Translation and validation of a lifestyle questionnaire related to prostate cancer.

BACKGROUND: Valid and reliable instruments are needed to measure prostate cancer-related lifestyle changes, plan evidence-based interventions to modify lifestyle, and improve treatment outcomes. Due to the lack of appropriate instruments, this study was conducted to translate the Effects of Prostate Cancer upon Lifestyle Questionnaire (EPCLQ) into Persian and examine its psychometric properties in a sample of Iranian older adults with prostate cancer. METHODS: This methodological study was carried out between 2021 and 2022. Initially, the EPCLQ, comprising 36 items, was translated into Persian through a meticulous translation and back-translation procedure. Subsequent steps involved the assessment of face validity, qualitative content validity, content validity index, content validity ratio, construct validity via confirmatory factor analysis, and reliability testing of the Persian version of the EPCLQ. RESULTS: The psychometric evaluation led to the exclusion of 4 items from the EPCLQ. The refined model demonstrated satisfactory fit indices (PCFI = 0.732, PNFI = 0.696, CMIN/DF = 2.29, RMSEA = 0.072, IFI = 0.920, CFI = 0.919, and GFI = 0.971), indicating an appropriate fit of the final model. The internal consistency, as measured by Cronbach's alpha, was 0.67, and the intraclass correlation coefficient for the questionnaire was 0.938, reflecting high reliability. CONCLUSIONS: The Persian version of the EPCLQ, now consisting of 32 items, has been validated and is reliable for assessing the impact of prostate cancer on lifestyle among older adults. Its simplicity and the clarity of the items make it suitable for use in clinical settings or during home visits for follow-up assessments.

Predictors of nonresponse to treatment and low adherence to internet-based cognitive behavioral therapy in depressed/anxious women facing the couple's fertility problems: a secondary analysis of a randomized control trial.

BACKGROUND: The study aimed to examine the predictors of treatment nonresponse and low adherence to Internet-based cognitive behavioral therapy and face-to-face therapy for treating depression and anxiety in women facing the couple's fertility problems. METHODS: This is a secondary analysis based on a previous randomized controlled trial including 152 depressed/anxious women facing the couple's fertility problems. The study defines low adherence as receiving less than 4 sessions (out of 8 sessions). Nonresponse to treatment refers to a < 50% reduction in the anxiety and depression total scores. RESULTS: A high level of anxiety/depression score before psychotherapy increases the risk of nonresponse to both Internet-based and face-to-face psychotherapies by 1.4 to 2 times in women facing the couple's fertility problems after the treatment and in the 6-month follow-up. However, 4 factors, including diagnosis of mixed anxiety and depression, low education level, long marriage duration, and infertility caused by mixed female/male factors, reduced the risk of nonresponse to psychotherapies. CONCLUSION: Women facing the couple's fertility problems with high depression and anxiety scores are at risk of poor prognosis in response to psychotherapy. Psychologists and healthcare providers of infertility centers should pay more attention to the timely identification and referral of depressed/anxious patients to psychologists.

Impact of primary care posttraumatic stress disorder (PC-PTSD) on fertility problem of Iranian women with infertility during the COVID-19 pandemic.

