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Abstract Background This study focuses on the phenomenon of demoralization, a common experience among terminally ill patients, especially those diagnosed with cancer. The primary objective is to adapt and validate a practical assessment tool for demoralization, the Demoralization Scale‐24 (DS‐24), within the context of Iranian society. Methods In this cross‐sectional study, we employed the DS‐24 as the principal instrument, which had been exactly translated and evaluated for its psychometric properties in 160 Persian cancer patients. The assessment included exploratory factor analysis, confirmatory factor analysis (CFA), as well as evaluations of convergent validity and internal consistency or reliability. Results The CFA unveiled a five‐factor model, consistent with the original structure of the DS‐24. Moreover, statistically significant correlations were observed between the DS‐24 and both the Beck Depression and MUNSH happiness scales. Cronbach's alpha indicated high internal consistency, with a value of .92 for the total score. Conclusion In Iran, like in other countries, the demoralization questionnaire demonstrates significant validity and reliability. This ensures the timely diagnosis of demoralization in cancer patients and the prompt initiation of therapeutic interventions.

Objective: Suicide is an important health issue nearly all over the world. The Columbia Suicide Severity Rating Scale (C-SSRS) is a well-known instrument for suicide risk assessment. Our purpose in this study is to provide a Persian version of the C-SSRS and evaluate its psychometric properties in the Iranian military population, particularly suicide risk leveling characteristic of the C-SSRS. Method: For linguistic adaptation, we gathered opinions of an expert panel consisting of 23 professionals in mental health sciences. Furthermore, this version was administered to two groups of soldiers, one representing a sample of normal population (N = 338), while the other group comprised a sample of clinical population from a referral psychiatric hospital (N = 348) in Tehran, capital of Iran, from July 2021 until one year later. Besides the C-SSRS, the Beck Scale for Suicidal Ideation (BSSI), Beck Hopelessness Scale (BSS), and General Health Questionnaire 28 (GHQ28) were obtained from the participants. Correlation coefficients, internal consistency, and factor analysis were evaluated using the Statistical Package for the Social Sciences (version 23) software. Results: All items of the Persian version of the C-SSRS had acceptable content validity and face validity. This tool demonstrated high correlation coefficients with the BSSI (r = 0.73, P < 0.001) and BHS (r = 0.64, P < 0.001), but a low correlation coefficient with the GHQ28 (r = 0.22, P < 0.001). Specifically, the suicide risk level based on the C-SSRS had a high correlation with both the BSSI and BHS. Also, its internal consistency was satisfactory (Cronbach's alpha = 0.89). Furthermore, factor analysis revealed two factors that is consistent with suicidal ideation and suicidal behavior factors. Conclusion: Our results indicated acceptable validity and reliability for the Persian version of the C-SSRS, demonstrating its capability to classify suicide risk. It can be concluded that the ordinal suicide risk level (as red, orange, yellow and green) is a valid index for the application of the C-SSRS.

Objective: Psychosis is one of the most vital disorders in children and youths. The definite pathophysiology of schizophrenia and other psychotic disorders in the growth period has remained ambiguous. Therefore, the purpose of the current study was to investigate the predictive value of parental psychiatric disorders and the mediator role of comorbid disorders of children and youths. Method: The sample, consisting of 29884 individuals aged between 6 to 18 years old from the Iranian population, were selected by multistage cluster sampling during September 22, 2016 to January 3, 2018. Parents were requested to complete a survey around their potential psychiatric disorders, based on their Millon’s Clinical Multiaxial Inventory-III (MCMI-III). The Semi-Structured Interview (Kiddie-SADS-Present, Lifetime Form (K-SADS-PL)) was utilized to analyze psychiatric disorders concurring to the DSM. Results: The fit indices of the model show that the research model has a good fit and the psychiatric disorders of parents directly and indirectly through comorbid disorders are effective on the psychosis symptoms of children and adolescents (RMSEA=0.06, CFI=0.89, PGFI=0.75, PNFI=0.75).The incidence of Schizotypal Personality Disorder, Anxiety, Bipolar Spectrum Disorder, PTSD, Schizophrenia Spectrum and Delusional Disorder were statistically higher in parents of psychotic children and adolescents. However, Borderline Personality Disorder was more frequent among their mothers while Alcohol Dependency and Drug Dependency were significantly more prevalent among their fathers. Conclusion: The outcomes of our study showed that there were statistically significant differences between the mean scores of each scale assessed by Millon’s inventory between parents of psychotic versus non-psychotic pediatric cases. In addition, psychiatric disorders were more common among children and youths with psychosis spectrum in comparison with the general population.

