The Association of Poor Mental Health Status and Sociocultural Factors in Men: A Population-Based Study in Tehran, Iran.

Mental ill-health has increased among Iranian men in the recent years. Mental health is complexly determined by sociocultural, psychological, demographic characteristics, and some health-risk behaviors such as smoking. This study aimed to explore the association(s) between demographic factors, smoking status, social capital, and poor mental health status in a sample of Iranian men. The data were derived from a survey titled "Urban Health Equity Assessment and Response Tool-2" in Tehran, Iran ( n = 11,064). A multistage sampling method was applied in the study. The General Health Questionnaire-28 was used to assess poor mental health status (range = 0-84, scores higher than 23 indicated poor mental health status). The data were analyzed using t test, chi-square test, and multivariate logistic regression. The means of age and family size were 47.14 ± 17.26 years (range = 20-91) and 3.54 ± 1.32 individuals (range = 1-15), respectively. The majority of the participants were employed (57%, n = 6,361). The prevalence of poor mental health was 36.36%, 95% confidence interval (CI) [35.46, 37.26]. The components of social capital were positively associated with poor mental health status. Family size (adjusted odds ratio [AOR] = 0.93; 95% CI [0.90, 0.96]), job status (unemployed vs. employed, AOR = 1.34; 95% CI [1.16, 1.55]), marital status (widowed and divorced vs. single, AOR = 1.09; 95% CI [1.02, 1.17]), education level (illiterate vs. academic, AOR = 1.18; 95% CI [1.09, 1.29]), and smoking status (smokers vs. nonsmokers, AOR = 1.46; 95% CI [1.31, 1.62]) were directly associated with poor mental health status in the logistic regression model. These results suggest that social capital could be an important approach for men to attain suitable mental health and reduce mental disorders. The high prevalence of poor mental health in men merits more attention in mental health policy and program planning.

Psychometric Properties of a Screening Instrument for Domestic Violence in a Sample of Iranian Women.

BACKGROUND: Domestic violence against women is regarded as an important health problem among women and a serious concern in issues related to human rights. To date, a few screening tools for domestic violence exist for Iranian married women, but they assess only some of the domestic violence components. OBJECTIVES: The present study aimed to design and determine the validity and reliability of a screening instrument for domestic violence in a sample of Iranian women. MATERIALS AND METHODS: The present study was a cross-sectional psychometric evaluation conducted on 350 married women in Ilam, Iran, in 2014. The samples were selected through multistage sampling and the main method was cluster sampling. A 20-item, self-administered questionnaire was validated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). An Eigen value > 1 and a loading factor > 0.3 for each component were considered as indices for extracting domestic violence components. Reliability was calculated by test-retest and Cronbach's alpha. Also, the content validity index (CVI) and content validity ratio (CVR) were used to measure content validity. The data were analyzed using SPSS-13 and LISREL 8.8 software programs. RESULTS: The self-administered instrument was completed by 334 women. The CFA and EFA methods confirmed embedding items and the three-factor structure of the instrument including psychological, physical, and sexual violence, which explained 66% of the total variance of the domestic violence. The ICC and Cronbach's alpha coefficients were > 0.7 for the components of the questionnaire. The test-retest also revealed strong correlations for each of the domestic violence components (r > 0.6). CONCLUSIONS: The used instrument for measuring domestic violence had desirable validity and reliability and can be used as a suitable instrument in health and social researches in the local population.

Prevalence of Cigarette Smoking and Associated Factors among Male Citizens in Tehran, Iran.

BACKGROUND: Cigarette smoking is as the leading cause of cancer mortality and other chronic diseases in males worldwide. The prevalence of cigarette smoking is different across and within countries by age, education level, occupation, and so on. This study aimed to determine the prevalence of cigarette smoking and its relationship with individuals' demographic factors and BMI in adolescent men living in Tehran, Iran. MATERIALS AND METHODS: This study involved secondary analysis of the 'Urban Health Equity Assessment and Response Tool-2' survey conducted in Tehran, Iran, among men aged 20+, 2011-2012. Using a multistage sampling method, 45,990 men were included in the study. The cigarette smoking status, BMI and demographic factors measured through a self-administered questionnaire. Chi-square, t-test, and logistic regression model were used to examine the relationships between the independents variables and cigarette smoking behavior, using SPSS software version 21. RESULTS: In the total of 45,990 men, the overall prevalence of cigarette smoking was 14.6% (CI 95%: 14.29- 14.94). Age (OR=0.96; CI 95%:0.94-0.98), house ownership (OR=0.68; CI 95%: 0.64-0.72), job status (OR=0.60; CI 95%: 0.46-0.86), marital status (OR=0.42; CI 95%: 0.39-0.47) and educational levels (OR=0.50; CI95%: 0.45-0.54) were associated with the prevalence of cigarette smoking. However, associations with BMI, family size, residency years, and district were not statistically significant. CONCLUSIONS: Given the relatively high prevalence of cigarette smoking in the study population, policy interventions are required to address this major public health issue, with a focus on the population demographic influences.

Social and Psychological Predictors of Initial Cigarette Smoking Experience: A Survey in Male College Students.

