Long-term effects of sulfur mustard on civilians' mental health 20 years after exposure (The Sardasht-Iran Cohort Study).

BACKGROUND: Sulfur mustard (SM) is an alkylating agent that induces short and long term toxicity on various organs. The aim of this study was to assess the long-term psychological symptoms among samples of exposed to sulfur mustard gas compared with unexposed civilians 20 years after exposure. METHODS: This historical cohort study was conducted on 495 civilians of Sardasht and Rabat in two age matched groups, including 367 sulfur mustard exposed participants from Sardasht and 128 unexposed subjects from Rabat. Psychological symptoms was assessed using the Symptom Check List-90 Revised (SCL-90-R) including measures of somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism providing three global distress indices namely: Global Severity Index (GSI), Positive Symptom Total (PST) and Positive Symptom Distress Index (PSDI). Comparison was made between exposed and unexposed civilians. RESULTS: There were significant differences in somatization (P = 0.002), obsessive-compulsive (P = 0.031), depression (P = 0.007), anxiety (P = 0.042), and hostility (P = 0.002), between the exposed and unexposed groups. In addition there were significant differences between two groups concerning the GSI (P = 0.045) and the PSDI (P < 0.001). The differences between two groups in other subscales were not significant. CONCLUSIONS: The findings from this study showed that civilians who exposed to sulfur mustard gas were suffering from a number of psychological symptoms even 20 years after exposure. Providing mental health services and more resource allocation for this community are highly recommended.

The Brief Fear of Negative Evaluation Scale (BFNE): translation and validation study of the Iranian version.

BACKGROUND: The Brief Fear of Negative Evaluation Scale (BFNE) is a commonly used instrument to measure social anxiety. This study aimed to translate and to test the reliability and validity of the BFNE in Iran. METHODS: The English language version of the BFNE was translated into Persian (Iranian language) and was used in this study. The questionnaire was administered to a consecutive sample of 235 students with (n = 33, clinical group) and without social phobia (n = 202, non-clinical group). In addition to the BFNE, two standard instruments were used to measure social phobia severity: the Social Phobia Inventory (SPIN), and the Social Interaction Anxiety Scale (SIAS). All participants completed a brief background information questionnaire, the SPIN, the SIAS and the BFNE scales. Statistical analysis was performed to test the reliability and validity of the BFNE. RESULTS: In all 235 students were studied (111 male and 124 female). The mean age for non-clinical group was 22.2 (SD = 2.1) years and for clinical sample it was 22.4 (SD = 1.8) years. Cronbach's alpha coefficient (to test reliability) was acceptable for both non-clinical and clinical samples (alpha = 0.90 and 0.82 respectively). In addition, 3-week test-retest reliability was performed in non-clinical sample and the intraclass correlation coefficient (ICC) was quite high (ICC = 0.71). Validity as performed using convergent and discriminant validity showed satisfactory results. The questionnaire correlated well with established measures of social phobia such as the SPIN (r = 0.43, p < 0.001) and the SIAS (r = 0.54, p < 0.001). Also the BFNE discriminated well between men and women with and without social phobia in the expected direction. Factor analysis supported a two-factor solution corresponding to positive and reverse-worded items. CONCLUSION: This validation study of the Iranian version of BFNE proved that it is an acceptable, reliable and valid measure of social phobia. However, since the scale showed a two-factor structure and this does not confirm to the theoretical basis for the BFNE, thus we suggest the use of the BFNE-II when it becomes available in Iran. The validation study of the BFNE-II is in progress.

Depression and quality of life in cancer patients with and without pain: the role of pain beliefs.

BACKGROUND: Pain is said to be one of the most feared and distressing symptoms of cancer and one that disrupts all aspects of life. The purposes of this study were: 1) to compare depression and quality of life among Iranian cancer patients with and without pain; and 2) to determine the relationships between pain beliefs and depression and quality of life. METHOD: A consecutive sample of gastrointestinal cancer patients attending to Tehran Cancer Institute were entered into the study. Three standard instruments were used to measure quality of life (the EORTC QLQ-C30), depression (the HADS) and pain beliefs (the PBPI). RESULTS: A total of 142 hospitalized gastrointestinal cancer patients, 98 with pain and 44 without pain were studied. The main findings of this study were that cancer patients with pain reported significantly lower levels of role functioning, emotional functioning and global quality of life. They also showed higher levels of depression than cancer patients who did not experience pain. Among patients with pain, higher scores on pain permanence and pain consistency were positively and significantly associated with higher depression. Also, higher scores on pain consistency were negatively and significantly associated with global quality of life. CONCLUSION: This study has demonstrated the effect of cancer pain on patients' quality of life and emotional status and has supported the multidimensional notion of the cancer pain experience in cancer patients. Although these data are correlational, they provide additional support for a biopsychosocial model of chronic pain.