Mindfulness-based Cognitive Therapy for Generalised Anxiety Disorder: a Systematic Review and Meta-analysis

BACKGROUND: Generalised anxiety disorder (GAD) has harmful effects on physical and mental health and quality of life. Mindfulness-based cognitive therapy (MBCT) is a treatment option for GAD. This meta-analysis was conducted to determine the effectiveness of MBCT on GAD. METHODS: Two authors independently performed the eligibility, quality assessment, and data extraction processes, and consensus was reached in case of discrepancies. Electronic databases were searched for eligible studies (randomised controlled trials, randomised trials, cluster randomised controlled trials, and clinical trials) up to November 2018 using keywords: mindfulness-based cognitive therapy OR mindfulness based cognitive therapy OR MBCT AND general anxiety disorder OR GAD*. The methodological quality of studies was assessed using the revised Jadad scale. Cohen's formula was used to determine the effect size based on the mean and standard deviation of the changes in the study groups before and after the intervention. RESULTS: Six studies that compared the effectiveness between MBCT and controls were included for analysis. The mean revised Jadad score of the six studies was 4.3 (range, 3-6). The overall mean effect size was -0.65. The funnel plot of effect sizes in relation to the effect size standard error showed a symmetrical distribution. Compared with controls, MBCT significantly improved the treatment outcome of GAD in all studies, except one. CONCLUSION: MBCT was effective for treating GAD

Subsidization of substance use treatment: Comparison of methadone maintenance treatment and abstinence-based residential treatment in Iran

Background: Subsidization is a policy to encourage the purchase and use of goods and services and to promote their affordability for the poor. The Welfare Organization of Iran subsidizes substance use treatment in order to increase coverage and adherence to treatment. Objectives: This study aimed to answer the following questions: is the model efficient? Has the policy resulted in increased coverage and higher adherence to substance use treatment? How could the model be improved? Methods: We compared two types of substance use treatments of abstinence-based residential program and outpatient methadone maintenance. Based on their severity of addiction and retention in treatment clients who benefited from subsidization were compared with other clients. Therefore, 109 clients, 78 from methadone maintenance and 31 from residential abstinence-based programs were interviewed. Results: Subsidization had an encouraging effect on clients to enter substance use treatment in both treatment programs (P = 0.001). However, we were unable to find evidence that subsidization helped retention in the treatment (P = 0.389), or that concomitant use of illegal substances in clients on methadone maintenance was lower (P = 0.500). Based on economic status of clients (P = 0.05) their criminal record (P = 0.001), length of use of substances (P = 0.05), and comorbid psychiatric conditions (P = 0.05), it was evident that assignment to subsidization in methadone maintenance services was significantly more reasonable, while it was almost random in abstinence-based residential facilities assignment. Conclusions: The current model of substance use treatment subsidization is not efficient. Addiction severity subscales and socioeconomic status of clients could be considered appropriate factors for assignment to the subsidization program. Copyright © 2020, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited

Effects of Kerack used in addict iranian people on fertility of adult mice

Background: Infertility is one of the most serious social problems. Illicit drug use can be an important cause of male factor infertility. Kerack which its use is rising up in Iran refers to a high purity street-level heroin (heroin Kerack). Heroin Kerack used in Iran is an opioid and has harmful effects on body organs. The aim of this study is to investigate the effects of Kerack used in Iran on fertility adult mice. Methods: In this study, 25 male mice were divided into five groups (control, sham and three experimental). Experimental groups of Kerack-dependent mice (received ascend-ing dose of Kerack for seven days) were divided into three categories, experimental I, II and III. Experimental I was given Kerack at a dose of 5 mg/kg, experimental II 35 mg/kg and experimental III 70 mg/kg, intraperitoneally twice a day for a period of 35 days. The sham group received normal saline and lemon juice (2.6 μl/ml) whilst the control group just received water and food. Mice were then scarified and sperm removed from cauda epididymis were analyzed for sperm count, motility, morphology (normal/abnormal) and viability. Testes were also removed, weighed and processed for light microscopic studies. Results: The results showed that fertility were significantly decreased in addicted mice compared with control groups (P�0.05). Epididymal sperm parameters and thickness of seminiferous epithelium were significantly decreased in experimental groups (dose-dependent) compared with sham and control groups (P�0.05). Gonadosomatic index was significantly reduced with high dose Kerack injected (70 mg/kg) in comparison with control testes (P�0.05). Conclusion: This study has shown the deleterious effects of Kerack used in addicted Iranian people on fertility for the first time. This effect is especially on epididymal sperm parameters in adult mice

Children addiction treatment and rehabilitation residential centers in Iran: report of a pilot study

Background: Until recently, there was no center specialized for the treatment and rehabilitation of children with substance use disorder in Iran. However, recently, a new initiation in the form of Children Addiction Treatment and Rehabilitation Residential Centers (CATRC) has been piloted in Iran. This brief report is an early evaluation of the performance of CATRC in the treatment and rehabilitation of children with drug use/use disorder. Methods: The evaluation on pilot project was done in two CATRCs established in the city of Zahedan. Subjects were 107 children between the ages of 0 and 18 with a history of drug use or drug use disorder sent to CATRCs to fulfill a judicial decision or by the Welfare Organization. Results: Out of 88 children discharged from the two CATRCs during the 1.5 years since their establishment, there were no relapses or criminal activity in 97.7 of children. Conclusion: this study showed early evidence of the positive performance of CATRCs in Iran. © 2019, © 2019 Taylor & Francis Group, LLC

Drug use among Iranian population: results of a national household survey

Objective: The aim of this study was to assess the prevalence of drug use among Iranian general households. Methods: A cross-sectional household survey was conducted in a sample of 61,000 individuals between 15 and 64 years in 2017 urban areas and 623 rural areas of 31 provinces of Iran from February to November 2015. Multistage cluster random sampling method was used to draw the sample. Data were collected using a self-administered data collection form, which elicited demographic data, and data related to report of any kind of drug use or illicit use of pharmaceuticals in the past week, past month, past year, and ever life. Different measures were taken to ensure the accuracy of the study results. Results: The study showed that 8.5 of the population reported ever use of any drugs, and 4.3 reported past-week use of any drugs. Conclusions: This study showed that the drug use prevalence in Iran was more than twice the previous estimations. © 2019, © 2019 Taylor & Francis Group, LLC

Lifetime and past-month substance use and injection among street-based female sex workers in Iran

Background: Street-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran. Methods: We recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95 confidence intervals (CI) were reported. Results: Lifetime and past-month non-injection drug use were reported by 60.3 (95 CI 51, 84) and 47.2 (95 CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6 (95 CI 6.9, 10.7) and 3.7 (95 CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95 CI 1.07, 3.74), temporary marriage (AOR 4.31 1.79, 10.40), had > 30 clients per month (AOR 2.76 1.29, 5.90), ever alcohol use (AOR 3.03 1.92, 6.79), and history of incarceration (AOR 7.65 3.89, 15.30). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 1.20�6.20), ever incarceration (AOR 5.06 2.48�10.28), and ever group sex (AOR 2.44 1.21�4.92). Conclusions: Non-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran. © 2021, The Author(s)