Impact of HIV status notification on risk behaviors among men who inject drugs in kermanshah, west of Iran

Background: It is unclear whether knowing of current HIV status is associated with change injecting behaviors among people who inject drugs [PWID] in Iran. The objective of the prese study was to determine whether awareness of HIV positive status is associated with a reductn in injecting risk behaviors, after matching for socio-demographic characteristics

Methods: Five hundred male PWID were recruited in 2014 from two drop-in centers [DICs] Kermanshah west of Iran

Trained interviewers collected data on socio-demograp characteristics, HIV testing and drug-related risk behaviors over the last month prior to intervi using a structured questionnaire

Our primary exposure of interest was awareness of HIV sts used to group participants into three categories: positive, negative, unaware. We u coarsened exact matching to make the three groups statistically equivalent based on age, pi of residence, education and income, and then compared them regarding the proportior borrowing, lending and reuse of syringes

Results: Matched sample [n=320] had a mean age +/- standard deviation [SD] of 33.5 +/-7J Overall, 25% [95% Cl: 14%, 32%] of participants reported [borrowing a syringe] in the month and 15% [95% Cl: 7%, 22%] of them reported [lending a used syringe] to others ii past month. In comparison to PWID who were unaware of their HIV status, those knew were HIV positive [OR 1.68, CI95%1.32-2.81] or negative [OR 1.54; 95% Cl: 1.28, 2.71] both more likely to report borrowing syringes in past month

Conclusions: PWID WHO know they are positive for H//V are more likely to borrow are person's syringe, to report reuse of their own used syringes and less likely to report lending syringes to others. Strategies to scale up HIV testing and counseling for PWID, whicl increase awareness of HIV status, may decrease injecting related the risk behaviors

Group reality therapy in addicts rehabilitation process to reduce depression, anxiety and stress

Substance abuse is one of the most outstanding socio-psychological hazards that can easily wreck one's personal, family and social life. Reality Therapy is a type of Cognitive rehabilitation [known as psychosocial rehabilitation method], and the application of this method in the treatment of different disorders has recently been the topic of research. The objective of this study was to examine the effectiveness of group reality therapy on the reduction of stress, anxiety and depression in addicts. A quasi-experimental study of pretest-posttest design, with a control group was conducted. The study population consisted of all addicts attending Tehran's 'Neda' Rehab Clinic. First, the DASS-21 questionnaire was administered and then 40 people were selected from those who had scored average and higher. They were randomly assigned to two test and control groups of 20 each. Analysis of co-variance was used to analyze the data, with which pretest scores were controlled, and the effect of the independent variable on posttest scores was evaluated. Following the intervention, there were significant decreases in the mean scores of all three variables, i.e. stress, anxiety and depression in the test group. Psychosocial rehabilitation based on reality therapy can be considered as an effective method for reducing stress, anxiety and depression in addicts and also as an adjunctive therapy in treating other ailments

Personality traits and psychopathology in nicotine and opiate dependents using the gateway drug theory

According to the gateway drug theory, tobacco use is a predisposing factor for future substance abuse. This study was conducted to compare nicotine and opiate dependents to identify the differences between their personality traits and psychopathology that makes them turn to other substances after cigarette smoking. A causal-comparative study was conducted. Three groups were randomly selected: nicotine dependents, opiate dependents and ordinary individuals [non-dependent population]. Cloninger's Temperament and Character Inventory-Revised, the Fagerstrom Test for Nicotine Dependence, Maudsley Addiction Profile, the Beck Depression Inventory, and Beck Anxiety Inventory were used to collect data. Analysis of variance was used to analyze data. Opiate dependents had higher 'novelty seeking' and lower 'cooperativeness' scores as compared to the other two groups. They also had higher anxiety and depression scores than the other two groups. Higher 'novelty seeking' and lower 'cooperativeness' scores are important personality traits predicting future substance abuse

Aggression in juvenile delinquents and mental rehabilitation group therapy based on acceptance and commitment

Objective: The most common problem that delinquent children and juveniles deal with at every moment is the lack of sufficient control over their aggression. Accordingly, the aim of this study is to investigate the effects of mental rehabilitation group therapy based on acceptance and commitment on decreasing aggression in juvenile delinquents

