Assessing risk behaviours in the Iranian general population: results from the Iranian Mental Health Survey.

BACKGROUND: The Islamic Republic of Iran is a majority Muslim country, with a culturally low acceptance of high-risk behaviours. AIMS: To investigate co-occurrence of risk behaviours in the Iranian general population. METHODS: This was a cross-sectional study. Data were obtained from a random subsample of 3508 participants in the Iranian Mental Health Survey conducted in 2011 who completed a self-administered questionnaire about risk behaviours. The latent class analysis was performed on 7 behaviours consisting of cigarette smoking, alcohol consumption, opium use, use of other illicit drugs, having multiple sexual partners, imprisonment, and running away from home. Unordered multinomial logistic regression was performed to examine characteristics of participants in the latent classes. RESULTS: In the past 12 months, the rates of cigarette smoking, alcohol consumption, opium use, and use of other illicit drugs were 19.4%, 6.3%, 4.4%, and 4.2%, respectively. Three classes were identified: 1, a large class with low prevalence of risk behaviours [89.2%; 95% confidence interval (CI): 88.2-90.2%]; 2, high prevalence of all risk behaviours except drug use (6.1%; 95% CI: 5.3-6.9%); and 3, high prevalence of all risk behaviours (4.7%; 95% CI: 4.1-5.5%). Men and individuals with psychiatric disorders were over-represented in both classes 2 and 3. CONCLUSION: Alcohol consumers and opium users were at risk of other risky behaviours.

Evaluation of Drug and Alcohol Abuse in People Aged 15 Years and Older in Iran.

BACKGROUND: Drug addiction is known as one of the health, medical and social problems of the present century. Beyond the harmful physical and mental consequences for addicts, drug abuse can cause serious social problems. The aim of this study was to evaluate drug and alcohol abuse in individuals aged 15 yr and over in Iran in 2015. METHODS: This descriptive cross-sectional study was done on individuals aged 15 yr and older who lived in urban and rural areas of Iran. Overall, 36,600 individuals were selected by systematic and cluster random sampling. The postal code was used to access the samples in 31 provinces of Iran. In each province 1200 individuals (50% men, 50% women) were evaluated. The used instrument was the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), and data were analyzed using SPSS software. RESULTS: The results showed 4.6% of individuals used Opium and its derivatives, 0.4% used Cannabis, 0.4% used Amphetamine stimulants, 6.1% used Sedative drugs, and 2.6% used Alcoholic beverages on a regular basis. Within the last 12 months, 3.9% of individuals used Opium and its derivatives, 0.4% used Cannabis, 0.3% used Amphetamine stimulants, 5.8% used Sedative drugs, and 1.9% used Alcoholic beverages. With the exception of Sedatives drugs men used more drugs than women and residents of rural areas used more opium and its derivatives than other groups of drugs. Based on the provincial distribution, Kerman and Qom used the highest and lowest prevalence percentage of Opium and its derivatives respectively. CONCLUSION: Overall, 2340000 individuals were addicts used Opium and its derivatives in 2015, therefore, medical and health officials should take all necessary measures to deal with these serious social problems.

Prevalence of Hookah Smoking among University Students in Iran: A Meta-Analysis of Observational Studies.

BACKGROUND: The rise in popularity of waterpipe smoking among younger people cause increase its deleterious effects on health in recent years. The aim of this study was to estimate the pooled prevalence of water-pipe smoking in university students in Iran. METHODS: We performed the literature search from 1946 to January 21, 2019, in several international and national databases such as Medline/PubMed, Web of Science, Scopus, Google Scholar, Magiran, Iranmedex, and IranPsych. To investigate the between-study heterogeneity we used the chi-squared test and I2 index. We used a random-effects model to estimate the pooled prevalence of water-pipe smoking. The potential source of heterogeneity was assessed by subgroup analysis and meta-regression. RESULTS: According to the eligibility criteria, we included 37 relevant studies in our meta-analysis. The pooled prevalence of lifetime water-pipe smoking was 25% (95% CI: 22-29) and in male and female subgroups was 37% (95%CI: 30-45), 17% (95%CI: 15-19) respectively. The pooled prevalence of water-pipe smoking in last year was 21% (95%CI: 16-25) and in last month was 8% (95%CI: 5-11). Results of meta-regression analysis showed that there was not any significant association between suspected variables and the prevalence of water-pipe smoking. CONCLUSION: The higher prevalence rate of water pipe smoking among university students indicates the emergency need for planning preventive program.

