Estimate the prevalence of daily caffeine consumption, caffeine use disorder, caffeine withdrawal and perceived harm in Iran: a cross-sectional study.

One of the informal diagnoses in DSM-5 is Caffeine Use Disorder (CUD). CUD and high levels of caffeine consumption could impact mental health conditions. This study aimed to estimate the prevalence of CUD, caffeine consumption, caffeine-related harms, and related psychiatric symptoms in Iran. A cross-sectional survey with a convenience sample of 1228 adults were conducted in Iran. Caffeine consumption was assessed across 20 products in Iran. Caffeine Use Disorder Questionnaire (CUDQ), Caffeine Withdrawal Symptoms Questionnaire (CWSQ), 14-item Caffeine-related Harm Screening (CHS), and Symptom Checklist-25 (SCL-25) were used in the present study. We used SPSS (desktop version 26.0) to analyze the data using descriptive statistics, chi-square, and the least significant difference (LSD) post hoc test. The daily average caffeine consumption was 146.67 mg. The prevalence of CUD and caffeine withdrawal (C.W.) were estimated at 19.5% and 46.62%, respectively. Also, 12.9% of responders received CUD and C.W.s simultaneously. The prevalence of CUD was higher in men than females (25.08% vs. 13.93%). 95% of participants (n = 1166) reported using at least one caffeine product yesterday. Moreover, the most reported caffeine-related harms were the desire for sugar (42.9%), insomnia (39.3%), and caffeine dependence (38.3%). Age significantly correlates with CUD (- 0.07) and daily caffeine intake (0.08). Moreover, all SCL-90 subscales had a significant correlation with daily caffeine intake. Finally, responders at younger ages reported higher levels of CUD and caffeine consumption than older adults(P < 0.05). High rates of C.W. and CUD in the Iranian population suggest that it is necessary to develop evidence-based treatments.

Mourning in the time of coronavirus: Examining how grief differs in those who lost loved ones to COVID-19 vs. natural causes in Iran.

OBJECTIVES: Our study aimed to analyze and compare the grief experiences of individuals in Iran who lost family members to COVID-19 and those who lost loved ones to other natural causes. METHODS: In this study, telephone interviews were conducted with 640 first-degree relatives, and finally, a total of 395 people remained in the research. Participants answered the Prolonged Grief Questionnaire (PG-13-R) and Grief Experience Questionnaire. RESULTS: The results showed that the most common symptoms and features of grief were feeling guilt, searching for an explanation, somatic reactions, and rejection, with no significant difference observed between the 2 death groups. However, the average scores for these symptoms were higher in the COVID-19 death group. Moreover, the majority of bereaved reported signs and symptoms of prolonged grief, with a higher percentage in the COVID-19 death group, although there was no significant difference between the 2 death groups in terms of the distribution of symptoms and signs of prolonged grief. These findings suggest that the bereavement process can be challenging, and losing a loved one to COVID-19 may lead to more intense experiences of grief. SIGNIFICANCE OF RESULTS: The study reveals high levels of guilt, searching for meaning, somatic reactions, and rejection among COVID-19 grievers. Losing loved ones to the pandemic appears linked to more intense, prolonged grief symptoms.

Effectiveness of information technology assisted relapse prevention program on relapse among people who live with severe mental disorders.