BACKGROUND: Infertility continued to be a major stressor among women with infertility during COVID-19pandemic. This study aimed to evaluate the impact of primary care posttraumatic stress disorder (PC-PTSD) on fertility problem of Iranian women with infertility during COVID-19 pandemic. METHOD: In this cross-sectional study, 386 women with infertility completed the questionnaires of PC-PTSD-5 and Fertility Problem Inventory (FPI) at an infertility center between 2020 and 2022. RESULTS: The mean of fertility problems was 145.20 (± 32.31). In terms of FPI subscales, the means were as follows: Sexual concern 21.80 (± 7.58), social concern 26.53 (± 8.94), relationship concern 26.02 (± 9.18), need for parenthood concern 40.88 (± 8.98), and rejection of childfree lifestyle 29.96 (± 7.69). The highest mean of FPI subscales was related to the need for parenthood concern in women with infertility. The strongest correlation was found between the subscales of sexual concern and social concern followed by sexual concern and relationship concern. The variables of PC-PTSD were a predictor of fertility problems (ß = 0.203, P < .0001). Additionally, the variables of PC-PTSDwere a predictor of sexual concern (ß = 0.248, P < .0001), social concern (ß = 0.237, P < .0001), relationship concern (ß = 0.143, P < .020), and need for parenthood concern (ß = 0.101, P < .010). After adjusting for demographic characteristics, there was a significant relationship between FPI with job (ß=-0.118, P < .031), education (ß=-0.130, P < .023), living place (ß = 0.115, P < .035), smoking (ß = 0.113, P < .036), relationship with husband (ß = 0.118, P < .027), and PC-PTSD symptom (ß = 0.158, P < .0001). In addition, the multivariate linear regression showed a significant association between sexual concern and education (ß=-0.152, P < .008), smoking (ß = 0.129, P < .018), PC-PTSD symptom (ß = 0.207, P < .0001); social concern and job (ß=-0.119, P < .033), PC-PTSD symptom (ß = 0.205, P < .0001); relationship concern and education (ß=-0.121, P < .033), living place (ß = 0.183, P < .001), relationship with husband (ß = 0.219, P < .0001); and rejection of childfree lifestyle and job (ß=-0.154, P < .007). CONCLUSION: Systematic PTSD screening during COVID-19 pandemic by healthcare providers can be uniquely used to identify, evaluate, and treat trauma-related health conditions in infertility settings, which can link women with infertility to mental health services. This can be novel and useful for future policymakers and practitioners in the infertility field.

Psychological distress in pregnancy and postpartum: a cross-sectional study of Babol pregnancy mental health registry.

BACKGROUND: Psychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum. METHODS: A cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions. RESULTS: The prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (ß = 1.776, P < 0.001), as well as its three subscales: somatization (ß = 1.355, P = 0.019), anxiety symptoms (ß = 2.249, P < 0.001), and depressive symptoms (ß = 1.381, P = 0.028). Additionally, women with a gestational age < 20 weeks had a higher risk of psychological distress (ß = 1.344, P = 0.038) and the somatization subscale (ß = 1.641, P < 0.001). During the postpartum period, women residing in urban areas were at higher risk of psychological distress (ß = 1.949, P = 0.012), as well as two subscales: anxiety symptoms (ß = 1.998, P = 0.012) and depressive symptoms (ß = 1.949, P = 0.020). CONCLUSION: The high prevalence of psychological distress emphasizes detecting and treating PD during pregnancy and postpartum, particularly in women with high-risk pregnancies. This study suggests that obstetricians and midwives should implement programs to identify women experiencing psychological distress during early pregnancy through postpartum visits.

The impact of social support, physical and psychological performance on sleep outcomes in Iranian older adults: a case-control study.

BACKGROUND: Sleep quality is one of the most important factors to improve the quality of life in older adults and physical and mental health plays an essential role in better sleep quality. This study aimed to determine the impact of social support, and physical and psychological performance on sleep outcomes in Iranian older adults. METHODS: In this case-control study, 400 elder people, who were exposed to sleep problems, and 400 people without sleep problems were randomly selected during 2016-2017 in Amirkola, Iran. Subjects in the case and control groups were matched in terms of gender and age. The demographic characteristics, Duke Social Support Questionnaire (DSSI), Physical Activity Scale for the Elderly (PASE), Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), Mini-Mental State Examination (MMSE), and Pittsburgh Sleep Quality Questionnaire (PSQI) questionnaires were used to collect data. T-test, Chi-square, Pearson Correlation coefficient, and multiple Logistic regression were used for data analysis. RESULTS: The mean score of DSSI and its domains including social interaction (DSSI.Int) and social satisfaction (DSSI.Sat) were 28.15 ± 3.55, 9.31 ± 1.23, and 18.84 ± 2.88 in the case group and 28.87 ± 3.20, 9.48 ± 1.10, and 19.83 ± 2.44 in the control group, respectively. In this study, the mean scores of MMSE, PASE, ADL, and IADL were 25.36 ± 3.95, 101.71 ± 56.99, 13/97 ± 0.37, 20.59 ± 2/79; respectively. There was a significant inverse correlation between poor sleep quality with DSSI score (rho = -0.165, P < 0.0001), DSSI.Int (rho = -0.113, P < 0.001), DSSI.Sat (rho = -0.160, P < 0.0001), PASE (rho=-0.160, P < 0.0001), and IADL (rho = -0.112, P < 0.001) score. Therefore, more social support and physical activity improved the quality of sleep. There was a significant negative relationship between DSSI, and its domains with sleep quality in terms of gender. DSSI (rho = 0.25, P < 0.0001), DSSI.Int (P < 0.0001, rho=-0.18), and DSSI.Sat (P < 0.0001, rho=-0.22) was significant in men but not in women. The results of the adjusted logistic regression revealed a significant association between sleep quality problems and DSSI (p < 0.045, OR = 1.40), the use of hypnotic drugs (p < 0.0001, OR = 7.56), and occupation (p <0.03, OR= 12.66). CONCLUSIONS: The results of the present study suggest that low social support and all its domains, PASE, IADL, and using hypnotic drugs may play a role in the development of sleep problems. It can be used as an effective, safe, and low-cost strategy for promoting sleep quality in older adults.