Methods: This study employed a quasi-experimental method with a pretest-post-test design and a 2-month follow-up with both the experimental and the control group. To conduct this study, 30 cases of delinquent juveniles were selected by the Buss and Perry Aggression Questionnaire, and randomly assigned to two experimental and control groups. The Experimental group received 8 sessions of acceptance and commitment group therapy

Results: Results were analyzed using ANOVA, and showed that the experimental group demonstrated a significant reduction in aggression and its aspects [physical aggression, verbal aggression, anger and hostility] compared with the control group. This difference was also maintained in the follow-up phase [P< 0.001]

Discussion: The results showed that acceptance and commitment group therapy can effectively reduce overall aggression and its dimension [physical aggression, verbal aggression, anger and hostility], and that the results last to the follow-up phase

Early maladaptive schemas in opiate and stimulant users

Objective: Early maladaptive schemas are valid representations of unpleasant childhood experiences that shape a person's viewpoints of the world, and lead to clinical symptoms such as depression, personality disorders, and substance abuse. Given the importance of this matter, we conducted a research on early maladaptive schemas in substance-abusers, to allow more appropriate preventive measures to be taken with a better understanding of the issue

Methods: For this descriptive-comparative study, 115 patients [91 opiate users and 24 stimulant users] visiting drug addiction treatment centers were selected through convenience sampling from persons who were admitted to substance abuse treatment centers [Methadone Maintenance therapy centers], addiction treatment camps and self-help groups and Narcotics Anonymous [NA] of Yasuj. Data were collected using a Demographic Information Questionnaire and Young's Schema Questionnaire-Short Form [SQSF]. Data analysis was done with ANOVA and t-tests

Results: The results showed a significant difference [P<0.05] between users of opiates and stimulants in terms of vulnerability to harm or illness, enmeshment, subjugation, emotional inhibition, entitlement, insufficient self-control/self-discipline, emotional deprivation, social isolation, defectiveness, failure/shame, and dependence. The average score of the stimulant-users was higher than that of opiateusers in all the schemas except for the dimensions of abandonment, mistrust, and unrelenting standards

Discussion: Stimulant users have more early maladaptive schemas and are at a greater risk of psychological vulnerability. Early maladaptive schemas can be used by clinicians and researchers as a psychopathology and treatment method for substance dependence disorder

Neuro cognitive rehabilitation for disease of addiction (NECOREDA) program: from development to trial

Despite extensive evidence for cognitive deficits associated with drug use and multiple publications supporting the efficacy of cognitive rehabilitation treatment [CRT] services for drug addictions, there are a few well-structured tools and organized programs to improve cognitive abilities in substance users. Most published studies on cognitive rehabilitation for drug dependent patients used rehabilitation tools, which have been previously designed for other types of brain injuries such as schizophrenia or traumatic brain injuries and not specifically designed for drug dependent patients. These studies also suffer from small sample size, lack of follow-up period assessments and or comprehensive treatment outcome measures. To address these limitations, we decided to develop and investigate the efficacy of a paper and pencil cognitive rehabilitation package called NECOREDA [Neurocognitive Rehabilitation for Disease of Addiction] to improve neurocognitive deficits associated with drug dependence particularly caused by stimulants [e.g. amphetamine type stimulants and cocaine] and opiates. To evaluate the feasibility of NECOREDA program, we conducted a pilot study with 10 opiate and methamphetamine dependent patients for 3 months in outpatient setting. NECOREDA was revised based on qualitative comments received from clients and treatment providers. Final version of NECOREDA is composed of brain training exercises called [Brain Gym] and psychoeducational modules called [Brain Treasures] which is implemented in 16 training sessions interleaved with 16 review and practice sessions. NECOREDA will be evaluated as an add-on intervention to methadone maintenance treatment in a randomized clinical trial among opiate dependent patients starting from August 2015. We discuss methodological features of NECOREDA development and evaluation in this article