BACKGROUND: Severe Mental Disorders (SMDs) cause mental health worldwide challenges because of several relapses and extensive recovery periods of hospitalization, which put a lot of economic and social burden on families and governments. Therefore, interventions are necessary to decrease the relapse of these disorders. AIM: This study was conducted to investigate the effect of Information Technology Assisted Relapse Prevention Program (ITAREP) on relapse among people who live with SMDs. METHOD: This study was a randomized clinical trial with intervention and control groups. ITAREP is a remote intervention based on monitoring the Early Warning Signs (EWS) to decrease the number of potential relapses. Using convenience sampling, people with SMDs admitted to Sina Juneqan Psychiatric Hospital and their caregivers were recruited in this study and randomly allocated to the control and intervention groups. Two checklists of the EWS for the patient and the patient's caregiver were used for monitoring the relapse signs. Data were collected at baseline and 90 days after discharge and were analyzed using t-test and Chi-square statistical tests and linear regression in SPSS software. RESULTS: Fifty-two patients who lived with SMDs participated in this study (26 in the intervention group and 26 in the control group). The two groups were homogeneous regarding age, gender, type of mental disorder, and duration of the disorder. Forty-two males and ten females participated in this research. Most of the participants were diagnosed with schizophrenia. The results showed that the number of relapses in the intervention group was significantly lower than in the control group in the post-test. CONCLUSION: Social workers, as the case managers and a member of the interdisciplinary psychiatric team, can actively perform follow-up measures after discharge using ITAREP, and it can be expected that these interventions will reduce the number of relapses among patients who live with SMDs.

How might cancer patients experience existential guilt? A qualitative research.

OBJECTIVES: Existential guilt is a deep and multidimensional concept that is correlated with concepts, such as in/authenticity, existential anxiety, decisiveness, and personal and social responsibility. The aim of the present study is to investigate the experience of existential guilt among cancer patients. METHODS: The present research was conducted with a qualitative method with a content analysis design. A purposeful sampling method was used to select the participants and the sampling procedure went on until we reached data saturation. Data were obtained using semi-structured interviews with the participants. RESULTS: From a total of 18 interviews, 94 codes related to existential guilt were obtained. After the analysis, three main concepts were extracted: (1) incompleteness, (2) passivity, and (3) feelings of harm to self and others. Each of these had a number of subcategories. SIGNIFICANCE OF RESULTS: The participants of the present research were found to experience existential guilt in different ways. The research showed that it is necessary to find the sources of existential guilt in order that effective therapeutic attention can be given cancer patients.

Factors associated with smoking intensity among adult smokers: findings from the longitudinal cohort of the Tehran lipid and glucose study.

BACKGROUND: Smoking is a significant public health problem, and there is a scarcity of documents regarding its severity, particularly in developing countries. This study aimed to determine factors related to the number of cigarettes consumed daily by adult smokers in Tehran. METHODS: This study was conducted within the framework of the longitudinal study of Tehran Lipid and Glucose Study (TLGS). The study included 786 adult smokers living during four consecutive follow-ups from 2005 to 2016. The intensity of smoking was measured by the number of cigarettes consumed daily by adult smokers. Data analysis was done longitudinally and based on the mixed effects zero-inflated discrete Weibull (ZIDW) regression model. RESULTS: The mean age of the individuals was 40.35 ± 12.68 years, and 643 (81.8%) of them were men. Also, 52.7% of individuals were daily smokers, 15.6% were occasional smokers, and 31.7% were non-smokers who became smokers during the study. Variables of age 1.005 (95%CI: 1.001-1.008), gender of male 1.196 (95%CI: 1.051-1.39), and marital status (divorced/widowed vs. single) 1.168 (95%CI: 1.015-1.39) were positively associated with smoking intensity. Education level (master and higher vs. illiterate) 0.675 (95%CI: 0.492-0.926)), employment status (student vs. unemployed) 0.683 (95%CI: 0.522-0.917), (housewife vs. unemployed) 0.742 (95%CI: 0.606-0.895), (Unemployed with income vs. unemployed) 0.804 (95%CI: 0.697, 0.923), implementation of smoking prohibition regulations (yes vs. no) 0.88 (95%CI: 0.843-0.932), and history of cardiovascular disease in male relatives (yes vs. no) 0.85 (95%CI: 0.771-0.951) were associated with lower smoking intensity. CONCLUSION: We showed that demographic factors are associated with the intensity of smoking among adults and should be considered in policymakers' intervention programs to reduce smoking and quit smoking.

Comparison of Caregivers' Burden among Family Members of Patients with Severe Mental Disorders and Patients with Substance Use Disorder.