Therapist-guided internet-based cognitive behavioral therapy versus face-to-face CBT for depression/anxiety symptoms in infertile women with adjustment disorders: A randomized controlled trial.

OBJECTIVE: The present study compared the effectiveness of ICBT to face-to-face CBT on the improvement of adjustment disorder symptoms in infertile women. Method: In a pragmatic, multi-center (public or private), single-blinded, non-inferior randomized controlled trial (RCT), 152 patients with AD (100 women in public center and 52 women in private canter) were assigned to ICBT and CBT. Primary outcomes were Adjustment Disorder New Module-20 (ADNM-20) and Hospital Anxiety and Depression (HADS). Secondary outcomes were the Fertility Problem Inventory (FPI) and Fertility Adjustment Scale (FAS). Results: "Peaceful mind" ICBT was feasible and accessible for delivering the treatment to infertile women with AD. At end-of-treatment, improvements in ICBT were non-inferior to CBT for symptoms of AD, anxiety, and depression. Additionally, the non-inferiority of ICBT to CBT was maintained at a three-month follow-up. Conclusions: ICBT was non-inferior to CBT in improving mental symptoms in infertile women with AD.

Psychological predictors of medical residents' perspectives on shared decision-making with patients: a cross-sectional study.

BACKGROUND: Shared Decision Making (SDM) is as ideal model for resident-patient relationship which may improve medical outcomes. Nevertheless, predictive psychological factors influencing residents' perspective regarding SDM are unclear. The current study investigated the relationship between two psychological factors, mental health and personality traits, and residents' views toward SDM. METHOD: In a cross-sectional study, 168 medical residents of the Babol University of Medical Sciences studying in 13 field specialties were recruited. The residents completed three questionnaires including Shared Decision-Making Questionnaire (SDM-Q-Doc, physician version), General Health Questionnaire (GHQ-12), and Big Five Personality (NEO-FFI). RESULTS: Residents had an overall agreement of about 88% regarding SDM with patients. There was no significant difference between male and female residents in terms of the degree of agreement for SDM. Concerning SDM, there was no significant relationship either between residents' views and neuroticism, extraversion, agreeableness, and conscientiousness. In multivariate regression, mental health did not predict the SDM, but openness to experience negatively predicted residents' views concerning SDM (ß = - 0.388, p < 0.001). CONCLUSION: The residents' personality trait of openness to experience was a significant negative predictor of SDM with patients. A better understanding of how psychological factors relate to residents' perspectives may help clinicians properly discuss the treatment options with the patient thereby encouraging them for SDM or to consider their own preferences.

Gender as predictor and moderator of outcome in cognitive behavior therapy and pharmacotherapy for adult depression: an "individual patient data" meta-analysis.