Introduction: Due to significant social, economic, cultural, and lifestyle changes in Iran during past decades and the relationship among the unstable social and economic status and mental complications the study of psychiatric disorders has become important and necessary, the aim of this study was epidemiology of psychiatric disorders in children and adolescents. Methods: A total of 1035 children aged 6-18 years from Yazd Province, Iran were enrolled in this cross-sectional study in 2017 using a multistage cluster sampling method. Data were collected using the following inventories for school-age children (6-18 years): Kiddie-SADS-Present and Lifetime Version (K-SAD-SPL). Logistic regression and SPSS version 16 software were used for data analysis. Results: 44.1% of participants were boys and 55.9% were girls. The mean age of the participants was 11.3±3.9 years. The prevalence of psychiatric disorders in children and adolescents was 35.5%. Meanwhile, anxiety disorders had the highest prevalence rate (22.2%) and among anxiety disorders, separation anxiety disorder (8.7%) and generalized anxiety (8.6%) were the most prevalent. There was a significant difference in all psychiatric disorders based on gender, more evident in the high rate of obsessive-compulsive disorder, enuresis, tic, attention deficit hyperactivity disorder, hyperactivity, oppositional defiant disorder, conduct disorder, smoking disorder, and epilepsy were more evident in boys (P-value < 0.05). Conclusion: The prevalence rate of psychiatric disorders in young population of Yazd Province is relatively high and because of its impact on individuals' social and personal function, it could have substantial implications for mental health services.

Objectives: In this double-blind, randomized clinical trial, the effectiveness of buprenorphine (BUPRE) in the reduction of anxiety symptoms among the methamphetamine (MA) dependents was evaluated. Materials and Methods: The 60 MA-dependent patients were randomly assigned to three groups (0.1 mg, 1 mg, and 8 mg of BUPRE), The Hamilton Anxiety Rating Scale was administrated to assess the anxiety symptoms daily at baseline and second to the 5th day after intervention. The inclusion criteria were the MA dependence, age of over 18 years, and absence of any chronic physical illnesses; exclusion criteria were the presence of other drug dependence in combination with MA. The mixed-design analysis of variance was performed for data analysis. Results: A significant main effect of time (F = 51.456, P < 0.001) and group (F = 4.572, P = 0.014) and group-by-time interaction (F = 8.475, P < 0.001) were detected. Conclusions: This finding supports the efficacy of BUPRE to decrease anxiety. High doses of the drug (1 and 8 mg) were more effective than 0.1 mg. Here was not a significant difference between anxiety score when patients received 1 mg of BUPRE instead of 8 mg.

Abstract Background In addition to affecting the nerves and muscles, amyotrophic lateral sclerosis (ALS) disease also affects the behavior and cognition of patients. In this study, we examine the validity and reliability of the Persian version of Motor Neuron Disease Behavioral instrument (MiND‐B) questionnaire to investigate behavioral changes in Persian‐speaking ALS patients. Methods Forty‐six Persian‐speaking patients with ALS filled out the MiND‐B questionnaire. Then, the overall scores and each of the domains of this questionnaire were statistically analyzed. Results Cronbach's alpha coefficient was calculated .70 for the whole questionnaire. To check the validity of the questionnaire, the correlation of its scores with the Edinburgh Cognitive and Behavioral ALS screen (ECAS‐A) questionnaire was taken, and this correlation was significant (p = .038). Conclusion The findings of this study show that the Persian version of the MiND‐B questionnaire has the necessary validity and reliability to investigate behavioral changes in Persian‐speaking patients with ALS.

Objectives: Our objective is to measure the prevalence of bipolar mood disorder (BMD) in Iranian children and adolescents and its comorbidity with psychiatric disorders. Also, the main purpose of this study is to characterize the main risk factors for BMD in children and adolescents. Methods: This is an analytical cross-sectional study. In a community-based study, we sampled 1000 children and adolescents from the age of 6 to 18 years in each province via the multistage cluster sampling method. The total valid sample size reached 29 812 cases. The instructed clinical psychologists completed the Persian version of the kiddie schedule for affective disorders and schizophrenia present and lifetime version (K-SADS-PL). Furthermore, the demographic data were obtained. To analyze the data, descriptive statistics, multinomial, and multiple logistic regressions were utilized to evaluate the relationships. Results: The total prevalence rates for BMD were 0.29%; it was 0.26% in males and 0.29% in females. BMD rates were larger in children and adolescents whose mothers had an occupation. Also, after controlling the effective variables (sex and age), location (rural or urban), the father’s education, and the psychiatric hospitalization of the mother or the father, none predicted BMD significantly. Moreover, patients with comorbidities showed a superior prevalence compared to those without comorbidities, ranging from 1.96% for posttraumatic stress disorder to 39.22% for the oppositional defiant disorder. Conclusion: BMD was more prevalent among women. The gender or the father’s education level was not the risk factor for BMD symptoms. Several factors, such as maternal education and maternal job were also important for the prevalence of BMD symptoms.