Objective: The burden on caregivers of patients with severe mental disorders is significantly higher than the care burden of patients with other medical conditions. Substance use disorder is also one of the most common psychiatric disorders that has negative effects on people's quality of life. This study was designed to investigate caregiver burden in severe mental disorders versus substance use disorder. Method : First-degree relatives of patients admitted to the Razi Psychiatric Hospital of Tehran with a diagnosis of schizophrenia, bipolar disorder type1, schizoaffective disorder, or substance use disorder entered this study. They completed the sociodemographic questionnaire for patients and caregivers and the Zarit burden interview for caregivers. Results: Our study shows that caregiver burden in substance use disorder has no significant difference with that in severe mental disorders (P > 0.05). In both groups, the highest spectrum of burden was moderate to severe. To find caregiver burden related factors, a general linear regression model with multiple predictor variables was fitted. In this model, caregivers' burden was significantly higher in patients with comorbidity (P = 0.007), poor compliance (P < 0.001), and in female caregivers (P = 0.013). Conclusion: Statistically speaking, the caregiver burden in substance use disorders is as severe as other mental disorders. The considerable burden on both groups necessitates serious efforts to minimize its negative effects.

Mental Health System Responsiveness during COVID-19 in People with Pre-Existing Psychiatric Disorders: Experiences from Iran.

Mental health system responsiveness (MHSR) is one of the important indicators in measuring the performance of mental health systems. Recognizing this function can be effective in responding appropriately to the needs of People with Pre-Existing Psychiatric Disorders (PPEPD). This study aimed to investigate MHSR during the COVID-19 period in PPEPD in Iran. Using stratified random sampling, 142 PPEPD who were admitted to a Psychiatric Hospital in Iran one year before the onset of the COVID-19 pandemic were recruited for this cross-sectional study. Participants completed a demographic and clinical characteristics questionnaire as well as a Mental Health System Responsiveness Questionnaire through telephone interviews. The results show that the indicators of prompt attention, autonomy, and access to care were reported as the worst-performing and the confidentiality indicator as the best-performing. The type of insurance affected the access to care and the quality of basic amenities. MHSR has been reported to be poor in Iran in general and this problem worsened during the COVID-19 pandemic. Considering the prevalence of psychiatric disorders in Iran and the degree of disability of these disorders, structural and functional changes are needed for adequate MHSR.

Psychometric Properties of the Posttraumatic Cognitions Inventory-9 items in an Iranian sample.

INTRODUCTION: The Posttraumatic Cognitions Inventory is a largely used measure to assess negative posttraumatic cognitions that are common among individuals with trauma-related disorders. There was a need to have a valid and reliable short form of it in Persian. OBJECTIVE: This study aimed to translate the Posttraumatic Cognitions Inventory-9 item (PTCI-9) into Persian, and evaluate its characteristics and psychometric properties. METHODS: This was a cross-sectional psychometric study using the translation and back-translation technique, experts assessed the content validity of the scale. Participants were 207 Iranian individuals recruited from the general population and 151 of them were trauma-exposed. Participants completed the Persian version of the PTCI-9, Beck Depression Inventory (BDI-II), and the WHO Quality of Life (WHO-QOL) scale. The psychometric properties of the Persian version of PTCI-9 were assessed using Exploration and Confirmatory factor analysis methods. Cronbach's α coefficient and Pearson's analysis were calculated, as well. RESULTS: Factor analyses supported a 3-factor model including the Self, World, and Self-blame subscales. The Cronbach's alpha of the Persian version of PTCI-9 (α=0.74) and its subscales (0.76, 0.82, 0.78) demonstrated its acceptable reliability. The Persian PTCI-9 also had strong test-retest reliability (r=0.79). The correlation between the Persian version of PTCI-9 and the BDI-II (r=0.60), and WHO-QOL (r=-0.54) indicated the convergent validity of the scale. CONCLUSION: The Persian version of PTCI-9 showed acceptable psychometric properties. It is a brief and pragmatic measure that can be used in Iranian trauma-exposed patients for research and clinical purposes.

