Background: Multiple Sclerosis (MS) is a chronic progressive disease coinciding with the ages of social activities. Therefore, this disease is associated with significant effects on the quality of life and psychological status of these patients. It is well-accepted that the psychological status of patients is an effective factor in the process of treatment and living in chronic conditions. With this background in mind, the present study was conducted to identify the psychological status of these patients from their own perspective and specialists&apos viewpoints.
Methods: The current qualitative study was conducted with a thematic analysis approach. The participants of the current study included 24 MS patients with maximum diversity in gender, age, illness duration and severity, and 8 experts in neurology, psychiatry, clinical psychology, and nursing from Guilan province. Participants were selected by a purposive sampling method and the data were gathered through unstructured interviews which continued up to data saturation. Data analysis was performed using a thematic analysis approach by the Attride-Stirling method.
Findings: From the total information, three global themes, including individual problems, interactive problems, and disease-related problems were identified. Individual problems included: personality disorders, depression, sleep, cognitive, anxiety, physical, self-regulation, self-destructive behaviors, psychosis, as well as substance and alcohol abuse. Interactive problems incorporated: interpersonal sensitivity, aggression, sexual, social, and dependence. In addition, disease-related problems involved reaction to disease.
Conclusion: As evidenced by the obtained results, patients with MS are involved in several psychological problems in individual, interactive and disease-related domains. Accordingly, it is necessary to develop and present psychological programs and interventions based on these problems in order to improve their mental status, quality of life, and adaptability.

Background: The aim of this study is to investigate the effect of Acceptance and Commitment Therapy (ACT) on cognitive fatigue in female patients with multiple sclerosis (MS).
Methods: This was a quasi-experimental study with a pre-test and post-test design and three months of follow up performed on three groups of therapy, placebo, and waiting list. Thus, among the female patients with MS referred to the MS Society of Ahwaz, Iran, 41 patients were chosen with the convenience sampling method and divided into therapy (n = 13), placebo (n = 13), and waiting list (n = 14) by random sampling.
Findings: All patients completed the Modified Impact of Fatigue Scale (MFIS) in the pretest and posttest stages and after the three-month follow-up period. The results of the mixed analysis of variance (ANOVA) showed that the interaction between time and therapy can reduce the cognitive fatigue in patients with MS (F = 3.53, P = 0.014, effect size = 0.16, statistical power = 0.84) and this reduction will remain and until the follow-up.
Conclusion: According to fatigue as a main and pervasive complaint of this group, the results of this study can be used as an appropriate method to reduce cognitive fatigue in patients with MS.

Background: Multiple sclerosis (MS) is one of the most common and debilitating neurological diseases at the young age. Previous studies have suggested that nutrition as an environmental factor plays an important role in the development of the disease and its relapse. Therefore, this study aimed to identify inappropriate diet in patients with MS with relapses in the past year.
Methods: This study was conducted in a qualitative paradigm with a phenomenological approach in 2019. 15 patients with MS and 5 specialists from Rasht City, Iran, participated in the study. Participants were selected by purposeful sampling method with maximum diversity, and the unstructured interviews were done to the point of theoretical saturation. Data were analyzed using Attride-Stirling thematic analysis approach.
Findings: From the total interviews, three global themes were identified: 1- eating behaviors, 2- self-regulation in eating behaviors, and 3- malnutrition. Organizing themes for eating behaviors included “eating ready meals and inappropriate cooking”, for self-regulation in eating behaviors included “temptation, purpose, and meal management”, and for the malnutrition included “insufficiencies and excesses”.
Conclusion: The results of this study suggest that the diet of people with MS with a history of relapsing, in the field of nutritional behaviors, self-regulation, and malnutrition has some deficiencies that the patients and specialists’ perceptions have an effective role in relapse of the disease. Accordingly, it seems that further research and development of educational interventions to improve the diet of these people is necessary.