Introduction: Socio-cultural norms can either be encouraging or a barrier to addiction treatment. More, rigorous research is needed on nonindigenous models in addiction treatment, to better understand the role of socio-cultural differences. Methods: The present qualitative study is part of the project, “The Inclusive Assessment of the Barriers of Drug Addiction Treatment Services in Iran,” which was conducted in Tehran from 2018 to 2021. The participants consisted of eight people who used drugs, seven individual family members of the people who used drugs participants, seven service providers, and four policymakers. A purposeful sampling method was used for the selection of the participants, and the process continued until reaching the theoretical saturation of data. Analysis used the Graneheim and Lundman methods, classifying primary codes, the sub-themes, and themes were classified according to the similarities and differences between primary codes. Finding: The most important socio-cultural barriers to addiction treatment in Iran are: unrealistic expectations of the family and society from the people who use drugs, addiction stigma, mistrust between various components of the treatment system, perceptions that professional substance use disorder treatment is inefficient and low uptake of that treatment, the disturbed relational boundaries between the people who use drugs and their relatives, the interweaving of treatment and ethical and religious principles, low acceptance of maintenance treatments, treatment focusing on short-term outcomes, and presence of facilitating backgrounds of using drugs. Conclusions: The Iranian socio-cultural characteristics play an important role in the addiction treatment of the people who use drugs, so it is necessary for treatment interventions to be sensitive to these characteristics.

objective: This investigation explored the barriers and facilitators to substance use disorder (SUD) treatment in the integrated paradigm. methods: A search technique for barriers and facilitators of SUD treatment was applied to the PubMed and Web of Science databases to identify relevant systematic reviews. The eligibility criteria included systematic review (SR) or SR plus meta-analysis (MA) articles published before the end of 2021, human research, and the English language. Each of the 12 relevant review articles met the inclusion criteria. AMSTAR was utilised to evaluate the methodological quality of the systematic reviews. results: Two authors analysed 12 SR/SR-MA articles to identify barriers or facilitators of SUD treatment. The cumulative summary results of these 12 evaluations revealed that barriers and facilitators may be classified into 3 levels: individual, social and structural. By analysing these review papers, 37 structural barriers, 21 individual barriers and 19 social barriers were uncovered, along with 15 structural facilitators, 9 social facilitators and 3 individual facilitators. conclusions: The majority of barriers indicated in the review articles included in this analysis are structural, as are the majority of facilitators. Consequently, the design of macro models for the treatment of substance use disorders may yield various outcomes and potentially affect society and individual levels.

Objective: Stressful events increase in traumatic conditions. Coronavirus is a new and serious challenge and significant public health problem, which can cause different stressors. This study has identified stressful events experienced by Iranian adults during the COVID-19 epidemic. Method: Data on stressful events during the COVID-19 epidemic were collected online from 418 adults (mean age 37.16 years; 57.4% female and 42.6% male) using quota sampling method. Epidemic Stressful Events Checklist was applied for data collection. Data were analyzed by applying descriptive graphs and tables, the independent sample t-test, the Fisher’s F test, and post hoc Bonferroni test. Results: The most frequent stressful event was rise in essential goods prices (84.7%); however, its perceived stress was not at the highest level. The highest severity of perceived stress was related to the death of a family member (4.83) due to COVID-19 infection, which was an event with the least occurrence, and the lowest severity of perceived stress was related to medical team performance (2.50). The results showed the severity of perceived stress is higher in women than men (t = 3.42; P value < 0.01) and also in the laboring occupations compared to other occupations (F = 3.18; P value < 0.05). Conclusion: Traumatic events can lead to more serious concerns, eg., worrying about those we love, concerns about the future of our life, and about what politicians and macro planners will do to protect our lives. Moreover, traumatic events can cause concerns about food, basic needs, and lack of resources to survive.

