atefeh zandifar

Chronic pain is used to describe non-cancerous and refractory pain (1). Chronic pain is a pain that has continued every day for at least three months for the past six months (5). This pain affects the quality of life, so it is necessary to identify and pay attention to the role of chronic pain in mental and physical health. Psychological factors are indirectly related to the process of pain perception. As pain becomes more chronic, the role of psychological factors in the spread and persistence of pain becomes more prominent than the role of biological factors. In this regard, researchers have emphasized the importance of the locus of control (7). Belief in the extent to which a person controls their circumstances, behavior, and thoughts can be considered a factor in determining the severity of pain (8). Numerous psychosocial factors can affect the severity of pain. Studies have shown that emotion regulation and its components directly affect the intensity, frequency and duration of pain perception (11). Emotion regulation is a set of processes that control and evaluate a person's emotional reactions and even change these reactions if necessary, so that the person functions properly (12). The results of studies show that there is a relationship between the locus of control and regulation of emotion. Patients with an internal control source, experience less pain intensity than patients with an external control source. Patients with impaired emotion regulation also experience greater pain intensity (5). On the other hand, most studies have examined the relationship between these components in a correlational manner, but the mediating role of emotion regulation in the relationship between loci of control, pain intensity and the interactive relationship of variables have not been investigated. According to the above points, the present study aimed to investigate the mediating role of emotion regulation in the relationship between locus of control and pain intensity in chronic pain patients

The method of this research is descriptive and correlational. The statistical population of this study was all patients with chronic pain of Esfarayen in 2019. The sample consisted of 200 patients with chronic pain aged 25 to 45 years who were selected by available sampling method from Imam Khomeini Hospital, specialized clinic of medical sciences and health centers of Shahid Shokouhi, Shahid Montazeri and Imam Reza (AS). Brief pain inventory, health locus of control scale and emotion regulation questionnaire were used as research tools. Correlation test, regression analysis and path analysis were used to analyze the findings. Data were analyzed using SPSS-23 software.

Based on the findings, the mediating role of emotion regulation (re-evaluation- suppression) in the relationship between the source of internal control and pain intensity was confirmed. In this way, individuals with a source of internal control were more likely to use an adaptive reassessment strategy and less of a maladaptive repression strategy, and consequently experienced less pain intensity. Furthermore; In this study, the mediating role of emotion regulation (re-evaluation-suppression) in the relationship between external control source and pain intensity was also confirmed. According to this finding, people with an external source of control were more likely to use a maladaptive suppression strategy that leads to more severe pain.

The results of this study supported the mediating role of emotion regulation in the relationship between locus of control and pain intensity. This finding indicates the importance of emotion regulation in explaining the severity of pain in patients with chronic pain. The findings of this study showed that emotion regulation (re-evaluation - suppression) has a mediating role in the relationship between external control source and pain intensity in patients with chronic pain. Incompatible emotion management strategies, such as repression or catastrophe, lead to reduced physical and social activity, psychological disorders, and feelings of helplessness and lack of control. So that the feeling of lack of control, in turn, intensifies the experience of pain. Thus, people come to believe that they have no sense of control and form a vicious circle (5). One of the most fundamental reasons people turn to dysfunctional emotional regulation strategies such as avoiding, repressing, criticizing, blaming themselves or others, and paving the way for the formation of chronic psychological disorders, including chronic pain, is the belief in lack of internal control (30). Some of the beliefs of most patients with chronic pain are that "my illness is the fault of my spouse, child or boss", "my pain is terrible", "I am going crazy" (31). As a result, patients engage in a maladaptive emotional behaviors and strategies, such as criticizing, blaming themselves or others, or even suppressing their emotions, in order to gain a sense of control over their illness and pain (30). Patients with chronic pain lose more control over the disease and their condition, which leads to more pain. Emotion regulation (re-evaluation - suppression) mediates the relationship between the source of internal control and pain intensity in people with chronic pain. Patients who use adaptive emotion management strategies in the face of problems, ie; problem-oriented strategy, define stressors, and therefore, such people experience fewer negative outcomes and feel more in control of their condition and experience less pain intensity. These patients are more successful in solving problems and dealing effectively with stress caused by life events, and this effective coping and satisfaction in solving the problems makes them feel in control of the stress which caused by important life events. The source of internal control is related to accepting pain and being prepared for change. In general, self-regulation is one of the factors that can be effective in causing or controlling pain in patients. People with chronic pain will be able to prevent information bias in the processing of information that leads to the experience of negative emotions by adjusting their emotions through the relationship between pains and adapt more effectively to their illness (33). Therefore, if the training program of these patients is accompanied by emotion regulation strategies, it can help reduce the severity of pain in these patients.

