Background: Chronic pain is commonly associated with anxiety and depression, making it more challenging to be managed. Psychological interventions are suggested for such complicated issues which are well evident in the United States and Europe. However, generalizing the evidence to Iranian population – as a Middle Eastern society – might be questionable. We aimed to synthesize our evidence on the effectiveness of these interventions among Iranian populations. Methods: This was a systematic review and meta-analysis. Persian and English literature were searched through Iran-doc, Elm-net, and PubMed until March 2019 using the following terms (or its Persian synonyms): chronic pain; persistent pain; chronic fatigue; fibromyalgia; neuropath*; LBP; irritable bowel; CFS; psycho*; cogniti*; acceptance; meaning; mindfulness; relaxation; biopsychosocial; rehabilitation; educat*. Eligible trials were randomized trials that evaluated the effectiveness of psychological interventions on Iranian adults with chronic pain. No setting restriction was considered. Risk of bias for each trial was assessed, and the random-effect model was used to pool summary effect across trials. Results: In all 30 eligible RCTs, the risk of bias for randomization was low except for one study. The pooled standardized mean difference (SMD) for depression and anxiety were 1.33 (95%CI: -1.42 to -0.68) and 1.25 (95% CI: -1.55 to -0.96), respectively. Conclusion: This study suggests that psychological interventions are highly effective in reducing depression and anxiety in Iranian patients with chronic pain, compared to what observed in theU.S. and European studies. However, there are still some methodological issues to be addressed. Future research should focus on high-quality trials with considerations on the methodological issues reported in the present study.

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Objectives: This study had three objectives: first, to investigate the relative importance of the five mindfulness facets to negative affect (NA) among patients with chronic musculoskeletal pain; second, to test the hypothesis that observing is associated with lower NA only if occurs in an accepting manner; and third, to investigate the relation between mindfulness and obsessive-compulsive symptoms (OCS). Methods: One hundred and nineteen patients with chronic musculoskeletal pain filled the Five-Facets Mindfulness Questionnaire (FFMQ), the Depression, Anxiety, Stress Scale (DASS), and the Obsessive-Compulsive Inventory-Revised (OCI-R). A latent variable was constructed to represent NA. Multiple regression analysis was conducted, and several indices of relative importance were calculated. Results: Except for Observing, all mindfulness facets had significant bivariate and unique relation with NA. Acting with Awareness was the most important predictor, followed by Nonjudging and Describing. The contribution of Nonreactivity was small. Regarding the second objective, the Observing x Nonjudging and Observing x Nonreactivity interactions were not significant. Finally, the five facets of mindfulness explained about one-half of the variance in obsession and one-fifth of the variance in compulsion. After excluding the shared variance between obsession and compulsion, mindfulness was only related to obsession. Conclusion: Except for Observing, all mindfulness facets seem to have unique contributions to psychological symptoms; among them, Acting with Awareness seems most important. Current evidence is inconsistent in supporting the dependency of the effect of observing on acceptance. Finally, regarding the relation between mindfulness and OCS, it seems that mindfulness is more related to obsession than compulsion.

Background: : Irritable bowel syndrome (IBS) is a common health problem, with considerable effects on the individual's quality of life, mental health, work productivity, and financial aspects. Psychological interventions, which are commonly used as adjunct treatments, have received fairly strong empirical support. In Iran, several randomized clinical trials (RCTs) have evaluated the efficacy of these treatments; however, the results of these RCTs have not been synthesized yet. Therefore, in this meta-analysis, we aimed to summarize the results of these trials on the efficacy of psychological interventions in Iranian adults with IBS. Methods: We searched IranDoc, ElmNet, PubMed, and Scopus for eligible RCTs. The risk of bias was assessed in each trial, according to the Cochrane guidelines, and the random-effect model was used to pool the effect size (EF) across trials. Results: Twenty RCTs met the eligibility criteria and were included in the meta-analysis. Compared to the controls, the standardized mean difference (SMD) for psychological interventions was large regarding the severity of IBS symptoms (-1.21; 95% CI: -1.63 to -0.80), anxiety (-0.97; 95% CI: -1.32 to -0.63), and depression (-0.86; 95% CI: -1.28 to -0.44). There was considerable heterogeneity among the included RCTs regarding all three outcomes, which could not be explained by the available information. On the other hand, the EF of health-related quality of life was 0.64 (95% CI: 0.38 to 0.85), with no significant heterogeneity among RCTs. Conclusion:The existing evidence suggests that psychological interventions can be highly effective in improving the severity of IBS symptoms, mental health, and quality of life for Iranian adults with IBS. However, some weaknesses should be considered in the interpretation of the results and future research. The risk of randomization was high or unclear in almost all of the existing trials; there was no single large trial in this area; and there was substantial inconsistency in the EFs, which might be related to methodological or clinical moderators.

Objectives: This study had three objectives: first, to investigate the relative importance of the five mindfulness facets to negative affect (NA) among patients with chronic musculoskeletal pain; second, to test the hypothesis that observing is associated with lower NA only if occurs in an accepting manner; and third, to investigate the relation between mindfulness and obsessive-compulsive symptoms (OCS).Methods: One hundred and nineteen patients with chronic musculoskeletal pain filled the Five-Facets Mindfulness Questionnaire (FFMQ), the Depression, Anxiety, Stress Scale (DASS), and the Obsessivecompulsive Inventory-Revised (OCI-R). A latent variable was constructed to represent NA. Multiple regression analysis was conducted, and several indices of relative importance were calculated.Results: Except for Observing, all mindfulness facets had significant bivariate and unique relation with NA. Acting with Awareness was the most important predictor, followed by Nonjudging and Describing.The contribution of Nonreactivity was small. Regarding the second objective, the Observing × Nonjudging and Observing × Nonreactivity interactions were not significant. Finally, the five facets of mindfulness explained about one-half of the variance in obsession and one-fifth of the variance in compulsion. After excluding the shared variance between obsession and compulsion, mindfulness was only related to obsession.