Background: During coronavirus (COVID-19) pandemic, frontline medical staff were exposed to numerous psychological problems due to unpredictable conditions. A psychological intervention for medical staff is the provision of a group where emotions and feelings are shared. Objectives: The purpose of this study was to evaluate the experiences of front-line medical staff about virtual Balint group. Methods: Eight sessions of virtual Balint group were held through Skype. Participants were the frontline medical staff involved in the treatment of COVID-19 patients. The group leader was a psychiatrist and an analytical psychotherapist. The group had two co-leaders, a clinical psychologist and a psychiatrist. They were both experienced conductors who had a background of participation in Balint groups. Finally, eight in-depth semi-structured interviews were performed. Interpretative phenomenological analysis (IPA) was carried out to analyze the obtained data. Results: Three themes were extracted, including the effects of Balint group, Balint group structure, and virtuality of Balint group. Each theme included several categories, and each category had some codes. Conclusions: Leaders in the Balint group were active and had a supportive role. Some participants did not share their faces, and this made others feel insecure. Body language is an important issue in empathy and understanding of others that is overlooked in virtual Balint groups.

Background: Fibromyalgia syndrome (FMS) is a chronic musculoskeletal condition, which can reduce the quality of life (QoL). Objectives: This study aimed to evaluate the impact of FMS on health-related quality of life (HRQoL) and the possible related factors such as sociodemographic and psychological variables. Methods: In this cross-sectional study, 150 women patients with FMS were included who visited a psychosomatic clinic at a referral center in northern Iran. The samples were selected in a consecutive procedure from April 2019 to March 2019. Sociodemographic variables, HRQoL score [36-Item Short Form (SF-36) Health Survey], and the Pittsburgh Sleep Quality Index (PSQI) were recorded. Data were analyzed using the SPSS Statistics software (ver. 24). The quantitative data were reported as mean ± SD, and the qualitative variables were presented as frequency and percentage. Also, analysis was performed using analytical tests such as chi-square test (χ2). P < 0.05 was considered to be significant. Results: The mean (SD) age was 42.35 (11.73) years. The mean physical and mental health scores were 33.45 (16.22) and 48.99 (18.19), respectively. Moreover, 88% of patients had moderate-to-severe sleep disorder, and those who did not, had a better physical and mental health status [42.7 (14.1) vs. 32.2 (16.1), P-value = 0.009 and 62.2 (16.3) vs. 47.2 (17.7), P-value = 0.001, respectively]. History of depression according to self-reporting was associated with worse mental health subscale scores [44.4 (16.8 Vs. 52.4 (18.5), P-value = 0.007], and lower scores in social functioning and emotional well-being (P-value = 0.012, P-value = 0.001, respectively). Being postmenopausal was associated with a lower physical health quality (P-value = 0.049). Body Mass Index (BMI) reversely correlated with HRQoL subscales (r = -0.163, P-value = 0.046), but the subscales were not affected by the level of income (P-value = 0.644, P-value = 0.170, respectively). Conclusions: Patients with fibromyalgia report a considerable significant impact on their quality of life and impaired sleep quality. Assessment of sleep quality and QoL are needed in patients with fibromyalgia.

Background: The study of the smoking and drug use profile of the Tabari cohort enrolment phase, the outcomes of which will be evaluated in the coming years, has proper comprehensiveness. Therefore, the present study aimed to determine the cigarette and drug use status in the population of the Tabari cohort study (TCS). Methods: In this study, the profile of cigarette and drug use in the TCS was evaluated. Data analysis was performed in SPSS version 24 using percentage, mean, and standard deviation, chi-square, and independent t test. Findings: The frequency of daily smoking in the entire population was 9.1%, and the frequencies in men and women were 21.5% and 0.6%, respectively (P<0.001). The frequency of exposure to smoking in the home, at present or in the past, in the entire population was 30.5%, and in the populations living in urban and mountainous areas were 35.4% and 19.8%, respectively (P<0.001). The mean age at first use of cigarettes in the entire population was 20.50±7.61, whereas the mean age of regular smoking was 23.19±8.02. Furthermore, the frequency of experiencing drug abuse in the total population was 6.1%, and the frequencies in men and women were 14.1% and 0.7%, respectively. Conclusion: According to the results of this study, cigarette smoking and drug use are significant in men, and overall exposure of the Tabari cohort population to tobacco and drugs in the home is high. If effective prevention is not on the agenda, a significant proportion of the future outcomes in this population may be attributable to these risk factors.

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Context: Neuroleptic malignant syndrome (NMS) has been introduced as a rare but lethal and idiosyncratic reaction to neuroleptics/antipsychotics. The most obvious risk of this syndrome is the use of neuroleptics, especially high-potency ones. Metoclopramide is also known as an anti-nausea medication administered before surgery to manage digestive problems. Evidence Acquisition: Formerly, it had been assumed that metoclopramide was a type of chlorobenzamide that was not in the phenothiazine group but free of extrapyramidal side effects (EPSs). The sequential reports of complications indicate that metoclopramide can cause EPSs and drug-induced motor side effects. A total number of 5,046 articles were obtained after the initial search. Then, two researchers independently screened out their titles, and abstracts and 20 articles were finally selected based on the inclusion criteria. Results: Of the 20 articles reporting metoclopramide-induced NMS, treatments had been successful in 16 (80%) cases, but it had led to death in four (20%) patients. There were 11 and 8 male and female patients, respectively, and gender was not mentioned for a patient in one article. The age range of the patients was from six months to 84 years, and the mean age was 50.92 years. Conclusions: Although NMS following metoclopramide intake is reported very rarely, it should be considered for any psychiatric symptoms with unexpected mental changes, muscle rigidity, and fever after being treated with metoclopramide. The neuroleptic malignant syndrome can occur following multiple doses or just one dose of metoclopramide. Also, metoclopramide use in patients affected with kidney failure is accompanied by a higher risk of NMS. A previous history of NMS, a recent episode of catatonia, and severe agitation are all taken into account as risk factors in this domain.