Prevalence of cigarette smoking among college students in Iran: An updated systematic review and meta-analysis of observational studies.

Background: Cigarette smoking is known as a gateway drug for illicit drug use in youth. The objective of this study is to assess the prevalence of cigarette smoking in the college students in Iran. Methods: We searched electronic databases including Scopus, Medline/PubMed, Google Scholar and Web of Science, and national databases such as Magiran, Scientific Information Database, Iranmedex, Medlib, Irandoc, and IranPsych from 1946 to 21st July 2018 without any language restriction using a proper search strategy. We used a random effect model to calculate the pooled prevalence of cigarette smoking in college students in Iran. Chi-square test and I2 index were used to evaluate the heterogeneity between the studies. We used the meta-regression and subgroup analysis to assess the potential source of heterogeneity. Stata software, version 11 (StataCorp, TX) was used for all statistical analysis. Results: We included 60 eligible articles in our study. The pooled prevalence of cigarette smoking at least once in the lifetime was 19% (95%CI: 17-22). The I2 index indicated considerable between-study heterogeneity (I2 =98%, p<0.001). The pooled prevalence of cigarette smoking at least once in the lifetime in males and females was 28% (95% CI: 23-34) and 9% (95% CI: 6-13), respectively. In multivariable meta-regression, a significant association was shown between the year of study (ß=-13.1, p=0.011) and sampling method (ß=-12.8 p=0.017) and daily use in the last month. Conclusions: Increasing prevalence of smoking among Iranian university students is an important health priority. Increasing preventive and health education programs are recommended.

Self-Reported and Network Scale-Up Estimates of Substance Use Prevalence among University Students in Kerman, Iran.

BACKGROUND: This study aimed to estimate the prevalence of substance use among university students measured by direct and indirect methods, and to calculate the visibility factor (VF) defined as ratio of indirect to direct estimates of substance use prevalence. STUDY DESIGN: A cross-sectional study. METHODS: Using a multistage non-random sampling approach, we recruited 2157 students from three universities in Kerman, Iran, in 2016. We collected data on substance use by individual face-to-face interview using direct (i.e. self-report of their own behaviors) and indirect (NSU: Network scale up) methods. All estimates from direct and indirect methods were weighted based on inverse probability weight of sampling university. RESULTS: The response rate was 83.6%. The last year prevalence of water pipe, alcohol, and cigarettes indirect method was 44.6%, 18.1%, and 13.2% respectively. Corresponding figures in NSU analysis were 36.4%, 18.2%, and 16.5% respectively. In the female population, VF for all types of substance was less than male. CONCLUSIONS: Considerable numbers of university students used substances like a water pipe, alcohol, and cigarettes. NSU seems a promising method, especially among male students. Among female students, direct method provided more reliable results mainly due to transmission and prestige biases.

Psychiatric Axis I Comorbidities among Patients with Gender Dysphoria.

Objectives. Cooccurring psychiatric disorders influence the outcome and prognosis of gender dysphoria. The aim of this study is to assess psychiatric comorbidities in a group of patients. Methods. Eighty-three patients requesting sex reassignment surgery (SRS) were recruited and assessed through the Persian Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Results. Fifty-seven (62.7%) patients had at least one psychiatric comorbidity. Major depressive disorder (33.7%), specific phobia (20.5%), and adjustment disorder (15.7%) were the three most prevalent disorders. Conclusion. Consistent with most earlier researches, the majority of patients with gender dysphoria had psychiatric Axis I comorbidity.

The frequency of personality disorders in patients with gender identity disorder.

BACKGROUND: Co-morbid psychiatric disorders affect prognosis, psychosocial adjustment and post-surgery satisfaction in patients with gender identity disorder. In this paper, we assessed the frequency of personality disorders in Iranian GID patients. METHODS: Seventy- three patients requesting sex reassignment surgery (SRS) were recruited for this crosssectional study. Of the participants, 57.5% were biologically male and 42.5% were biologically female. They were assessed through the Millon Clinical Multiaxial Inventory II (MCMI- II). RESULTS: The frequency of personality disorders was 81.4%. The most frequent personality disorder was narcissistic personality disorder (57.1%) and the least was borderline personality disorder. The average number of diagnoses was 3.00 per patient. CONCLUSION: The findings of this study revealed that the prevalence of personality disorders was higher among the participants, and the most frequent personality disorder was narcissistic personality disorder (57.1%), and borderline personality disorder was less common among the studied patients.