BACKGROUND: It has yet to be established whether gender moderates or predicts outcome of psychological and pharmacological treatments for adult depression because: (1) individual randomized trials typically lack sufficient statistical power to detect moderators and predictors and (2) meta-analyses cannot examine such associations directly. METHODS: We conducted an "individual patient data" meta-analysis with the primary data of 1,766 patients from 14 eligible randomized trials comparing cognitive behavior therapy (CBT) with pharmacotherapy. Five studies also compared CBT and pharmacotherapy with pill placebo. We examined the extent to which gender moderates or predicts outcome, using the Hamilton Rating Scale for Depression-17-item (HAM-D-17), with mixed effects models. RESULTS: Despite the high statistical power, we did not find any indication (P > 0.05) that gender moderates outcome (i.e., no indication that either men or women respond better or worse to CBT than to pharmacotherapy or vice versa). Gender was neither a nonspecific predictor (indicating whether gender is related to improvement, regardless of comparison or control groups), nor a specific predictor (predicting outcome of CBT and pharmacotherapy compared to pill placebo). The average differences between men and women within three conditions (CBT, pharmacotherapy, and pill placebo) were less than one point on the HAM-D-17. CONCLUSIONS: The lack of predictive relations in a this good sized sample suggests that gender does not moderate differential response to CBT versus medication treatment and that it neither predicts nonspecific response across the treatments nor the specificity of response for either treatment with respect to pill placebo.

Prevalence and Risk Factors of Prenatal and Postnatal Depressive Symptoms in Babol Pregnancy Mental Health Registry: A Cross-Sectional Study.

BACKGROUND: Prenatal and postnatal depression (PND) is associated with adverse outcomes for mother, fetus, and child. The aim of study was to examine the prevalence and risk factors of prenatal and postnatal depressive symptoms. MATERIALS AND METHODS: This was a cross-sectional and hospital-based survey of 2305 pregnant women and post-partum women (18-48 years) that was registered in the Babol Pregnancy Mental Health Registry (BPMHR) database from June 2020 to March 2021. Two questionnaires, including demographics and depression, were analyzed in this study. Also, the Edinburg Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms. Independent t test and the analysis of variance were used to compare the means. Multiple logistic regressions were used to determine risk factors for depressive symptoms. RESULTS: According to the EPDS scale, the prevalence of depressive symptoms was 19.8% in the pregnant woman group in comparison with the postpartum period (11.6%). Risk factors for antenatal depressive symptoms were parity (women with parity ≥ 4 vs. 1 parity, ß=1.808, P=0.020), two groups of gestational age (gestational age ≤12 weeks vs. 28 weeks, ß=1.562 P=0.030) as well as (gestational age 21-27 weeks vs. 28 weeks (ß=1.586, P=0.033), and high-risk pregnancy (high-risk vs. low-risk pregnancy, ß=1.457, P=0.003). For postnatal depressive symptoms, none of the factors were a significant risk. CONCLUSION: Prenatal and postnatal depressive symptoms should be screened, particularly for women in the first and second trimesters, with high parity, and those with a high-risk pregnancy, as recommended by the present study.

Preliminary examination of acceptability, feasibility, and effectiveness of internet-based cognitive behavioral therapy for treatment of depression and anxiety in infertile women.

Background: Despite a large body of evidence supporting the effectiveness of internet-based cognitive behavior therapy (ICBT) for the treatment of depression and anxiety, there is no report of the efficacy of ICBT program in the Iranian population. The present study aimed to test the acceptability, feasibility, and effectiveness of ICBT program for the treatment of depression or anxiety in infertile women. Method: This study consisted of two phases. In the first phase, we designed "Peaceful Mind", an eight-session therapist-guided ICBT program. In the second phase, we tested the efficacy of the program by conducting 2-arm parallel group, non-inferiority randomized control trial, between October 2020 and July 2021.60 infertile women diagnosed with depression or anxiety disorders were divided randomly to ICBT treatment (n = 30) and face-to face CBT (n = 30). The participants received individual CBT sessions (60 min, over 8 weeks) and completed the questionnaires at the beginning, in mid-trial, and 8 weeks after the trial. The outcomes comprised Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI, Fertility problem inventory (FPI), Client Satisfaction Questionnaire (CSQ-8), and System usability scale (SUS). Results: The usability scores of the "Peaceful Mind" ICBT (M = 67.07, SD = 17.23, range = 1-100) and satisfaction with the treatment (M = 25.06, SD = 4.18, range = 1-32) were high. Patient adherence to the treatment in the ICBT group (86.6%) was the same as that in the CBT (73.3%). The between-group mean differences at the post-trial were -4.79 (CI 95% = -10.81 to 1.23) for depression scores and -4.15 (CI 95% = -9.52 to 1.22) for anxiety scores; both differences were within the non-inferiority margin points for the lower 95%CI. Conclusion: "Peaceful mind" ICBT was found to be feasible and accessible for delivering the treatment to the patients. The study confirmed that both ICBT face-to face CBT were equally effective in reducing depression and anxiety of the patients.