Caregivers' experiences and perspectives of factors associated with relapse in Iranian people living with schizophrenia: A qualitative study.

BACKGROUND: Relapse in People Living with Schizophrenia (PLS) has several reasons and recognizing these can increase the effectiveness of treatment interventions. Formal and informal caregivers are an informed source to reduce relapse in PLS. AIM: This study explores the caregivers' perspective in Iran on the factors affecting relapse in PLS. METHOD: A total of 28 caregivers (16 formal caregivers and 12 informal caregivers) of PLS were enrolled in our qualitative study. A content analysis was conducted using individual and group, semi-structured in-depth interviews with informal and formal caregivers of PLS. This study was conducted in a hospital, three universities, and a non-governmental organization in Tehran, Iran. RESULTS: The majority (69%) of the participants were females. About half of the informal caregivers were over 60 years old and about 40% of the formal caregivers were in the age range of 30 to 40 years. The average number of years of work for informal caregivers was 17.6 years and the average of work experience among the formal caregivers was 14.1 years. Seven key dual themes were identified from data: 'awareness-stigma', 'social support-social exclusion', 'treatment adherence-treatment discontinuation', 'holistic approach - one-dimensional approach', 'supported employment-social dysfunction', 'emotional management in family - family with high emotional expression', and 'access to treatment-treatment gap'. CONCLUSION: The results of this research can help practitioners and policymakers to enable evidence-based practices to reduce relapse in PLS by emphasizing and acting on factors identified in our analyses.

The design and process of a family and community-based intervention for relapse prevention in people living with schizophrenia in Iran.

BACKGROUND: People living with schizophrenia (PLS) suffer frequent relapse accompanied by emergency room visits, premature mortality, lower quality of life and a substantial social and economic burden on families and health systems. There is a dearth of community-based relapse prevention interventions (RPIs) in Iran. AIMS: To determine an ideal model for a community-based RPIs for PLS. METHODS: A qualitative study with 27 experts in Iran was carried out to understand the ideal RPIs for PLS and the key components of such interventions. RESULTS: In 16 semi-structured interviews and 8 group-discussions, the participants identified six major stages of family and community-based RPIs including preparation, social mobilization, local team formation, design an RPI, implementing the RPI, participatory monitoring, and evaluation of the RPI. CONCLUSIONS: Given the suboptimal healthcare systems and lack of professionals and services, PLS in Iran may benefit from family and community-based RPIs. Our findings warrant pilot testing of such initiatives across developing communities like Iran to improve health outcomes of PLS.

Assessing related factors to fasting blood sugar and glycosylated hemoglobin in patients with type 2 diabetes simultaneously by a multivariate longitudinal marginal model.

The multivariate marginal model can be used to simultaneously examine the factors affecting both FBS and HbA1c using longitudinal data. The model fitted to multivariate longitudinal data should prevent redundant parameter estimation in order to have greater efficiency. In this study, a multivariate marginal model is used to simultaneously investigate the factors affecting both FBS and HbA1c with longitudinal data for patients with type 2 diabetes in Northern Iran. The present research is a retrospective cohort study. Overall, 500 medical records with complete information were reviewed. The multivariate marginal model is used to determine the factors associated with FBS and HbA1c using longitudinal data. Data have been analyzed in R-3.4.0 using 'mmm2' package. Given that the coefficients for the interactions of rtype with the intercept, time, family history of diabetes, history of hypertension, history of smoking, insulin therapy, systolic/diastolic blood pressure and duration of disease at first visit are significantly different from zero (P < 0.05), the effect of the independent variables on the two response variables is different and different coefficients should be used for each. Therefore, the interactions of these variables with rtype are kept in the final model. The coefficients for the interactions of rtype with sex, age at first visit, history of high cholesterol, and weight are not significantly different from zero (P > 0.05), indicating that their effect on the two response variables is similar and only one coefficient should be used for each. We examined the similarity of coefficients when fitting the longitudinal multivariate model for the relationship between FBS/HbA1c and sex, age, history of high blood cholesterol, and body weight. If an independent variable has similar effects on both responses, only one coefficient should be estimated, which will increase the efficiency of the model and the reliability of the results.