The present study aims to determine the fear of COVID-19 in the elderly newly diagnosed with cancer referred to selected hospitals affiliated to Alborz University of Medical Sciences.

In this longitudinal study, 174 elderly people newly diagnosed with cancer referred to the selected hospitals participated, who were selected using a continus sampling method. To collect data, a demographic form, the Abbreviated Mental Test, and the 7-item fear of COVID-19 scale were used before diagnosis, one month after, and two months after. The data were analyzed in SPSS software, version 22.

Fear of COVID-19 level at the time of cancer diagnosis was moderate (mean score: 17.69±4.74). In the second stage (one month after the diagnosis), the mean score was 14.26±4.09. In the third stage (two months after diagnosis), the mean score was 11.81±4.13. Fear of COVID-19 at the time of cancer diagnosis was significantly different based on marital status (P=0.049), underlying diseases (P=0.014), and perception of health (P=0.004). 

Fear of COVID-19 can disrupt the process of treatment and chemotherapy in elderly patients with cancer. It is recommended to develop interventions to improve the mental health of the elderly with cancer during the pandemic.

Domestic violence is recognized as a global health problem. In recent years, understanding the factors affecting violence against women has become one of the most prominent issues.

This study aimed to identify the relationship between the structural determinants of health and domestic violence against pregnant women.

This descriptive cross-sectional study was conducted on 560 volunteer pregnant women, aged 28 - 35 weeks, who were referred to healthcare centers affiliated with Shahid Beheshti University of Medical Sciences in Tehran, Iran, during 2021 - 2022, using a multistage cluster sampling method. The data collection tools used in this research included questionnaires on demographic and gynecologic/obstetric factors, socioeconomic status, and domestic violence. The collected data were analyzed by measuring descriptive and inferential statistics using the chi-square test and multivariate logistic regression analysis.

Based on the results, more than 50% of women were subjected to domestic violence during pregnancy (66.3% emotional violence, 10.2% physical violence, and 9% sexual violence). Domestic violence showed a significant relationship with the majority of the structural determinants of health (P < 0.005). Based on the logistic regression model, demographic/obstetric and socioeconomic factors explained 73% and 85.3% of the variance in domestic violence, respectively. Certain structural social determinants of health acted as protective factors against domestic violence toward pregnant women, as the possibility of domestic violence was lower in women with high school education, working spouses, and high income (OR = 0.310, 0.217, and 0.255, respectively).

This study showed that more than half of Iranian women experienced domestic violence during pregnancy. To prevent adverse maternal and neonatal consequences, it is necessary to identify these women and introduce them to support centers

COVID-19 changed the global view of education in less than a few weeks and changed how students are taught worldwide. Online education, while having many advantages, also brings limitations and problems for some students. Therefore, this study was conducted to investigate the “level of concentration” and “full presence in the class” of perfectionist students in online education among the exceptionally talented students of the higher secondary school in Iran. This cross-sectional study was performed on 100 randomly selected exceptionally talented students of a higher secondary school in Karaj, Iran. The research tools included perfectionism and concentration skill questionnaires that were provided to students online. The findings showed no significant difference in the class’s level of concentration and full presence between students with different degrees of perfectionism (p=0.514 and p=0.247, respectively). However, due to the technical problems of online classrooms, 64% of students with high perfectionism were fully present in the classroom in less than 30 min. This rate was 47% for students with low perfectionism. It seems that due to the difference between face-to-face and virtual learning environments, holding online classes along with determining and setting the topics of lessons and training hours differently from face-to-face classes and shorter and more concise in creating an interactive atmosphere may be more useful.