Social Work Guidelines for Street Children with Substance Use Disorders

This study was designed with the purpose of providing organized instructions on how to improve the psychological, medical, and social circumstances of street children with concurrent substance use disorders. Due to the special vulnerabilities of these children, customized guidelines are required in order to maximize the treatment outcomes. Systemic review of literature was applied on a large number of national and international journal articles available on the phenomenon of substance use among street children. The literature review was followed by a qualitative study using in-depth interviews in order to record and analyze the experience of experts working in this field. The preliminary draft was reviewed by the experts and final modifications were applied. The ultimate guideline presents practical recommendations for different stages of providing service for the target population including case finding, motivational interventions, assessment, care and intervention planning, and follow-ups. Street children face various physical, psychological, and social complications. Substance use disorders can exacerbate their circumstances and add to the complexity of their problems. The current guideline is an initial step to better understanding and treating street children who use drugs. Further research is required to investigate the effectiveness and long term results of this guideline .considering the fact that Iran is one of the many countries dealing with this phenomenon, adjustments should be made for application in different cultures.

tentative component analysis of Norjizak: a new abused drug in Iran

Norjizak is a new drug abused in the past few years in Iran with symptoms and complications distinct from other common forms of drug and characterized by higher rate of mortality. The present study aims to analyze the chemical components of this substance. Five samples were obtained from abusers referring from different areas of Tehran to a treatment clinic. All samples were 2ml vials with yellowish fluid. Thin Layer Chromatography [TLC] was performed first to analyze the samples semi-quantitatively and the quantitative levels of components were then explored using high-performance liquid chromatography [HPLC]. TLC revealed steroid [in form of betamethasone], heroin, codeine, morphine and thebaine in all five samples. Four samples contained acetaminophen and two samples contained caffeine. None of them contained amphetamine, benzodiazepine, tricyclic antidepressant, aspirin, barbiturates, tramadol and buprenorphine. HPLC revealed that heroin, codeine, morphine and thebaine constituted the narcotic foundation in all samples. In addition, the heroin to acetylcodeine ratio was significantly lower in three samples, which indicates their higher toxicity. The results of the present study on the chemical components of Norjizak showed that this substance is an opiate one similar to heroin and the heroin-based crack prevalent in Iran which contains betamethasone

Component analysis of iranian crack ; a newly abused narcotic substance in Iran

Iranian crack is a new form of narcotic substance that has found widespread prevalence in Iran in the past years. crack only nominally resembles crack cocaine as it is widely different in its clinical signs. Thus the present study aims to quantify the chemical combination of this drug. The samples included 18 specimen of crack collected from different zones of Tehran, Iran. All specimens were in the form of inodorous cream solid powdery substance. TLC and HPLC methods were used to perform semi-quantitative and quantitative analysis of the components, respectively. The TLC analysis showed no cocaine compound in the specimens while they all revealed to contain heroin, codeine, morphine and caffeine. All but two specimens contained thebaine. None of the specimens contained amphetamine, benzodiazepines, tricyclic antidepressants, aspirin, barbiturates, tramadol and buprenorphine. Acetaminophen was found in four specimens. HPLC revealed heroin to be the foundation substance in all specimens and most of them contained a significant amount of acetylcodeine. The present analysis of the chemical combination of crack showed that this substance is a heroin-based narcotic which is basically different from the cocaine-based crack used in Western countries. Studies like the present one at different time points, especially when abnormal clinical signs are detected, can reveal the chemical combination of the target substance and contribute to the clinical management of its acute or chronic poisoning

Acceptance and commitment therapy in the satisfaction of veterans with spinal cord injuries spouses

The aim of this study was to examine the effectiveness of psychotherapy based on acceptance and commitment therapy [ACT] on the subscales of marital satisfaction; overall satisfaction, religious orientation, relations with children, sex, occasional conflicts, interpersonal conflicts and arrogance, by single case study in the spouses of veterans with spinal cord injuries. Participants completed Enrich marital satisfaction questionnaire at baseline [3 to 6 weeks], during six session's psychotherapy and the two-month follow-up. Analysis method of charting and visual analysis of the results showed that the [ACT] is an effective therapeutic approach to 4 marital satisfaction subscales but second and third participant didn't show any improvement.. Considering the above, [ACT] is an effective therapeutic approach to overall satisfaction, occasional conflicts, relations with children and interpersonal conflicts

[Effects of kerack used in addict Iranian people on fertility of adult mice]