Objective: Studies conducted on severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and COVID-19 epidemics have shown PTSD can occur during and after infectious diseases. However, more studies are needed to explore PTSD during and after COVID-19 outbreak. The objective of this study is to provide a protocol of systematic review and meta-analysis to report the global prevalence of PTSD during and after coronavirus pandemics among general population, health care workers, survivors, or patients with coronaviruses. Method: We include all studies that reported the prevalence of PTSD during and after coronavirus pandemics and search databases, including Web of Science, PubMed, Scopus, Embase, and Google Scholar from first of November 2002 to May 18, 2020. Two authors independently use relevant checklists to quality assessment of the included studies and extract data. We use the graphical methods and fixed or random effect models to aggregate prevalence estimates. Also, we will assess heterogeneity between the included studies using the I2 heterogeneity statistic and use subgroup and sensitivity analysis to assess the sources of heterogeneity. Discussion: We infer that PTSD is a common experience during and after infectious disease pandemics, especially COVID-19. The findings of this study can be used by health policymakers and other stakeholders and will provide a path to future studies.

Background and Aims: COVID-19 has infected more than 77 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing, and “lockdown” measures have affected drug and alcohol supply chains and subsequently their availability, price, and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic.Design: Cross-sectional survey.Setting: Worldwide.Participants: Starting on April 4, 2020 during a 5-week period, the survey received 185 responses from 77 countries.Measurements: To assess addiction medicine professionals' perceived changes in drug and alcohol supply, price, use pattern, and related complications during the COVID-19 pandemic.Findings: Participants reported (among who answered “decreased” or “increased”) a decrease in drug supply (69.0%) and at the same time an increase in price (95.3%) globally. With respect to changes in use patterns, an increase in alcohol (71.7%), cannabis (63.0%), prescription opioids (70.9%), and sedative/hypnotics (84.6%) use was reported, while the use of amphetamines (59.7%), cocaine (67.5%), and opiates (58.2%) was reported to decrease overall.Conclusions: The global report on changes in the availability, use patterns, and complications of alcohol and drugs during the COVID-19 pandemic should be considered in making new policies and in developing mitigating measures and guidelines during the current pandemic (and probable future ones) in order to minimize risks to people with SUD.

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic.Methods: One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health responses were categorized around (1) managerial measures and systems, (2) logistics, (3) service providers, and (4) vulnerable groups.Results: Respondents from over 88% of countries reported that core medical and psychiatric care for SUDs had continued; however, only 56% of countries reported having had any business continuity plan, and 37.5% of countries reported shortages of methadone or buprenorphine supplies. Participants of 41% of countries reported partial discontinuation of harm-reduction services such as needle and syringe programs and condom distribution. Fifty-seven percent of overdose prevention interventions and 81% of outreach services were also negatively impacted.Conclusions: Participants reported that SUD treatment and harm-reduction services had been significantly impacted globally early during the COVID-19 pandemic. Based on our findings, we highlight several issues and complications resulting from the pandemic concerning people with SUDs that should be tackled more efficiently during the future waves or similar pandemics. The issues and potential strategies comprise the following: (1) helping policymakers to generate business continuity plans, (2) maintaining the use of evidence-based interventions for people with SUDs, (3) being prepared for adequate medication supplies, (4) integrating harm reduction programs with other treatment modalities, and (5) having specific considerations for vulnerable groups such as immigrants and refugees.

Personality disorders (PDs) would be associated with an unhealthy lifestyle. To date, however, there have not been sufficient studies on the relationship between them. This study aimed to investigate the association between personality disorders and an unhealthy lifestyle by using an analytical cross-sectional study. We selected 1538 married women based on the multistage cluster sampling method. We used the Millon Clinical Multiaxial Inventory (MCMI) and Lifestyle Questionnaire (LSQ). Apart from descriptive statistics, a one-sample t-test, multivariate analysis, and structural equation modeling were used. Analysis of the data suggested that negativistic (β= -0.321), schizotypal (β= -0.285), schizoid (β= -0.159), borderline (β= -0.136), melancholic (β= -0.079) PDs had a significant association with an unhealthy lifestyle, respectively. Cluster A personality disorders were prone to an unhealthy lifestyle more than the other two clusters.