The aim of this study was to determine the predictors of maternal blouse in the postpartum period based on social determinants of health of the World Health Organization (WHO) model.

This cohort study was conducted on 449 postpartum women who were referred to healthcare centers of Shahid Beheshti University of Medical Sciences. The sampling method was a multi-stage random method. The tools used in this research were demographic and gynecological characteristics questionnaire, socio-economic status questionnaire, depression anxiety and stress scale-21 (DASS-21), multidimensional scale of perceived social support (MSPSS) (multidimensional scale of perceived social support [MSPSS]), domestic violence questionnaire (DVQ), unhealthy behavior questionnaire. Postpartum blouse was also measured based on the Stein’s questionnaire. The data were analyzed using SPSS software, version 24.

The information of 449 pregnant women participating in the study was examined. The mean age of women was 26.96±4.46 years and their husbands’ mean age was 32.17±5.6 years. The path analysis results demonstrated that among the variables related to maternal blouse (one-path test), in the indirect path analysis, socio-economic status had the most negative effect on the maternal blouse and also in the direct path analysis, DASS21 showed the most negative effect on the maternal blouse (B=-0.19) and the unfortunate event had the most positive effect (B=0.18). Violence had the most positive effect on the maternal blouse (two-path test) (B=0).

Considering the importance of the role and the high prevalence of maternal blouse in the mental health of women after childbirth, it seems necessary to pay attention to these factors for prevention and screening in terms of timely diagnosis and necessary measures.

Mental health education aims to increase mental health literacy (MHL) and plays a crucial role on mental health of community members. However, its implementation in primary health care (PHC) faces obstacles and problems. Therefore, this study was conducted to explain the challenges of the public mental health education program with an emphasis on self-care in Iran's PHC.

This was a qualitative study with a content analysis approach. The research sample consisted of 20 stakeholders through purposive sampling with maximum diversity. This study was conducted in Tehran and Alborz, Iran. Data were collected through in-depth and semi-structured interviews and analyzed by Graneheim and Lundman approach.

By analyzing data, the challenges were categorized into six main themes and 15 categories. The six main themes included educational challenges, inefficiency of the educational method, unsuitable intersectoral collaboration, infrastructural challenges, inadequate resources and barriers to participation in education.

Given multidimensionality challenges and obstacles, reform and adoption of appropriate implementation methods using mental health experts seem necessary. Future research and policies could explore ways to optimize program implementation in PHC.

Severe mental disorders impose a significant burden of illness directly on the patient and their caregivers. In this study, the prevalence of suicidal ideation and the severity of depression in patients who received home care were evaluated in comparison with other patients who experienced usual outpatient care. 

The study design was cross-sectional and the sample was assigned in two groups. Structured scale and inventory were used to evaluate the prevalence of suicidal thoughts and severity of depression among the patients. Beck Depression Inventory and Ideation for Suicide Beck Scale were utilized for this evaluation. The study was conducted from June 2019 to June 2020.

The total number of participants in the study was 71 patients. The results of multivariate analysis showed that the observed difference between the two groups in all components and in the total score of Beck Suicide Scale and Beck Depression Scale was statistically significant. Regarding Ideation for Suicide Beck Scale, the mean in the home visit group was 0.94 (standard deviation (SD)= 4.24) and in the Treatment as Usual (TAU) group was 3.83(SD =5.44) (p-value=0.016). Regarding Beck Depression Scale, the mean in the home visit group was 6.14(SD= 7.75) and in the TAU group was 11.17(SD= 9.18) (p-value=0.015).