Infertility is one of the most serious social problems. Illicit drug use can be an important cause of male factor infertility. Kerack which its use is rising up in Iran refers to a high purity street-level heroin [heroin Kerack]. Heroin Kerack used in Iran is an opioid and has harmful effects on body organs. The aim of this study is to investigate the effects of Kerack used in Iran on fertility adult mice. In this study, 25 male mice were divided into five groups [control, sham and three experimental]. Experimental groups of Kerack-dependent mice [received ascending dose of Kerack for seven days] were divided into three categories, experimental I, II and III. Experimental I was given Kerack at a dose of 5 mg/kg, experimental II 35 mg/kg and experimental III 70 mg/kg, intraperitoneally twice a day for a period of 35 days. The sham group received normal saline and lemon juice [2.6 micro l/ml] whilst the control group just received water and food. Mice were then scarified and sperm removed from cauda epididymis were analyzed for sperm count, motility, morphology [normal/abnormal] and viability. Testes were also removed, weighed and processed for light microscopic studies. The results showed that fertility were significantly decreased in addicted mice compared with control groups [P

[Quality of studies on the prevalence of psychiatric disorders in Iran]

The aim of this research was to investigate the quality of studies on the prevalence of psychiatric disorders in Iran. All studies on the prevalence of psychiatric disorders among Iraniangeneral population as well as school children over 15 were identified through searching several databases including PubMed, ISI WOS, PsychINFO, CINAHL, Irandoc, EMBASE, IranPsych, IranMedex, and Scientific Information Database as well as reference lists of the accessed documents, unpublished reports, conference proceedings and dissertations. The original studies, which contained an estimation of the prevalence of "any psychiatric disorder" [overall prevalence] among a sample of general population or high school students in the country were selected. A quality assessment checklist was developed based on the following criteria: accurate description of research questions, random sampling, representativeness of the study sample for a defined target population, using the same method of data collection for the entire sample, using valid and reliable tools, and proper analysis of the results. The assessment was performed on those studies on the prevalence of any psychiatric disorder in the country that had used random sampling [43 studies]. It showed that in only about 40% of the studies the sample was representative of the target population. In more than 25% of the studies, validity and reliability of the Persian translation of the instruments were not assessed or were not reported. In total, nearly a third of studies had acceptable quality [random sampling, application of valid and reliable tools, and sample representing the target population]. Although this research - as part of a systematic review-was based only on a group of prevalence studies in psychiatric disorders, its findings indicated that a significant proportion of these studies are non-compliant with key quality measures. Instead of mere emphasis on increasing the number and quantity of studies, policy makers should employ strategies to improve research quality

[Analysis of Iran's mental health research over 3 decades: a scientometric study]

Objective: To describe the characteristics of Iran’s mental health research articles that are published over a 30-year period

Method: The articles include those concerned with psychiatry, psychology, and neuroscience that were published in the national as well as international scientific journals. These articles were drawn from a national database of published research in psychiatry, psychology as well as neuroscience [IranPsych]. For this study, articles were limited to those published in a 30-year period of 1973-2002 [1352-1381 in Persian calendar]

Results: Of a total of 3031 articles published in the 30-year period, 19.8% were published in the international journals. The publication trends showed a marked increase in number over item, especially in the last 5 years. Among research areas, psychology, clinical sciences, and the neurosciences constituted the largest proportions [52.8%, 31.6%, and 13.5%, respectively]. The trend of research areas revealed an upward trajectory for the proportion of neuroscience research and a decline in the proportion of mental health service research. The topic of 38.6% of all articles was in the category of mental disorders, with pharmacotherapy and psychotherapy researches constituting 14.5% and 5.7% of the articles, respectively. Among mental disorders, the largest proportions of the published research were about mood disorders, substance use related disorders, and anxiety disorders. The most commonly used research method was cross-sectional, with experimental designs comprising 15.9% and prospective research accounting for 1%. The preferred places for data collection included hospitals, schools and universities. In more than 90% of the articles there were no references to the funding sources and only 2.1% of the articles were carried out with international collaboration of the authors

Conclusion: The rising trend of mental health research publications shows the significant contribution of nation’s mental health researchers. The results of this study could provide an empirical basis for policy making and strategic planning in mental health research