The prevalence of adjustment disorder and predisposing factors in infertile women.

BACKGROUND: Infertility is a stressful life event that increases the risk of developing mental disorders, particularly adjustment disorder (AD). Given the paucity of data on the prevalence of AD symptoms in infertility, the purpose of this study was to ascertain the prevalence, clinical presentation, and risk factors for AD symptoms in infertile women. METHOD: In a cross-sectional study, 386 infertile women completed questionnaires including the Adjustment Disorder New Module-20 (ADNM), the Fertility Problem Inventory (FPI), the Coronavirus Anxiety Scale (CAS), and the Primary Care Posttraumatic Stress Disorder (PC-PTSD-5) at an infertility center between September 2020 and January 2022. RESULT: The results indicated that 60.1% of infertile women exhibited AD symptoms (based on ADNM > 47.5). In terms of clinical presentation, impulsive behavior was more common. No significant relationship was observed between prevalence and women's age or duration of infertility. Infertility stress (ß = 0.27, p < 0.001), coronavirus anxiety (ß = 0.59, p = 0.13), and a history of unsuccessful assisted reproductive therapies (ß = 2.72, p = 0.008) were several predisposing factors for AD symptoms in infertile women. CONCLUSIONS: The findings suggest that all infertile women be screened from the start of infertility treatment. Additionally, the study suggests that infertility specialists should focus on combining medical and psychological treatments for individuals predisposed to AD, particularly infertile women who exhibit impulsive behaviors.

Perceived challenges and barriers for medical students in the COVID-19 crisis.

BACKGROUND: Unpredictable and immediate changes, especially in the clinical and practical fields of medical sciences following the coronavirus disease (COVID-19) epidemic, have posed many challenges for medical students. This study was conducted to identify the experiences and students' understanding of the challenges in the COVID-19 crisis. MATERIALS AND METHODS: The present qualitative research was conducted by performing semi-structured interviews with the students along with holding a student panel. The study population consisted of 30 clinical and basic medical students of Babol, Iran and Kermanshah universities of medical sciences who were selected by purposive sampling method. Data were collected based on students' perceived experiences of challenges, obstacles, and problems in the COVID-19 crisis. The data analysis process was performed by conducting interviews and information obtained from the panel using v10 R150410 software. Finally, the related factors and components were identified. RESULTS: Challenges and perceived obstacles of medical students in the COVID-19 crisis were identified in the form of eight factors including student life factors, interaction and communication, psychological factors, educational technology, factors related to the professors, limitations of educational and research planning, crisis management, and educational evaluation. CONCLUSION: Identifying the challenges of medical education perceived by students in this study and adopting appropriate strategies to overcome existing barriers open new opportunities for expanding the scope of the curriculum, providing education, and promoting community health to universities; moreover, the challenges of medical education and any skill-based discipline, such as medical sciences in the COVID-19 pandemic will require much attention and investigation in cognitive sciences.

Is human cytomegalovirus a potential risk factor for mood disorders? A systematic review and meta-analysis.