It seems that home care for patients with severe mental disorders may be more effective than outpatient care in reducing suicidal ideation and severe depression. The use of longitudinal and multicenter studies with larger sample sizes can be effective in assessing the impact of home care on improving indicators of suicidal ideation and severity of depression.

Pregnancy is a complex and vulnerable period that causes some challenges including the development of postpartum psychiatric disorders (PPDs) for women. Identifying the factors associated with these disorders can be effective in reducing maternal symptoms and supporting mother, child and family. The aim of this study was to identify the relationship between postpartum mental health and mediating social determinants of health in Iran.

In this systematic review, the Persian and English observational studies in Iran were obtained through advanced search in online databases, such as PubMed, Scopus, EMBASE, SID, Magiran, Psycinfo, and Google Scholar search engine in the period of January 2005 to August 5, 2021 using the following keywords: social determinants, mediating factors, social support, mental health, risk factors, postpartum, Iran, and their English equivalents through Mesh. Articles were selected based on the inclusion and exclusion criteria and quality assessment of articles was performed using the standard Newcastle-Ottawa Scale (NOS).

Out of 42 eligible articles (total sample: 39216), 40 articles examined the relationship between postpartum depression and 2 articles studied the relationship of maternal grief with some mediating social determinants. In general, these factors were classified into five categories, including midwifery and pregnancy-related factors, psychosocial conditions, factors related to postpartum status, behavioral factors and material status or conditions, and health care.

Mothers' mental health is affected by many underlying factors; Therefore, identifying the risk factors associated with mental disorders in this population based on the model of the WHO (World Health Organization), especially in the mediating area (Material and environmental conditions, Psychosocial, Behavioral factors, Health system) due to the extent of this area is very important.

Since schizophrenia was called the “disease of civilization” at the dawn of the 20th century, there has been controversy over its incidence and prevalence in low- and middle-income countries (1). Schizophrenia, as a highly disabling and under-recognized psychiatric disorder, puts a heavy economic burden on different societies. Inadequate health care services are often provided to patients with the disease and their families (2). Some schizophrenia researchers point to the need for reexamination in results for better prognosis of the disease in low- and middle-income countries due to methodological limitations in related studies, lack of evidence for the positive effects of some socio-cultural factors on the prognosis of the disease, and rapid socioeconomic changes in these countries in recent years that impaired the traditional family care system for people with schizophrenia (3).With the global spread of COVID-19, serious concerns have been raised about the possible increase in the prevalence of the disease in the coming decades for a variety of reasons (4). This point highlights the need to pay more attention to this severe mental health disorder and the need to increase vigilance for the symptoms of psychosis among people with COVID-19 (5).

Spironolactone (C24H32O4S), a potent mineralocorticoid receptor (MR) inhibitor, is a potassium-sparing diuretic that is traditionally used to treat fluid build-up in the body or for its anti-androgenic properties. Thisstudy isa double-blind, placebo-controlled, randomized clinical trial assessing the beneficial effects of spironolactone in addition to risperidone in improving negative symptoms of schizophrenia.

40patients with chronic schizophrenia, aged 18–60 years, were assigned to two groups: risperidone + spironolactone or risperidone + placebo. Risperidone was administered to both the spironolactone and placebo groups with a dose up to 6 mg/day throughout the trial. Spironolactone (C24H32O4S) was ordered 100 mg/day for the full 8-week course of the study. Patients were rated on the Positive and Negative Syndrome Scale (PANSS) at four timepoints: baseline, weeks two, four, and eight. The PANSS negative subscale score was the main objective.

PANSS negative,positive, and total scores showed significantly greater improvements in the spironolactone relative to the placebo group from baseline to the trial endpoint (P (Cohen’s d): 0.004 (0.96), 0.007 (0.90), and 0.042 (0.66), respectively). Similarly, ANOVA alsopresented significant time × treatment interaction effect for spironolactone on PANSS negative (F= 9.04; ηp2= 0.19; df= 1.38; P= 0.002), positive (F= 3.43; ηp2= 0.08; df= 2.72; P= 0.023), and total (F= 3.94; ηp2= 0.09; df= 2.05; P= 0.022) scores. However, spironolactone did not cause significant decrease in the general psychiatric pathology score of PANSS.

