Out-of-pocket cost of drug abuse consequences: results from Iranian National Mental Health Survey

Drug abuse has significant cost to the individual, the family and the society. This study aimed to assess out of-pocket costs of consequences of drug use disorder. Data were drawn from the Iranian Mental Health Survey [IranMHS] through face-to-face interviews with 7841 respondents aged 15-64 years. We used a bottom-up cost-of-illness method for economic analysis. Out-of-pocket costs for treatment of mental and drug problems, treatment of medical illnesses, as well as costs of crimes were assessed. The average of total annual expense was US dollar 2120.6 for those with drug use disorder, which was 23.5% of annual income of an average Iranian family in the year 2011. The average of total out-of-pocket cost was US$ 674.6 for those with other mental disorder and US dollar 421.9 for those with no mental disorder. Catastrophic payment was reported in 47.6% of the patients with drug use disorder and 14.4% of those with other mental disorder. Thus, considerable amount of family resources are spent on the consequences of drug use

Assessing measurement error in surveys using latent class analysis: application to self-reported illicit drug use in data from the Iranian Mental Health Survey / 한국역학회지

Latent class analysis (LCA) is a method of assessing and correcting measurement error in surveys. The local independence assumption in LCA assumes that indicators are independent from each other condition on the latent variable. Violation of this assumption leads to unreliable results. We explored this issue by using LCA to estimate the prevalence of illicit drug use in the Iranian Mental Health Survey. The following three indicators were included in the LCA models: five or more instances of using any illicit drug in the past 12 months (indicator A), any use of any illicit drug in the past 12 months (indicator B), and the self-perceived need of treatment services or having received treatment for a substance use disorder in the past 12 months (indicator C). Gender was also used in all LCA models as a grouping variable. One LCA model using indicators A and B, as well as 10 different LCA models using indicators A, B, and C, were fitted to the data. The three models that had the best fit to the data included the following correlations between indicators: (AC and AB), (AC), and (AC, BC, and AB). The estimated prevalence of illicit drug use based on these three models was 28.9%, 6.2% and 42.2%, respectively. None of these models completely controlled for violation of the local independence assumption. In order to perform unbiased estimations using the LCA approach, the factors violating the local independence assumption (behaviorally correlated error, bivocality, and latent heterogeneity) should be completely taken into account in all models using well-known methods.

Reliability of a patient survey assessing "Short Form Injury Questionnaire 7" in Iran / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Injury is a major cause of morbidity and mortality in the world. The assessment of patterns and severity of injury in high-risk groups is crucial for planning and service development. On a large scale national household survey, we estimated the annual incidence and the patterns of injury, the demographics of the injured people, as well as the service use for all injuries in Iran. The current study aims at assessing the reliability of the questionnaire before carrying out a national survey.</p><p><b>METHODS</b>In a pilot study using cluster random sampling approach, 73 people were interviewed. The interviewers asked the participants to report all injuries occurred in them and the care provided during the previous 12 months, based on "Short Form Injury Questionnaire 7" About two weeks later, the interview was repeated by another interviewer.</p><p><b>RESULTS</b>In our test-retest reliability, Kappa score was good for three and moderate for four questions. The question on the injured organ had the highest test-retest reliability with a Kappa score of 0.84.</p><p><b>CONCLUSIONS</b>The reliability of the questionnaire and the procedure of questioning are confirmed. The ques-tionnire is proper for utilization in large national surveies.</p>

[ role of depression, stress, happiness and social support in identifying suicidal thoughts in students]

This study has investigated the predictive value of psychological constructs including stressfulness of life, depression, happiness and social support on the rate of suicidal thoughts in students. The study sample included 1094 boys and girls residing in the Tehran University's student dormitory. The participants completed Suicidal Ideation Scale [SIS], Student Depression Scale [SDS], Student Life Stress Inventory [SLSI], Oxford Happiness Scale [OHS], and Social Support [SS] scale. The statistical data analysis using multiple regression techniques showed that happiness, depression, stress and social support account for 76 percent of the changes in students' suicidal thoughts. In addition, the results showed that depression has the strongest predictive power of suicidal thoughts. Depression and related structural variables could be used for predicting and efficiently identifying students' suicidal thoughts

[Lifetime prevalence of tobacco use among high school students in Iran: a systematic review]

Objective: The prevalence of smoking in the adolescence is a valuable indicator for prediction of national burden of smoking in the future. The aim of this systematic review is to determine the prevalence of lifetime smoking among high school students in Iran

Methods: Various search methods have been used including searching Pubmed, ISI, PsycINFO, CINAHL, Embase, IranMedex, IranPsych and database on drug abuse, as well as hand-searching. All original researches, which had described lifetime use of cigarette, hookah, and pipe among high school students were included in the study with no restriction on date of publication, and were qualitatively assessed. Subsequent to data extraction, heterogeneity test was carried out on indicators for which more than two studies were found and meta-analyses were performed

Results: In total, 18 studies were included in this review. The combined prevalence of lifetime cigarette smoking for boys, girls and total high school students were calculated as 30.9% [95% confidence interval [CI]: 25-36.8], 14% [95% CI: 7-20.9] and 21% [95% CI: 15.1-26.9], respectively. The combined prevalence of lifetime cigarette smoking for boys was significantly different [P<0.001] in the year 2001 and before [38.6%], with the years after 2002 [21.5%]

Conclusion: In Iran, the prevalence of smoking in this age range is lower than many other countries and in recent years, a decreasing trend was found in boys. These findings can be attributed to the national control and prevention strategies. However, some studies have several qualitative limitations, which points to the necessity of high quality repeated surveys in the future