Mood disorders are among the common mental disorders worldwide. Because of the persistence of cytomegalovirus (CMV) in the body and nervous system, this virus can be activated when the immune system is weakened and continues to exert its destructive effects throughout life. This study aimed to investigate the seroprevalence and association of human cytomegalovirus with mood disorders. Eligible articles were extracted using online international databases Science Direct, Medline, Web of Science, Scopus, and Google Scholar between 2000 and 2023. After quality assessment and specific inclusion and exclusion criteria, a total of eight eligible articles were included in the meta-analysis. Our finding showed that the seropositivity of CMV in mood disorders was 51.6% (95% CI; 42.8-60.4). There were statistical differences between mood disorders and control groups regarding the seropositivity of CMV 1.327% (95% CI; 13.27-10.45). The results of the publication bias using the Egger test confirmed no publication bias in each sub-group. The results of this meta-analysis study demonstrated that CMV infection might have associations with the incidence of mood disorders. Furthermore, we found that there were statistical differences between mood disorders and control groups regarding the seropositivity of CMV.

Comparison of Aripiprazole and Risperidone effectiveness in treating obsessive-compulsive disorder in patients with bipolar disorder: Double-blind, randomized clinical trial.

Background: Obsessive-compulsive disorder (OCD) is a mental illness with a chronic coarse and waxing and waning of symptoms. Treatment of OCD in patients with bipolar disorder (BD) remains challenging. Objectives: The present study aims to compare the safety and effectiveness of Risperidone and Aripiprazole as adjunctive therapy with valproate sodium, in treating mania, depression, and OCD in patients with comorbidity of OCD-BD. Methods: This research is 3 phase, double-blind, randomized clinical trial, with a total number of 64 patients. The diagnostic psychiatrist clinical interview was based on diagnostic and statistical manual of mental disorders, 5th edition (DSM-5) criteria. For assessing severity of OCD, mania, and depression, Yale-Brown obsessive-compulsive scale (Y-BOCS), young mania rating scale (YMRS), and Hamilton depression rating scale (HAM-D) scores were used. Patients were randomly assigned to the two parallel groups. All patients in both group were received valproate sodium, one group was treated with Aripiprazole and the other group was treated with Risperidon as adjective therapy with valproate sodium.The SPSS software (version 22), χ 2 test, t-test, and analysis of variance with repeated measures were used to analyze the data. Results: The dosage and time of both drugs were statistically significant in reducing the mean score of all three mentioned scales, but the effect of group was not statistically significant in HAM-D and YMRS scores, only in terms of OCD, the mean of the Y-BOCS score was significantly lower in the Aripiprazole group (p < 0.001). In relation to side effects, Risperidone induced statistically significant weight gain (p < 0.001) and Aripiprazole induced statistically significant sleep disturbance (p < 0.05). Conclusions: Both Aripiprazole and Risperidone can be used effectively as adjunctive therapy with valproate sodium in treating OCD in patients with BD without any serious and life threatening adverse effect. Aripiprazole is more effective than Risperidone in treating OCD in BD.

Prevalence of Psychological Distress and Posttraumatic Stress Symptoms and Associated Factors in Hospitalized Iranian COVID-19 Patients.

Objectives: To investigate the prevalence of psychiatric symptoms/distress and posttraumatic stress (PTS) and associated factors among inpatients with COVID-19 before discharge from the hospital. Methods: This cross-sectional study was conducted in two teaching referral hospitals in Babol, Iran from July to November 2020. The subjects were inpatients diagnosed with COVID-19 who were clinically stable. Before their discharge from the hospital, the patients completed three questionnaires: demographic data, Brief Symptom Inventory, and Primary Care Post Traumatic Stress Disorder Screen for Diagnostic and Statistical Manual-5. Results: The subjects were 477 inpatients diagnosed with COVID-19 including 40 (8.4%) admitted to intensive care units. Their average age was 60.5±17.9 years; 53.9% were female. Most had symptoms of significant psychological distress (96.0%) and PTS (8.1%) prior to discharge. A higher level of education (-0.18; standard error (SE) = 0.05; p < 0.001) was a negative predictor of psychiatric distress. The admission to intensive care units (0.86; SE = 0.08; p< 0.001) was a positive predictor of psychiatric distress. Conclusions: Most COVID-19 inpatients suffered significant psychiatric distress and PTS symptoms before discharge. Appropriate mental health crisis interventions are recommended for COVID-19 patients during hospitalization.

