (2001-2020).

BACKGROUND: Suicide is a global preventable public health problem. About a quarter of all suicides in the world occur in South Asia. As means restriction is an important suicide prevention strategy, gaining knowledge of the common suicide methods and their changing trends in each country and region is crucial. AIMS: We aimed to assess the suicide methods in South Asian countries over the last two decades. METHODS: A search was performed in PubMed, PubMed Central, Scopus, and Google Scholar with the search terms. Original articles of quantitative studies, published in the English language, from 2001 to 2020, with full-accessible text, that rank different methods of suicide in eight South Asian countries, were included. RESULTS: A total of 68 studies were found eligible for review. The Maximum number of studies were found from India (n = 38), followed by Bangladesh (n = 12), Pakistan (n = 9), Sri Lanka (n = 6), and Nepal (n = 3). Hanging (n = 40, 55.8%) and poisoning (n = 24, 35.3%) were the two most common suicide methods reported, in that order. Hanging followed by poisoning were the commonest suicide methods in Bangladesh, India, and Pakistan while in Sri Lanka, poisoning was the preferred method to hanging. There is a decline in suicide by poisoning and an increase in suicide by hanging in Sri Lanka, Bangladesh, and India. Although hanging is still the commonest method in Pakistan, the use of firearms is growing in recent years (2011-2020). CONCLUSIONS: There is a steady decline in the incidence of suicides by poisoning following pesticide regulations in South Asian countries. However, there is heterogeneity of study methods, probable under-reporting of suicide, and lack of robust suicide data.

Psychoeducational Group Therapy for sexual function and marital satisfaction in Iranian couples with sexual dysfunction disorder.

BACKGROUND: Having sexual relations plays a very important role in the success and scope of procreation. Understanding sexual function can lead to sexual satisfaction and ultimately to marital satisfaction and reconciliation of spouses. OBJECTIVE: The aim of this study was to evaluate the effectiveness of a psychoeducational programme on sexual function and marital satisfaction of Iranian couples. MATERIALS AND METHODS: This is a semi-experimental pre-test and post-test study with control group. The statistical population included all couples diagnosed with sexual dysfunction referred to Bahar Consulting Center in Mashhad in 2019. A total of 40 individuals were randomly assigned to the two treatment conditions which were experimental (n = 20) and control (n = 20) forming two groups. The individuals assigned to experimental condition experienced a 10 session psychoeducational program and the control condition comprised of Treatment As Usual (TAU) which was based on medical and general counseling regime. The data collection tool was marital satisfaction and sexual function questionnaire. Data was analyzed using SPSS version 22 software. RESULTS: there is a significant difference between the amount of sexual function and marital satisfaction before and after the test in experimental group (p < 0.01). The results of this study showed that Psychoeducational Group Therapy improved the sexual performance and improved marital satisfaction. CONCLUSION: Psychoeducational Group Therapy helps to increase marital satisfaction and sexual functioning of married couples. Therefore, this intervention is recommended as an effective program for improving marital satisfaction and sexual performance of couples. It can help to strengthen the foundation of the family.