Our findings suggest the efficacy and safety of spironolactone as an adjunctive therapy to risperidone in improving the symptomsof schizophrenia.

In order to identify the underlying values ​​of choosing a spouse, this study has studied the experience of individuals on the verge of marriage. The present research has been done with a qualitative approach and with the grounded theory method. Participants in this study included 21 couples on the verge of marriage in Karaj who was selected by the purposeful selection method based on the principle of saturation. The data collection method in this study was a semi-structured interview with open and standardized questions and the data were analyzed and classified according to the approach of Strauss and Corbin's underlying theory. The findings showed the values ​​of the participants in choosing a spouse in 5 central categories: "criteria, expectations, goals, responsibility, and meaning". The central category of "criteria" has 6 dimensions: "moral virtues, personality and behavioral characteristics, emotional relationships, fit and similarity, physical attractiveness and the way of acquaintance", the central category of "expectations" has 3 dimensions of "being together, having a good family and issues" "Sex", the central category of "goals" has 5 dimensions: "Marriage needs, marriage concerns, peace and security, completion and change and formation of the family", the central category of "responsibility" with 1 dimension of "cooperation for material and spiritual independence" and the category " Meaning is dimensionless. The result of this research was the discovery of a core category called "love of the content of life" which explains the 5 central categories of values ​​in order to choose the right and conscious choice of a spouse.

Postpartum psychiatric disorders are a key concept in maternal-infant mental health, and determining the related factors is necessary. We aimed to determine the relationship between postpartum mental health and social-structural determinants of health in Iran.

In this systematic review, all Persian and English observational studies in Iran carried out through advanced search in online databases such as Medline, Scopus, Web of Science, EMBASE, SID and Magiran, as well as the Google Scholar between 2005 and 2020, using keywords of social determinants, structural factors, socio-economic status, risk factors, mental health, postpartum, Iran, and their English equivalents were obtained from MESH. Article quality was assessed using the standard Newcastle-Ottawa Scale (NOS).

Out of 56 eligible articles (sample size: 36,515), 49 articles reported the prevalence of postpartum depression and one article reported the prevalence of postpartum psychosis. The lowest and highest prevalence of postpartum depression was between 4.8-68.5% using the Edinburgh tool in 2014-2017 and using the Beck tool between 3-78.27% in 2013-2014. Structurally significant effective factors on postpartum depression were identified including mother's age, mother's education, father's education, mother's job, father's job, family economic status (income adequacy), ethnicity and race, social class, culture, and religion, and in the field of postpartum psychosis, age, level of education, and mother's job. The most common structural determinant related to postpartum mental health was education and the least factor was related to social class.

Due to the effects of numerous related factors on common postpartum mental disorders, it is suggested that longitudinal studies be conducted to investigate the role of all the known factors, especially Intermediate factors, on postpartum mental health.

During the relatively short period of COVID-19 pandemic, we have witnessed numerous psychiatric and psychosomatic problems among patients with this disease and different groups of people and health care staff (1). Growing concerns about the uncertainty of the situation, along with fear and changes in biological rhythm, have played an important role in the formation of psychosomatic symptoms associated with this disease (2). In addition, increased depression and anxiety and decreased quality of life and well-being in different parts of the world, compared to the time before the recent pandemic, have been reported (3).

Since the identification and global spread of COVID-19 in Wuhan, China to date (1 September 2020), more than 26,506,670 people worldwide have been infected with the disease and more than 876,677 people have died of the disease (1). Observing what has happened during this period and paying attention to the way governments have dealt with this recent situation in the long run have raised serious concerns about slow and late steps of governments from the beginning of the spread of the disease (2).