Marital Commitment and Mental Health in Different Patterns of Mate Selection: A Comparison of Modern, Mixed, and Traditional Patterns.

Objective: Marital commitments and mental health are the important indicators of marital quality. Considering the modern and mixed marriage pattern in recent years, compared to the traditional pattern, as well as the increase in divorce rates due to reduced marital commitment, the present study was conducted to compare marital commitment and mental health in various patterns of mate selection among married women. Method : This cross-sectional study was performed on 160 married women aged 15-49 years in Babol city, Iran, who were selected by convenience sampling from health centers under the auspices of Babol University of Medical Sciences. Data collection tools included the spouse-selecting style, marital commitment (Adams and Jones), and general health questionnaires. Data analysis was performed in SPSS V.25 software, using analysis of variance (ANOVA), and Chi square tests. Results: Results showed that the mean score of marital commitment and its three dimensions (commitment to spouse, commitment to marriage and sense of commitment); general health; physical, anxiety and sleep disorders; as well as social function of married women are not significantly different in traditional, mixed and modern marriage patterns. There was a significant difference in the mean score of depression between traditional, mixed and modern marriage patterns. Pairwise, ANOVA revealed that the mean of the depression score was significantly higher in traditional marriage than in the mixed marriage pattern (P = 0.012). Different marriage patterns had statistically significant differences in demographic variables such as age, the place of birth of the wife and the husband, duration of marriage, number of children and the level of education (P < 0.05). Conclusion: It seems that there is a kind of convergence in marital commitment in various patterns of marriage among married women in Babol city.

Pharmacotherapy or Psychotherapy? Selective Treatment Depression in The Infertile Women with Recurrent Pregnancy Loss: A Triple-Arm Randomized Controlled Trial.

BACKGROUND: Recurrent pregnancy loss (RPL) and infertility are associated with significant psychiatric complications.
The study aimed to investigate the effectiveness of cognitive behavioral therapy (CBT) and sertraline
in the treatment of in depression, anxiety, and infertility stress of depressed infertile women with RPL in comparison
with usual care.
Materials and Methods: A triple-arm randomized controlled trial was carried out on the 60 depressed infertile
women with RPL, a population of Infertility Center of Babol city, Iran, who were randomly assigned into three
groups: pharmacotherapy with sertraline (n=20), psychotherapy with CBT (n=20), and a usual care as control
group (n=20). The participants of psychotherapy received CBT sessions (90 minutes each) over 10 weeks. The
participants in the pharmacotherapy group took 50 mg/day sertraline daily for 22 weeks. Outcomes were assessed
using the Beck Depression Inventory (BDI-II), fertility problem inventory (FPI), and State-Trait Anxiety
Inventory Form Y (STAI-Y) at the beginning of the trial, 10-weeks post-trial, and three months of follow-up.
Using statistical package for the social sciences (SPSS) software, data were analyzed.
Results: CBT considerably reduced the depression symptoms more than sertraline with a moderate effect size
at the post-trial (g=0.11, 95% CI: -0.03 to -0.50). Sertraline showed reduced the scores of state-anxiety more
considerably in comparison with control group by a large effect size of post-trial (g=-1.04, 95% CI: -1.70 to
-0.38). CBT reduced the total scores of FPI more considerably than sertraline, with a large, small size at follow
up-trial [95% CI=-0.03(-0.65, -0.58)]. Both CBT and sertraline were superior to the control group in reducing
depression and infertility stress.
Conclusion: Depression and infertility stress diminished under CBT and sertraline in depressed infertile women with
RPL, with a significant advantage of CBT. Sertraline was superior to CBT in reduction of anxiety (registration number:
IRCT201304045931N3).

Primary Dysmenorrhea Associated with Psychological Distress in Medical Sciences Students in The North of Iran: A Cross-Sectional Study.