The Cross-Talk between Polyphenols and the Target Enzymes Related to Oxidative Stress-Induced Thyroid Cancer.

The most serious hallmark step of carcinogenesis is oxidative stress, which induces cell DNA damage. Although in normal conditions ROS are important second messengers, in pathological conditions such as cancer, due to imbalanced redox enzyme expression, oxidative stress can occur. Recent studies with firmly established evidence suggest an interdependence between oxidative stress and thyroid cancer based on thyroid hormone synthesis. Indeed, a reduced antioxidant defense system might play a part in several steps of progression in thyroid cancer. Based on studies that have been conducted previously, future drug designs for targeting enzymatic ROS sources, as a single agent or in combination, have to be tested. Polyphenols represent the potential for modulating biological events in thyroid cancer, including antioxidative activity. Targeting enzymatic ROS sources, without affecting the physiological redox state, might be an important purpose. As regards the underlying chemopreventive mechanisms of natural compounds that have been discussed in other cancer models, the confirmation of the influence of polyphenols on thyroid cancer is inconclusive and rarely available. Therefore, there is a need for further scientific investigations into the features of the antioxidative effects of polyphenols on thyroid cancer. The current review illustrates the association between some polyphenols and the key enzymes that take place in oxidation reactions in developing thyroid cancer cells. This review gives the main points of the enzymatic ROS sources act and redox signaling in normal physiological or pathological contexts and supplies a survey of the currently available modulators of TPO, LOX, NOX, DUOX, Nrf2, and LPO derived from polyphenols.

Development of a speech production test in Azeri Turkish speaking children.

Due to the lack of appropriate tests for the assessment of speech sounds of Azeri Turkish speaking children, the present study aimed to develop and validate a single word test. A total of 150 typically developing children were recruited in the study (30 children for investigating the name agreement and 120 children to establish construct validity). In the first step, a test with 31 items was developed in terms of suggested criteria in the literature including word frequency, word length, syllabic structure, familiarity, and picturability of words. Then, we asked the expert panel's opinion for the test items. The value of the content validity ratio for each target word was 1.00 except for one item. To administer the test, we asked the participants to name images. Name agreement of the items was determined through administrating the test. The percentages for the indices of name agreement were 87.68 and 0.17, respectively. The findings of the item-by-item test-retest and inter-rater reliability showed satisfactory values in terms of consonants in the initial and final positions. Also, the value of the internal consistency was calculated to be kr = 0.78 (p < 0.001). The psychometric properties of this scale with 31 items proved that it is appropriate for quantifying the speech sound production in Azeri Turkish typically developing children.

Impact of Psychosocial Occupational Therapy Combined with Anodal Transcranial Direct Current Stimulation to the Left Dorsolateral Prefrontal Cortex on the Cognitive Performance of Patients with Schizophrenia: A Randomized Controlled Trial.

BACKGROUND: The most common cognitive dysfunctions in patients with schizophrenia are information processing, memory, and learning. Based on the hypothesis of rehabilitation and brain stimulation in memory and learning, adding a form of neuromodulation to conventional rehabilitation might increase the effectiveness of treatments. AIMS: To explore the effects of psychosocial occupational therapy combined with anodal Transcranial Direct Current Stimulation (tDCS) on cognitive performance in patients with Schizophrenia. METHODS: Twenty-four patients diagnosed with schizophrenia were randomized into the experimental and control groups. We used The Cambridge Neuropsychological Test Automated Battery (CANTAB) and the Loewenstein Occupational Therapy Cognitive Assessment battery (LOTCA) to assess spatial recognition, attention, visual memory, learning abilities, and high-level cognitive functions like problem-solving. All participants received customized psychosocial occupational therapy activities. Furthermore, the experimental group received 12 sessions of active anodal tDCS for 20 minutes with 2 mA intensity on the left dorsolateral prefrontal cortex (DLPFC) while the patients in the sham group received sham tDCS. RESULTS: Combining tDCS to conventional psychosocial occupational therapy resulted in a significant increase in spatial memory, visual learning, and attention. CONCLUSIONS: Anodal tDCS on the left DLPFC improved visual memory, attention, and learning abilities. Contrary to our expectations, we could not find any changes in complex and more demanding cognitive functions.