Creutzfeldt-Jakob disease (CJD) as a prion disease is an untreatable type of progressive neurodegenerative encephalopathy. Although no definitive case has been reported yet, here we report a case that given the history, course of symptoms, and recent dental practice, it is highly probable that it was caused by dental procedures

Case Report: 

The patient was a 52-year-old woman who has had memory problems gradually with forgetting the names of family members since 6 weeks prior to the visit and shortly after the dental procedure. She experienced progressive visual hallucinations accompanied by a sharp decline in cognitive, verbal, and motor abilities in just a few weeks. Finally, the diagnosis of Creutzfeldt-Jakob was made for her based on the clinical history and typical brain MRI.

Clinical evidence of this patient, along with positive brain MRI results, indicates the risk of prion transfer through dental procedures. Paying attention to the neurological aspects of psychiatric manifestations and increasing the awareness of dentists about how to deal with and act on the potential dangers of prion transfer is of paramount importance.

Major depressive disorder (MDD) is predicted to be the first cause of burden of disease. The antidepressant activity of gemfibrozil has been recently considered. This study was designed to evaluate the effectiveness of gemfibrozil as a sertraline adjunct in treating patients with MDD.

A total of 46 patients with MDD based on the DSM-V criteria with a minimum score of 22 on the 17-item Hamilton Rating Scale for Depression (HAM-D) were randomized to receive either 300 mg daily gemfibrozil or placebo in addition to 100 mg sertraline for 8 weeks in a randomized, double-blind placebo-controlled trial. Patients were evaluated for response to treatment using the HAM-D score at baseline and weeks 2, 4, and 8.

Forty-five patients completed the study and took part in all follow-up visits. Repeated measure ANOVA with a Greenhouse-Geisser correction showed a significant difference for time×treatment interaction on within-subjects HAM-D scores [p–value= 0.026]. A significant difference was seen in time [p–value < 0.001]. The test of between-subject effects also showed a significant effect of treatment on HAM-D scores at weeks 2, 4, and 8 [p–value = 0.07]. Using Kaplan-Meier estimate curves, time to remission periods were significantly different between the 2 trial arms [Log-Rank p–value = 0.003].

Gemfibrozil is an effective adjunctive treatment in MDD and can be used to reduce depression symptoms.

The global spread of COVID-19 has caused great psychological stress in health care workers (HCWs). This study aims to assess the prevalence and associated factors of posttraumatic stress symptoms (PTSS) and stigma among health care workers (HCWs) who are involved in treating COVID-19 patients. This study was conducted as part of studies related to assessing the mental health status of HCWs in Iran during the COVID-19 pandemic.

Overall, in this cross sectional study, 894 HCWs working in 9 general hospitals in Alborz province, Iran, in the field of diagnostic and treatment care of patients with COVID-19 were selected using multistage sampling method. PTSS and its subscales, including intrusion, avoidance, and hyper vigilance were obtained based on the Posttraumatic Stress Disorder-8 Item validated questionnaire. Information on Stigma's perception among HCWs was also obtained based on a questionnaire adopted from the HIV Stigma Scale. Predictors of PTSS and Stigma's perception among HCWs were assessed using multivariate logistic regression analysis.

Overall, 71.4% of the participants were women and 46.9% were front line staff. The prevalence of intrusion, avoidance, and hyper vigilance symptoms was 44.2% (95% CI: 40.8-47.6), 31. 8% (95% CI: 28.8-35.0), and 37.7% (95% CI: 34.5-41.0), respectively. A strong and positive significant correlation was found between stigma score with PTSD total score (coefficient: 0.83) and its components. In multivariate logistic regression model, female gender was associated with intrusion (OR: 1.46, 95% CI: 1.03-2.06) and avoidance (OR: 1.66, 95% CI: 1.147-2.417) and working in frontline increased the odds of intrusion (OR: 1.45, 95% CI: 1.06-1.97) and hyper vigilance (OR: 1.41, 95% CI: 1.03-1.91).