Knowledge about social and psychological risk factors for initial cigarette smoking experience (ICSE) is sparse. The present study aimed to estimate the prevalence of ICSE and to examine the psychological and social factors related to ICSE. In a cross-sectional survey, 1,511 male college students were recruited using multistage sampling techniques from four universities located within the city of Ilam, Iran. Self-administered multiple-choice questionnaires were distributed to students from March to June 2013. Risk factors for ICSE were evaluated using logistic regression models. Participants were 22.3 ± 2.4 years of age. ICSE prevalence was 30.6%. In multivariable adjusted analysis, risk taking behavior (odds ratio [OR] = 1.61; 95% confidence interval [CI] = 1.11-2.33), perceived peer smoking prevalence (OR = 2.48; 95% CI = 1.03-5.97), positive thoughts about smoking (OR = 1.06; 95% CI = 1.02-1.10), high self-efficacy (OR = 0.95, 95% CI [0.93, 0.98]), presence in smokers' gathering (OR = 4.45; 95% CI = 2.88-6.81), comity of smokers (OR = 2.56; 95% CI = 1.66, 3.92), very hard access to cigarettes (OR = 2.20; 95% CI = 1.16-4.16), close friends' medium reaction toward smoking (OR = 1.38; 95% CI = 1.02-1.88), and sporting activity (OR = 0.74; 95% CI = 0.56-0.98) were significantly associated with ICSE. This study identified that a combination of psychological and social variables account for up to 78% of the probability of ICSE. The most important protective factor against ICSE was physical activity, whereas the most important risk factor for ICSE was frequent gathering in the presence of smokers.

Identifying associated factors with social capital using path analysis: A population-based survey in Tehran, Iran (Urban HEART-2).

Background: Social capital has been defined as norms, networks, and social links that facilitate collective actions. Social capital is related to a number of main social and public health variables. Therefore, the present study aimed to determine the factors associated with social capital among the residents of Tehran, Iran. Methods: In this large cross-sectional population-based study, 31531 residents aged 20 years and above were selected through multi-stage sampling method from 22 districts of Tehran in 2011. The social capital questionnaire, 28-item General Health Questionnaire (GHQ-28), and Short-Form Health Survey (SF-12) were used. Hypothetical causal models were designed to identify the pathways through which different variables influenced the components of social capital. Then, path analysis was conducted for identifying the determinants of social capital. Results: The most influential variables in 'individual trust' were job status (ß=0.37, p=0.02), marital status (ß=0.32, p=0.01), Physical Component Summary (PCS) (ß=0.37, p=0.02), and age (ß=0.34, p=0.03). On the other hand, education level (ß=0.34, p=0.01), age (ß=0.33, p=0.02), marital status (ß=0.33, p=0.01), and job status (ß=0.32, p=0.01) were effective in 'cohesion and social support'. Additionally, age (ß=0.18, p=0.02), PCS (ß=0.36, p=0.01), house ownership (ß=0.23, p=0.03), and mental health (ß=0.26, p=0.01) were influential in 'social trust/collective relations'. Conclusion: Social capital can be improved in communities by planning to improve education and occupation status, paying more attention to strengthening family bonds, and provision of local facilities and neighborhood bonds to reduce migration within the city.

Survival Analysis of Drug Abuse Relapse in Addiction Treatment Centers.

BACKGROUND: Drug abuse is a chronic and enduring phenomenon, which is among the important challenging public health problems. One of the main aspects in drug abuse is the relapse. OBJECTIVES: The aims of this study were to estimate the time to relapse (survival rate) and to evaluate some of its associated variables by survival analysis. PATIENTS AND METHODS: This research was conducted in four addiction treatment centers on 140 self-referred addicts in Ilam city, Iran, in 2012. Cluster sampling method was used for selecting the samples and data were collected by interview and referring to the subjects' records. The gathered data were analyzed through the life table, Kaplan-Meier analysis, log rank test, and Cox regression. RESULTS: The relapse rate was 30.42%, mean and median of the time to relapse (survival time) were 27.40 ± 1.63 months (CI 95%: 24.19 - 30.60) and 25 ± 2.25 months (CI 95%: 22.5 - 27.5), respectively. In the first six months, the cumulative survival rate was 83%, while in the 24th month it was 46% and the following time was consistent. Job status (OR = 2.64), marital status (OR = 1.55), family size (OR = 1.20) and age (OR = 0.23) were statistically significant in Cox regression model. CONCLUSIONS: In the initial treatment, it seems necessary to supervise and monitor the treatment process through staff in addiction treatment centers together with the company of the addicts' families to reduce relapse rate.

Prevalence of Cannabis Lifetime Use in Iranian High School and College Students: A Systematic Review, Meta-Analyses, and Meta-Regression.

Cannabis is the most widely used substance in the world. This study aimed to estimate the prevalence of cannabis lifetime use (CLU) in high school and college students of Iran and also to determine factors related to changes in prevalence. A systematic review of literature on cannabis use in Iran was conducted according to MOOSE guideline. Domestic scientific databases, PubMed/Medline, ISI Web of Knowledge, and Google Scholar, relevant reference lists, and relevant journals were searched up to April, 2014. Prevalences were calculated using the variance stabilizing double arcsine transformation and confidence intervals (CIs) estimated using the Wilson method. Heterogeneity was assessed by Cochran's Q statistic and I(2) index and causes of heterogeneity were evaluated using meta-regression model. In electronic database search, 4,000 citations were retrieved, producing a total of 33 studies. CLU was reported with a random effects pooled prevalence of 4.0% (95% CI = 3.0% to 5.0%). In subgroups of high school and college students, prevalences were 5.0% (95% CI = 3.0% to -7.0%) and 2.0% (95% CI = 2.0% to -3.0%), respectively. Meta-regression model indicated that prevalence is higher in college students (ß = 0.089, p < .001), male gender (ß = 0.017, p < .001), and is lower in studies with sampling versus census studies (ß = -0.096, p < .001). This study reported that prevalence of CLU in Iranian students are lower than industrialized countries. In addition, gender, level of education, and methods of sampling are highly associated with changes in the prevalence of CLU across provinces.