Objective: Psychosis is still among the most debilitating and severe mental disorders. The main objective of the present study was to investigate the estimated prevalence of psychotic disorders and finding the main predictors of psychotic disorders among Iranian children and adolescents. Method: Our total sample consisted of 30 553 individuals (49% males and 51%females) from 30 provinces of Iran, aged between 6 and 18 years, who were selected via cluster sampling method from urban and rural areas of all provinces. The data were analyzed using descriptive statistical analysis and multiple logistic regression method. Results: The results of multiple regression analysis showed that prevalence estimate of psychotic disorders was 0.25%. It was 0.3% and 0.2% in males and females, respectively. The age of 10-14 (OR = 2.24; 95% CI, 1.11-4.55) and the age of 15-18 (OR = 3.42; 95% CI, 1.74-6.75) were significant positive predictors, whereas none of the demographic variables were predictors for psychotic symptoms. Conclusion: This research highlights the main predictors of psychosis in children and adolescents. The study design also allowed a better understanding of predictors of psychotic disorders. The assessment of the prevalence of psychiatric disorders, particularly their comorbidities, may help to prevent mental illnesses in children and adolescents.

Objective: Millon Clinical Multiaxial Inventory (MCMI) is one of the most widely used clinical tools in research studies and clinical settings. MCMI was revised 4 times and its last version was published in 2015. All previous versions of MCMI have been translated to Persian and validated and have been frequently used by Iranian clinicians or researchers. Thus, this study provides the Persian version of the last version of this popular inventory for clinical or research purposes. Method: The participants of this psychometric study were selected by combining purposeful and convenience sampling methods among inpatients and outpatients who referred to Roozbeh hospital from 2018 to 2019. After data screening by statistical methods and Validity Scales based on MCMI-IV profile, 400 participants’ profiles were analyzed to estimate the psychometric properties of the Persian Version of MCMI-IV. MCMI-IV, the Structured Clinical Interview for DSM-5 (SCID-5), and the Brief Symptoms Inventory (BSI) were used for clinical data gathering. Content Validity Ratio (CVR), Correlational Coefficients, Kappa Agreement, Spearman Brown Coefficient, and Cronbach Alpha were performed for data analysis. Results: According to the results of data analysis, the psychometric properties for MCMI-IV were estimated as follows: the content validity index (CVI, 0.29 to 0.99), criterion validity (0.13 to 0.40), convergent validity (-0.35 to 0.72), The Cronbach’s alpha for the personality scales was 0.48 to 0.90, the Spearman-Brown coefficient was from 0.49 to 0.90, and test-retest reliability was from 0.51 to 0.86. Conclusion: The psychometric properties of the Persian version of MCMI-IV, including validity and reliability indexes, are appropriate and in line with the findings of its original version.

Background and Aim: Psychiatric disorders in children and adolescents impose high costs on individuals, families and society, and are associated with significant problems in the future. The purpose of this study was to conduct the epidemiological study on psychiatric disorders in children between 6 and 18 years of age in Kurdistan Province in 2016. Material and Method: This cross-sectional study was conducted in Kurdistan Province in 2016. Using random cluster sampling and systematic method, 1016 people were selected and examined for psychiatric disorders by using a digital version of the K-SADS. Result: The results showed that the prevalence of psychiatric disorders in the children and adolescents in Kurdistan Province in 2016 was 33.8% (34.4% of the boys and 33.1% of the girls). Anxiety disorders (21.9%) and behavioral disorders (16.3%) had the highest prevalence rates. Abuse disorders (0.7%) and psychotic disorders (0.9%) had the lowest prevalence rates respectively. The highest prevalence rates belonged to attention deficit hyperactivity disorder (11.6%), oppositional defiant disorder (8.9%) and specific phobia (8.8%) respectively. Autism disorders (0.1%), substance use disorders (0.1%) and incopresis (0.1%) had the lowest prevalence rates. Conclusion: At least 33% of the children and adolescents in Kurdistan Province needed psychiatric outpatient and inpatient services. Awareness of this issue is essential to develop policies on prevention of mental illness, promotion of general health and provision of mental health services to people in Kurdistan Province. We should consider mental disorders of childhood and adolescence as a key risk factor for the future psychiatric problems.

Background and Aim: Psychiatric disorders in children and adolescents impose high costs on individuals, families and society, and are associated with significant problems in the future. The purpose of this study was to conduct the epidemiological study on psychiatric disorders in children between 6 and 18 years of age in Kurdistan Province in 2016. Material and Method: This cross-sectional study was conducted in Kurdistan Province in 2016. Using random cluster sampling and systematic method, 1016 people were selected and examined for psychiatric disorders by using a digital version of the K-SADS. Result: The results showed that the prevalence of psychiatric disorders in the children and adolescents in Kurdistan Province in 2016 was 33.8% (34.4% of the boys and 33.1% of the girls). Anxiety disorders (21.9%) and behavioral disorders (16.3%) had the highest prevalence rates. Abuse disorders (0.7%) and psychotic disorders (0.9%) had the lowest prevalence rates respectively. The highest prevalence rates belonged to attention deficit hyperactivity disorder (11.6%), oppositional defiant disorder (8.9%) and specific phobia (8.8%) respectively. Autism disorders (0.1%), substance use disorders (0.1%) and incopresis (0.1%) had the lowest prevalence rates. Conclusion: At least 33% of the children and adolescents in Kurdistan Province needed psychiatric outpatient and inpatient services. Awareness of this issue is essential to develop policies on prevention of mental illness, promotion of general health and provision of mental health services to people in Kurdistan Province. We should consider mental disorders of childhood and adolescence as a key risk factor for the future psychiatric problems.

