Prevalence and Determinants of Depression and Anxiety Symptoms in Surgical Patients.

OBJECTIVES: Mood disorders are prevalent in hospitalized patients. However, risk factors for early diagnosis have not been studied exclusively in surgical patients. Our study aimed to investigate the prevalence and determinants of depression and anxiety symptoms in surgical patients. METHODS: We included 392 surgical patients in this prospective cross-sectional study, which took place between June 2011 and June 2012. The Hospital Anxiety and Depression Scale (HADS) was used to screen for symptoms of depression and anxiety at weekly interviews. Regression analysis was performed to identify risk factors for early (the day after admission) and late (one week or more) in-hospital psychiatry symptoms. RESULTS: Depression and anxiety symptoms increased from the time of admission toward longer hospital stay. Scores obtained in the second and third weeks of admission were associated with the need for surgery while HADS in the third week was associated with lack of familial support and being under the poverty line (p < 0.050). Regression model analysis showed that early depression was associated with female gender, and early anxiety was inversely affected by female gender and protected by higher education level. A history of mood disorder was a risk factor. Later anxiety was also associated with longer hospital stay. CONCLUSIONS: Depression and anxiety symptoms are a major concern in surgical patients especially in females and those with a history of mood disorders or lower educational level. Patients with a longer hospital stay, in particular, those with underlying diseases, postoperative complications, lack of familial support, and the need for reoperation were also at increased risk.

Trend of smoking among students of Tehran University of Medical Sciences: results from four consecutive surveys from 2006 to 2009.

BACKGROUND: Smoking within students community of the medical sciences can negatively impact the attitudesof the society in future. The objectives of this study were to assess the prevalence and trends of smoking amongstudents of Tehran University of Medical Sciences. METHOD: This study was conducted in four consecutive years from 2006 to 2009. The study sample was takenfrom the first- to fourth-year, undergraduate and graduate (doctorate) students of Tehran University of MedicalSciences. Census was applied for sampling. Structured questionnaires were distributed to students of each class.The study was anonymous and self-administered. RESULTS: From 2006 to 2009, a total of 1568 to 1761 students participated in the study each year. Over thestudy period, i.e. 2006-2009, the prevalence of cigarette smoking was decreased (the overall prevalence was12.5% in 2006, 12.9% in 2007, 10.8% in 2008, and 10.5% in 2009). The corresponding values for the onemonth prevalence were 8.2%, 7.8%, 6.1%, and 5.8%, while those for the prevalence of daily smoking were3.4%, 4.0%, 2.9%, and 1.8%, respectively. The decreasing trend was particularly more significant for femalestudents. CONCLUSION: The findings suggest that the prevalence of smoking among students of Tehran University ofMedical Sciences was in the lower end of the spectrum, in comparison to other universities in Iran and othercountries. Additionally, similar to the pattern observed in the developed world, this trend was decreasing, particularlyamong girls. Implementing preventive measures for accelerating the decreasing trend, as well as continuousmonitoring is recommended.

HIV, hepatitis C virus, and hepatitis B virus co-infections among injecting drug users in Tehran, Iran.

OBJECTIVES: To assess the prevalence of HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and co-infections among injecting drug users (IDUs) in Tehran. METHODS: A sample of 899 IDUs (861 male and 38 female) was recruited in Tehran from treatment and harm reduction facilities and from drug user hangouts in public areas in equal proportions. ELISA testing for HIV, HCV antibody (HCV-Ab), hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (HBcAb) was carried out. Positive HIV tests were rechecked by Western blot. RESULTS: The prevalence of HIV was 10.7%, HCV infection was 34.5%, and past or current HBV infection was 50.7%. Infection with all three viruses was seen in 6.5% (95% confidence interval 4.9-8.2) of participants. HIV/HCV, HIV/HBV, and HBV/HCV co-infections were seen in 8.7%, 7.8%, and 21.0% of participants, respectively. The rate of HCV infection among HIV-positive cases was significantly higher than in HIV-negative IDUs (80.6% vs. 28.7%, p<0.0001). There was no significant association between these infections and co-infections with gender and source of sampling. CONCLUSION: In general, co-infection with these three blood-borne viruses is common among IDUs. Since co-infection increases the morbidity and mortality of all infections, the observed level of co-infection in the high number of IDUs in Iran necessitates a serious comprehensive response.

The impact of Bam earthquake on substance users in the first 2 weeks: a rapid assessment.

In the final days of the year 2003, an earthquake in the city of Bam, Iran, led to the death of some 35,000 of its inhabitants. The rate of opium abuse, which had been high among the male population in this city, caused problems after the earthquake. The aim of the following study was to examine the status of substance abusers during the first 2 weeks after the earthquake. The study was carried out in the city of Bam, one of its nearby villages and eight hospitals admitting earthquake victims. One hundred and sixty-three individuals were interviewed, including substance abusers, their family members, people living in Bam, service providers, and the authorities. During the first 2 weeks after the earthquake, about half of drug-dependent interviewees suffered from withdrawal symptoms. About half reported their problems to health care providers and asked for morphine or other analgesics. Around one third had used opium on the first day and two thirds in the course of the second day to the end of the second week after the earthquake. Although smoking had been the most common means of abuse before the earthquake, oral intake has become the most prevalent route after the disaster. Almost all obtained their opium from inhabitants of other cities as gifts. Members of rescue and health delivery systems had a lot of encounters with opium abusers, especially in the first 3 days after the earthquake, and had prescribed morphine and other analgesics. In societies with a considerable prevalence of substance abuse, this issue becomes a matter of utmost health care and social importance at times of disasters, and the necessary arrangements to deal with it should be present beforehand.