Participation instruments in persons with spinal cord injury: A narrative review.

Background: Spinal cord injury (SCI) has serious impacts on the patient's function. Therefore, their participation is important as one of the major indicators of the quality of life. This study reviews instruments that evaluate participation among people with spinal cord injury. Methods: Four electronic databases (WebofScience, Scopus, MEDLINE/PubMed, SID) were searched for studies published in the English language between 2000 and 2019 in one or more peer-reviewed journals on the measurement properties (reliability, validity and/or responsiveness) in all populations including adults with SCI. Instruments assessed based on special criteria designed for disability outcome measures. Results: Six instruments were included: Incontinence - Activity Participation Scale, Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P), World Health Organization's disability assessment tool-II (WHODAS-II), ICF Measure of Participation and ACTivities Screener (IMPACT-S), Impact on Participation and Autonomy (IPA) , Participation measure for Post-Acute care (PM-PAC). Evidence related to the reliability and validity was reported for all of the instruments. Only WHODAS-II, USER-P, and IMPACT were compared with each other in recent publications. Responsiveness was not obtained for any of the instruments. Conclusion: As the underlying structure of every instrument is different, the concept of the evaluated participation varies between instruments. The proper instrument for examining participation of the patients with SCI should be selected based on a thorough analysis of the individual's condition and context. Innovative models of disability should be the basis of emerging instruments for evaluation of participation, as well as empirical studies and modern measurement technologies that fill the gap between the perceived participation of the individual and the research's record.

Coronavirus Outbreak and Stress in Iranians.

Iran has faced one of the worst COVID-19 outbreaks in the world, and no studies to date have examined COVID-19-related stress in the general Iranian population. In this first population-based study, a web-based survey was conducted during the peak of the outbreak to assess stress and its correlates in the Iranian population. A 54-item, valid, and reliable questionnaire, including items on demographic characteristics and past medical history, stress levels, awareness about signs and symptoms of COVID-19, knowledge about at-risk groups and prevention methods, knowledge about transmission methods, trust in sources of information, and availability of facemasks and sanitizers, was deployed via social and mass media networks. A total of 3787 Iranians participated in the study where the majority of the participants were females (67.4%), employed (56.1%), from developed provinces (81.6%), without chronic diseases (66.6%), and with ≥13 years of formal education (87.9%). The mean age of study participants was 34.9 years (range = 12-73), and the average stress score was 3.33 (SD = ±1.02). Stress score was significantly higher for females, those who were 30-39 years old, housewives, those with chronic diseases, individuals who were aware that there is no vaccine to prevent COVID-19, those who could not get facemasks or sanitizers, and individuals with higher knowledge about at-risk groups (p < 0.05). There was a significant correlation of stress scores with knowledge about prevention methods for COVID-19 (r = 0.21, p = 0.01) and trust in sources of information about COVID-19 (r = -0.18, p = 0.01). All of the predictors, except knowledge of two important at-risk groups and education, had a significant effect on stress scores based on a multivariate regression model. The COVID-19 outbreak could increase stress among all population groups, with certain groups at higher risk. In the high-risk groups and based on experience with previous pandemics, interventions are needed to prevent long-term psychological effects. Professional support and family-centered programs should be a part of pandemic mitigation-related policymaking and public health practices.