Objective: Considering the impact of rapid sociocultural, political, and economical changes on societies and families, population-based surveys of mental disorders in different communities are needed to describe the magnitude of mental health problems and their disabling effects at the individual, familial, and societal levels. Method: A population-based cross sectional survey (IRCAP project) of 30 532 children and adolescents between 6 and 18 years was conducted in all provinces of Iran using a multistage cluster sampling method. Data were collected by 250 clinical psychologists trained to use the validated Persian version of the semi-structured diagnostic interview Kiddie-Schedule for Affective Disorders and Schizophrenia-PL (K-SADS-PL). Results: In this national epidemiological survey, 6209 out of 30 532 (22.31%) were diagnosed with at least one psychiatric disorder. The anxiety disorders (14.13%) and behavioral disorders (8.3%) had the highest prevalence, while eating disorders (0.13%) and psychotic symptoms (0.26%) had the lowest. The prevalence of psychiatric disorders was significantly lower in girls (OR = 0.85; 95% CI: 0.80-0.90), in those living in the rural area (OR = 0.80; 95% CI: 0.73-0.87), in those aged 15-18 years (OR = 0.92; 95% CI: 0.86-0.99), as well as that was significantly higher in those who had a parent suffering from mental disorders (OR = 1.96; 95% CI: 1.63-2.36 for mother and OR = 1.33; 95% CI: 1.07-1.66 for father) or physical illness (OR = 1.26; 95% CI: 1.17-1.35 for mother and OR = 1.19; 95% CI: 1.10-1.28 for father). Conclusion: About one fifth of Iranian children and adolescents suffer from at least one psychiatric disorder. Therefore, we should give a greater priority to promoting mental health and public health, provide more accessible services and trainings, and reduce barriers to accessing existing services.

Objective: Body mass index undergoes a substantial change in some psychiatric disorders. This study aimed to explore the status of body mass index (BMI) in different psychiatric disorders in a national survey among children and adolescents and to identify the role of gender in this regard. Method: A total of 30 532 children and adolescents were randomly selected using cluster sampling method with equal blocks of 3 age groups and 2 genders. Psychiatric disorders were assessed using a standardized face-to-face diagnostic interview of Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (KSADS-PL), and Body Mass Index (BMI) was measured for each participant. Results: In this study, 22 730 children and adolescents (109 46 boys and 11784 girls), with valid data of BMI, completed the KSADS-PL interview. The prevalence of psychiatric disorders was 21.2% among underweight participants, 22.8% among overweight participants, and 22.2% among obese participants, which was significantly higher than normal weight participants with 19.6% (X2 = 17.55; p = 0.001). In boys’ subgroup, depression and separation anxiety were mostly seen among the underweight category, while tic disorder was mostly seen in the obese category. In girls’ subgroup, on the other hand, generalized anxiety was mostly observed in the underweight category, while oppositional defiant disorder (ODD), depression, and mental retardation were mostly observed in the obese category. In total, the highest mean BMI rates were among the children and adolescents with alcohol abuse disorder, mania, and panic disorder. However, the lowest BMI rates were among those with attention deficit hyperactivity disorder (ADHD), separation anxiety disorder (SAD), and enuresis. Conclusion: This study gives an overall picture of BMI status in different psychiatric disorders according to gender. Furthermore, in a multidisciplinary approach, the results of this study drew the attention of child psychiatrists to the status of BMI in their clients.