BACKGROUND: Primary dysmenorrhea is the usual medical status in medical students that are defined as pain
during the menstrual period. This study was done to evaluate the psychological problems associated with dysmenorrhea.
Materials and Methods: Three hundred forty students aged 18 to 20 years participated in this cross­sectional
study (194 with dysmenorrhea and 150 without dysmenorrhea). In this cross­sectional study, data were collected
through the sociodemographic checklist, the verbal multidimensional scoring system (VMS), and the revised
version of the Symptom Checklist-90 (SCL-90-R) questionnaire using the convenience sampling method. This
questionnaire includes 9 Subscale and a GSI index. We considered psychological distress to be equivalent to
the Global Severity Index (GSI), which is obtained by dividing 90 questions by 90. The significance level of the
tests was considered 0.05.
Results: The GSI of the SCL-90 score in the 194 students with dysmenorrhea and 150 students without dysmenorrhea
was 1.02 ± 0.42 and 0.34 ± 0.15 respectively (P<0.001). In the group with dysmenorrhea, the severity
of dysmenorrhea was significantly associated with a family history of dysmenorrhea and mother's education
(P=0.012 and P=0.037, respectively). The strongest predictors of GSI>1 were a family history of dysmenorrhea
and mother's education [odds ratio (OR)=2.33, 95% confidence interval (CI), 1.43-4.15 and OR=0.45, 95% CI,
0.24-0.87, respectively].
Conclusion: According to the result, dysmenorrhea is associated with psychological distress. Psychological interventions
and counseling in addition to drug treatment are suggested for treatment of primary dysmenorrhea.
Therefore, it is necessary to formulate strategies and health policies to recover psychological issues of menstrual
health.

Screening of psychiatric disorders in women with high-risk pregnancy: Accuracy of three psychological tools.

PURPOSE: This study investigated the optimal cutoff points of three psychological tools for screening psychiatric disorders in women with high-risk pregnancy. DESIGN AND METHODS: In this cross-sectional study (N = 155), sensitivity/specificity of the Edinburgh Postnatal Depression Scale (EPDS), the Brief Symptom Inventory 53-items (BSI-53), and the BSI-18 were computed with respect to having a psychiatric diagnosis based on the clinical interview. RESULTS: The usual cutoffs (≥13 for EPDS, T-score of 63 for BSI-53) demonstrated poor diagnostic accuracy. The optimal thresholds were computed for EPDS cutoff of 6.5, GSI = 0.47 for BSI-53, and GSI = 0.5 for BSI-18. PRACTICE IMPLICATIONS: The use of psychological tools among pregnant women with high-risk pregnancy may need to be modified in order to accurately identify psychiatric disorders.

The role of psychological self-care on worry of vaccination against COVID-19 in Iranian pregnant women: A cross-sectional study.

Background and Aims: Although previous studies have reported some psychological factors to prevent the worry of vaccination against COVID-19 in pregnant women, the role of psychological self-care is unclear. The present study aimed to investigate the role of psychological self-care in pregnant women on the depressive symptoms, psychological distress, and worry of vaccination against COVID-19. Methods: The present cross-sectional study was conducted during the peak of the Delta variant of COVID-19 in Babol city (North, Iran) from August to November 2021. Two hundred pregnant women referring to three prenatal clinics completed five questionnaires including; demographic characteristics, Edinburgh postnatal depression scale, psychological self-care, brief symptom inventory 18, corona disease anxiety scale, and acceptance of vaccination-3 inventory. Results: Pregnant women were in relatively good condition based on psychological self-care but were not significantly associated with demographic characteristics, such as age, gestational age, educational background, pregnancy, and risk of parity. It was psychological self-care of pregnant women which negatively predicted the depressive symptoms (ß = -0.311, p < 0.001), anxiety symptoms (ß = -0.269, p < 0.001), psychological distress (ß = -0.269, p < 0.001), and worry of vaccination against COVID-19 (ß = -0.214, p < 0.001). Conclusion: Women's psychological self-care plays a protective role against the depressive symptoms, anxiety symptoms, psychological distress, and worry of vaccination against COVID-19 during pregnancy. Clinicians need to pay more attention to the role of psychological self-care as an important factor in preventing the symptoms of anxiety and depression during regular pregnancy visits.