Longitudinal Trend of Fasting Blood Glucose and Related Factors in Patients with Type 2 Diabetes.

BACKGROUND: Control of diabetes plays an important role in improving complications and disabilities and quality of life. This study aimed to evaluate the 3-year changes in fasting blood glucose (FBG) values and its related factors in patients with type 2 diabetes. METHODS: In this retrospective cohort study, 500 patients with type 2 diabetes covered by the National Diabetic Prevention and Care Plan during 2013-2016 were selected based on random cluster systematic sampling. A linear mixed model was used to study changes in FBG levels and their related factors. The data were analyzed using the R3.2.0 software. RESULTS: The patients' mean age was 47.7 years. Among these patients, 58.6% were female, 19.8% had a history of smoking. High FBG was associated with high disease duration, high body mass index (BMI), low age, normal BMI at baseline, insulin therapy, smoking, and family history of diabetes. Trend of FBG in follow-up was decreasing. CONCLUSIONS: Given that patients who received insulin therapy had higher mean FBG, it is recommended to examine their insulin dose and modifications should be made in terms of the patients' needs during their continuous follow-up. Weight loss during follow-up and cessation of smoking indicate a favorable prognosis of disease. More attention should be paid to younger patients in care. Patients are encouraged to start treatment and care at the same time diagnose.

Designing and Evaluating the Validity and Reliability of the Persian Gambling Disorder Screening Questionnaire.

BACKGROUND: Gambling disorder (GD) and substance use disorder (SUD) have mutual impact and each could aggravate the effects of the other. This is the first study on GD among Iranian substance users to develop and validate a GD Screening Questionnaire-Persian (GDSQ-P). METHODS: Iranian male adults (n = 503) with SUDs were recruited via clustered sampling. Problem gambling screening instruments and Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5) criteria for GD were used to develop the tool which was sequentially assessed for face validity, content validity index (CVI), content validity ratio (CVR), and reliability (Kuder-Richardson coefficient). To establish construct validity, interviews based on DSM-5 as a gold standard method were used. A receiver operating characteristic (ROC) curve was conducted to determine sensitivity and specificity. FINDINGS: After removing items with low CVI values, 27 final items remained in GDSQ-P with impact score greater than 1.5. Card games (33.8%), dice gambling methods (26.6%), betting on sports teams and players (24.1%), and betting on horseback, rooster, pigeon, dog, or other animals (16.7%) were common gambling methods among participants. Overall Kuder-Richardson coefficient was 0.95. Cut-off threshold for GDSQ-P was calculated as 4.5 with 98.9% sensitivity and 98.3% specificity. The interviewers confirmed GD for participants based on DSM-5 as the gold standard. The prevalence of GD among participants was 17.9% based on GDSQ-P and 19.1% based on DSM-5 criteria. CONCLUSION: GDSQ-P is a valid and reliable tool to screen for GD in SUD treatment centers and probably in the general population.

Empowering elderly Iranians through a social group work intervention: A trial study to assess the effect of the intervention on participants' quality of life.

We designed and ran an empowerment-oriented social group work intervention to assess whether the intervention could improve the quality of life of older Iranians. The intervention consisted of nine group sessions that focused on capacity building and increasing individual competences, environmental resources and opportunities. Using a randomised controlled trial (RCT), 60 elderly people (30 men and 30 women in the intervention and control groups) from Social Services Centres in Tehran Municipality participated in this study. The WHOQOL-BREF instrument was used to measure quality of life, comparing before, after and follow-up measures between the groups and within each group. ANOVA and GEE tests were applied to analyse the data. The results showed significant progress in overall quality of life of the participants, particularly in the domains of physical health, psychological health, social relationships and environmental health. In pretest, there were no significant differences between the groups in terms of quality of life and its domains, but there were significant differences in the post- and follow-up tests. This study provides support for the empowerment-oriented social group work intervention with Iranian elderly people. This kind of intervention can be a useful model for empowering older people, especially in countries where social support and health services for seniors are not yet freely available.