Objective: the aim of the present study was the estimation of validation and reliability test of ASSIST instrument in Iran. Method: our research populations were Iranian alcohol and drugs users and abusers in the year 1390 that had referred to rehabilitation camps and addiction treatment centers for self-improving. Sample sizes of 2600, average age 36/5, were selected by cluster random sampling in eight provinces. The ASSIST and demographic form exercised for all of sample group. Also in order to validity estimation, 300 number of main sample we interviewed by ASI, SDS, DAST and DSM-IV criteria. Findings: ASSIST reliability estimated by Cronbach’s alpha for all of domains was between %79 to %95. Data analyses showed fair criteria, construct, discriminate and multi dimension validity. These types of validity for other domains were Discriminative validity of the ASSIST was investigated by comparison of ASSIST scores as groupes of dependence, abuser and user. There were significant confirmation between this scores and DSM-IV scores. Construct validity of the ASSIST was investigated by statistical comparison with health scores. ASSIST's cut off points classify clients in 3 categories in term of intensity of addiction. Conclusion: we surely recommend researchers to use this instrument in research and screening purposes or other situations in Iran.

Objectives: The aim of the present study is to construct and norm-find a rating scale in elderly stressors Methods & Materials: We prepared a checklist including 100 items based on stressors scales and questionnaires, elderly problem checklists, sciences index and reference, interview with professional experts and elderly. The checklist was reduce to 45 items after review by experts and then to 40 items after initial analyses (pilot execution). Our Research population was total Elderly aged above 60 years old that had used insurance services in the year 1390. Sample sizes of 300 were selected by purposeful sampling and were interviewed by the use of target scale. 30 elderly of the sampling were retested by the target scale and test by holms and rahe scale and GHQ after 2 weeks. Results: Data analyses shows 6 factors that explain 68.47% of the total variance. The scale validity approved by content validity and correlation between scale scores and GHQ subscales confirmed construct validity of the scale. Scales reliability estimated by variety of methods, by Cronbach’s alpha is 0.95, by spearman brown is 0.84, test-retest is 0.79 and by pair form shows 0.81. Scale’s cut off point classify elderly in 5 category in term of intensity of stress include very low, low, moderate, sever and very sever. Conclusion: We recommend using this scale with confidence in research and screen purpose or other situation.

Background: The symptoms of conduct disorder and ADHD (attention deficit hyperactivity disorder) have many overlaps. These two disorders are considered to be the two most common psychiatric disorders among school aged children. It is notable to consider that when ever one of these disorders is present as the primary disorder with clinical manifestations, the other is believed to co morbid and coexisted with the first disorder. The present study was designed to develop a standard scale for diagnosis and grading of these disorders in the elementary schools children. Methods: This study was performed on a sample of 800 male and female elementary school children, who were selected through a normalized cluster sampling procedure in Tehran. The scale was administered to the student via their teachers, as well as the relevant professionals and the obtained results were gathered for further analysis. Findings: Factor analysis showed that 3 factors, dysthymic, aggressiveness, and oppositional defiant, could be involved in conduct disorder rating scale and the 3 factors, lavk of attention, hyperactivity, and aggression could be involved in ADHD rating scale. These 6 factors explained 0.69 of total variance. The criteria validity coefficient for conduct disorder rating scale was 0.79, and for attention deficit hyperactivity disorder rating scale was 0.76. Cronbakh’s alpha coefficient, spilt half coefficient, and test-retest coefficient for conduct disorder rating scale was 0.95, 0.87, and 0.91, and for attrition deficit hyperactivity rating scale was 0.96, 0.82, and 0.92 Conclusion: Based on the obtained factors which were approved in their content by relevant professionals, and considering the validity and reliability of the scale, it seems that the scale is suitable enough to be considered as a screening instrument in the clinical and research contexts. Key words: Developing scale, Normalizing, Conduct disorder, Attention deficit hyperactivity disorder.

Objective: Evaluation and diagnosis are determinants of treatment outcome; therefore, diagnostic tools should be accurate. The purpose of the present research is construction and norm-finding of a rating scale for the diagnosis of attention deficit hyperactivity disorder (ADHD). Method: A checklist based on behavioral symptoms of ADHD from clinical sources was constructed, based on interview with patients and the medical records. After being studied by specialists, this checklist was reduced to items and arranged in a rating scale format. The study population included Tehran's elementary school students (boys and girls) from which a sample of 800 children was chosen in a random-cluster manner. Then teachers were asked to rate the students according to the scale characteristics. After two weeks, the subjects were tested and interviewed using a corrected form of the scale, the rating scale of Swanson, Nolan and Pelham (SNAP-IV) and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). After data analysis the scale was reduced to 23 items. Results: According to the results of the analysis, the scale had two factors: The first factor was hyperactivity that explained 37.41%, and the second factor was attention deficit that explained 33.78% of the total variance . Cronbach's alpha was 0.96 and the alpha of the two subscales, hyperactivity and attention deficit, was 0.94 and 0.96, respectively. Spearman-Brown Coefficient was 0.78 and scale coefficient correlation with a similar from (SNAP-IV) was 0.82. Criterion validity coefficient of the scale was 0.76 and the content validity of the scale was confirmed by the experts. According to sensitivity analysis of the trait, the cutoff point of the scale was 35. Considering the above findings, we can safely use the above scale in clinical studies. Conclusion: Considering the obtained values in the psychometric indexes and the consensus among specialists on the basis of test content validity and also considering the calculation methods of the cutoff point, we can safely use this scale in different clinical situations, epidemiological studies, and other researches and also for studying ADHD children especially when teachers deal with evaluation of children's behavior.

