BackgroundThe nation-wide epidemiological survey of psychiatric disorders in term of lifetime prevalence is not adequately known in Iran. The prevalence of lifetime psychiatric disorders was estimated among the population of aged 18 and over on gender, age group, educational level, occupational status, marital status, and residential area.MethodsThe subjects were 25,180 individuals selected through a clustered random sampling method. The psychiatric disorders were diagnosed on the bases of Diagnostic and Statistical Manual of Mental Disorders-IV criteria. It is the first study in which the structured psychiatric interview administered to a representative sample of the Iranian population age 18 and over by the 250 trained clinical psychologist interviewers. The data was entered through EPI-Info software twice in an attempt to prevent any errors and SPSS-11 statistical software was also used for analyses. The odds ratios and their confidence intervals estimated by using logistic regression.Results and DiscussionThe prevalence of psychiatric disorders was 10.81%. It was more common among females than males (14.34% vs. 7.34%, P < 0.001). The prevalence of anxiety and mood disorders were 8.35% and 4.29% respectively. The prevalence of psychotic disorders was 0.89%; neuro-cognitive disorders, 2.78% and dissociative disorders, 0.77%. Among mood disorders, major depressive disorder (2.98%) and among anxiety disorders, phobic disorder (2.05%) had the higher prevalence. The prevalence of psychiatric disorders among divorced and separated 22.31%; residents of urban areas 11.77%; illiterates 13.80%; householders 15.48%; unemployed 12.33% that were more than other groups.ConclusionThe mental health pattern in Iran is similar to the western countries, but it seems that the prevalence of psychiatric disorders in Iran may be lower than these countries.It is estimated that at least about 7 millions of Iranian population suffer from one or more of the psychiatric disorders. It shows the importance of the role of the psychiatric disorders in providing preventive and management programs in Iran.

Cognitive dysfunction is common in multiple sclerosis (MS) and validated batteries are limited in languages other than English. We aimed to translate, cross-culturally adapt, validate, and assess reliability of Minimal Assessment of Cognitive Function in MS (MACFIMS) in Persian. The MACFIMS is a well-constructed battery in the MS literature. The battery was adapted to Persian in accordance with available guidelines. A total of 158 MS patients and 90 controls underwent neuropsychological assessment. For reliability assessment the battery was re-administered in a subset of 41 patients after a short interval using alternate forms to mitigate practice effects (approximately 10 days). Patients performed significantly worse than controls in all cognitive tests, supporting discriminant validity of our adapted battery. Approximately half of patients (46.2%) showed cognitive impairment as defined by the impairment in two or more tests. The Symbol Digit Modalities Test was the most robust test by ROC analysis. All tests showed acceptable to good level of reliability. This is the first validation of gold-standard cognitive testing in Persian. The Persian MACFIMS shows nearly the same psychometrics as its English counterpart.

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Use of reliable screening and diagnostic tests for assessment of cognitive abilities in neurological patients is rapidly increasing in clinical practice. This is due to the increase in the prevalence of dementias and the raised awareness of cognitive impairment in neurological disorders. Two well-known bedside screening tests for dementias among the English-speaking population are the Mini Mental State Examination (MMSE) and Addenbrooke’s Cognitive Examination (ACE). However, such tests have not been developed for the Persian-speaking population, which is estimated at 120 million worldwide. In this study we developed the Persian ACE and MMSE, adopted from the English version. We also assessed the sensitivity and specificity of these tests in the identification of Alzheimer’s disease (AD) and mild cognitive impairment (MCI). We found that the Persian ACE at a cutoff point of 84, has a sensitivity of 93% and a specificity of 91% in discriminating MCI from a normal population; at 78, the test has a sensitivity of 73% and a specificity of 93% in differentiating MCI from AD, and at a similar cutoff point has a sensitivity of 100% and specificity of 96% in discriminating AD from a normal population. We conclude that the Persian ACE is a valuable tool in clinical practice in the Persian-speaking population.