The prevalence of PTSS is high among HCWs during COVID-19 pandemic and it is associated with some demographic characteristics of HCWs. This situation should be considered by health policymakers so that while trying to control the disease, the mental health status of this group of personnel should be given much attention.

The mental health status of health care workers (HCWs) related to COVID-19 is of great importance. By designing cross sectional studies, we evaluated disorders related to the mental health of these health workers. Short-term and long-term diagnostic and treatment interventions are other components of this care protocol.

This study includes a collection of studies and interventions in the form of analytical cross sectional study at the level of educational hospitals of Alborz University of Medical Sciences. In this study, HCWs were evaluated for mental health disorders in quantitative and qualitative studies. Depression, Anxiety and Stress Scales (DAS), Posttraumatic Stress Disorder (PTSD) questionnaires, and Stigma questionnaire in quantitative studies with thematic approach in qualitative study were used to evaluate and analyze the data.

A series of coherent measures have been taken to prevent, screen, and treat mental healt
disorders of the staff who provide services to patients with COVID-19. We hope the results of these measures will be used as a guide for other professionals and academic and hospital centers in similar conditions to effectively control the disease and improve the mental health of HCWs.

In the last couple of years, with the advancement of imaging methods, the diagnosis of gray matter heterotopia has been more promising. Gray matter heterotopia is a rare disorder in the general population, but recent attention to its psychiatric aspects encouraged us to introduce a patient with a form of gray matter heterotopia, who suffers from the anatomical abnormalities with a variety of psychiatric disorders. Our patient is a 25-year-old woman, who presented a variety of organogenesis disorders such as imperforate anus and rectovaginal fistula with the presence of gray matter heterotopia and history of refractory mood and psychotic disorders during 9 past years. Because of the various clinical manifestations of the disease, syndromic attention to this disease seems to be helpful in diagnosing and treating its various aspects.

Dear Editor; It was reported that the First Vice President of the Islamic Republic of Iran had emphasized public trust beyond economic solutions in implementing economic programs and emphasized the role of the elite in raising social capital.(1) Trust is an essential component of social capital.(2) There are different views on the relationship between social capital and the economic situation.(3) (4) Due to its unique circumstances, Iran has always witnessed the economic impact of the situation over the past few decades.(5) In one of the latest academic studies in Iran, the amount of social capital and trust in Iran was above average.(6) High level of trust and enormous social capital during the imposed war, the formation of bonding and bridging social capital during the post-war construction period, and high participation in natural disaster relief are examples. In the current period when Iran is under severe economic sanctions, what has played a role in the historical memory of the Iranian people, the existence of public trust and social capital and other components to cope with the difficult livelihoods of the country and to come up with solutions to exit the situation. Trust and social capital is something that has been the focus of policymakers and government officials in the historical context of our country and expressing and expanding its meaning is one of the duties of the country's health authorities.

The recent flood in Iran was an opportunity to assess the practical status of social capital in Iran. Social capital is one of the key elements in shaping the interpersonal relationships of individuals in a society to achieve the highest humanitarian goals and improve the standard of living.[1] Flood occurrence in 15 provinces of the total of 31 provinces of Iran along with flooding of rivers and extreme rainfall, reaching over 1,000 mm in some cases, spans more than a half of the country's geographic surface.[2]From the early beginning of this tragedy, all people in Iran helped the flood victims. The institutions responsible for this area, such as the Red Crescent, the Interior Ministry, the Army and Police, all came to the aid of flood victims. But what all the world saw and was a huge reflection was the full participation of the people in this regard.Self-help groups were formed in all affected cities and villages. Various medical, engineering and support groups with their unique presence helped flood victims. In total, while flooding had halved Iran, all Iranians came to the aid of flood victims.In the short term, a large amount of intra-group and inter-group relationships was formed. Different ethnic groups helped each other and bonding and bridging social capital was formed. Trust was founded. Also,social network, participation and collaboration was formed.In short, it can be said that the flood in Iran showed the greatness of Iran's social capital to the world.