Background: SNAP-IV rating scale developed by Swanson, Nolan and Pelham to diagnose Attention Deficit Hyperactivity Disorder (ADHD). The aim of this study was determination of psychometrics specifications of this scale. Methods: This was a methodological, applied and validity assessment study. One thousand students at 7 to 12 years of age in primary school in Tehran city were selected by cluster sampling. Then the students' teachers were asked to complete rating scale to consider behavior of their student. Thirty staff members of sample group were retested with SNAP-IV and was interviewed with DSM-IV. Data were analyzed by factor analysis, Pearson correlation coefficient, Kolmogrov-Smirnov and Behrens-Fisher t tests. Findings: Criterion validity was 55%. Factor analysis was detected 2 factors that explain 71% of the total variance. Reliability coefficient by test-retest was 88%, internal consistency coefficient was 95%, and Split-half coefficient was 73%. Cut-off point in scale and subscale was 2.08, 2.10, and 2.37 respectively. Conclusion: The SNAP-IV rating scales have fit psychometrics characters. Therefore, it is useable in screen study and therapeutic conditioning. Key words: Rating scale, Attention deficit-hyperactivity disorder, Reliability, Validity, Cut-off point.

Objective: Evaluation and diagnosis are determinants of treatment outcome; therefore, diagnostic tools should be accurate. The purpose of the present research is construction and norm-finding of a rating scale for the diagnosis of attention deficit hyperactivity disorder (ADHD). Method: A checklist based on behavioral symptoms of ADHD from clinical sources was constructed, based on interview with patients and the medical records. After being studied by specialists, this checklist was reduced to items and arranged in a rating scale format. The study population included Tehran's elementary school students (boys and girls) from which a sample of 800 children was chosen in a random-cluster manner. Then teachers were asked to rate the students according to the scale characteristics. After two weeks, the subjects were tested and interviewed using a corrected form of the scale, the rating scale of Swanson, Nolan and Pelham (SNAP-IV) and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). After data analysis the scale was reduced to 23 items. Results: According to the results of the analysis, the scale had two factors: The first factor was hyperactivity that explained 37.41%, and the second factor was attention deficit that explained 33.78% of the total variance . Cronbach's alpha was 0.96 and the alpha of the two subscales, hyperactivity and attention deficit, was 0.94 and 0.96, respectively. Spearman-Brown Coefficient was 0.78 and scale coefficient correlation with a similar from (SNAP-IV) was 0.82. Criterion validity coefficient of the scale was 0.76 and the content validity of the scale was confirmed by the experts. According to sensitivity analysis of the trait, the cutoff point of the scale was 35. Considering the above findings, we can safely use the above scale in clinical studies. Conclusion: Considering the obtained values in the psychometric indexes and the consensus among specialists on the basis of test content validity and also considering the calculation methods of the cutoff point, we can safely use this scale in different clinical situations, epidemiological studies, and other researches and also for studying ADHD children especially when teachers deal with evaluation of children behavior.

Objective: This was the first national epidemiological study on oppositional defiant disorder (ODD) in Iran, which provided new information about the prevalence, comorbidities, and sociodemographic predictors of ODD. Methods: Data from a face-to-face household survey of 30,532 children and adolescents aged 6-18 years were collected from across all 31 provinces of Iran using a multistage cluster sampling design. The Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS-PL) was used in this study. Results: The lifetime prevalence of ODD was found to be 3.9%. ODD was significantly more common in boys than girls and appeared in late adolescence more frequently than in childhood. A lower prevalence of ODD was found among participants who lived in rural areas. ODD is highly likely to co-occur with attention deficit hyperactivity disorder, separation anxiety disorder, generalized anxiety disorder, and depressive disorders. Conclusions: The findings of this national population-based study confirm and extend previous findings on the prevalence, comorbidities, and sociodemographic predictors of ODD.