Mental health problems of Iranian female adolescents and its association with pubertal development: a nationwide study

Mental health problems including emotional and behavioral problems during puberty may be under influence of different risk factors including cultures, living in urban or rural areas and ethnic factors which may vary between different countries. The main aim of this study is to investigate the profile of emotional and behavioral problems and the role of factors such as age, stage of puberty, ethnicity, rurality and living in urban area, as risk factors in Iranian girls. As a part of a large national study we evaluated the emotional and behavioral problems in different stages of puberty in a community sample of Iranian adolescent girls from public schools that were selected by clustered random sampling method. In all subjects, demographic characteristics, and pubertal stages were measured. Emotional and behavioral problems were evaluated using Strength and Difficulties Questionnaire [SDQ]. The associations of age, pubertal development indices, socioeconomic and demographic factors with the behavioral problems were assessed. A total number of 4576 students enrolled the study and responded to the questions. The mean age of participants was 13.83 +/- 2.19 years. The mean total score of difficulties in participants was 14.34 +/- 5.81. According to these results 813 [17.8%] adolescents had total problem scores higher than Goodman's cutoff points and the most frequent problem domain was conduct problems [20.5%]. According to the results the most related variable with the total difficulty score of SDQ were ethnicity, residency in urban areas and development of menstrual cycle respectively. The results of this study showed that the most correlated factors with mental health problems in Iranian girls during puberty are ethnicity, urbanity and development of menstrual cycle

effect of parental presence on the 5 year-old children's anxiety and cooperative behavior in the first and second dental visit

One of the most significant problems in pediatric dentistry is behavioral resistance of preschool children in the first visit. There is a debate on parental presence in operation room. The purpose of this study was to evaluate the Iranian 5-year-old children's behavior including anxiety and cooperation relative to parental presence in the first and second dental appointments. The study was conducted on sixty seven 5-year-old children selected according to inclusion criteria and randomly divided into two subgroups. Children in group I were visited in parent's presence and in group II in parent's absence. Before the child's first dental visit, parents were interviewed. Forty eight of the children receiving the initial examination were recalled for a second visit. The children's responses during the Holst procedure of the first visit and restorative second visit were assessed using a combination of two measures including heart rate and clinical behavior. The dentist-patient interactions were regulated by standardized scripts and recorded on videotape. Then, the behavior of the child on the recording during each visit was quantified by two pediatric dentists independently according to Venham 6-point rating scale and Frankle 4-point rating scale. There were no significant differences between the heart rate measures of children in group I and II in the first and second visit [0.67, 0.8 respectively]. There were also no significant differences between the clinical anxiety scores of children in the two groups in the first and second visit [0.98, 0.42 respectively]. Moreover, there were no significant differences between the clinical cooperation scores of children in group I and group II in the first and second visit [0.88, 0.40 respectively], neither were there any significant differences between response measures of each child between two visits [P>0.05]. In addition, there were no significant differences related to sex, parental education and dental experiences [P>0.05]. Parental presence or absence doesn't affect an Iranian 5-year-old child's anxiety on the first and second dental visit, as well as an Iranian 5-year-old child's cooperation on the first and second dental visit

Quality of life and the associated psychological factors in caregivers of children with PKU

The main objective of this study was to investigate the association of psychological factors and life stressors with quality of life in caregivers of children with PKU. Participants were caregivers of children with PKU who were referred to a child and adolescent consultation-liaison psychiatry clinic for a clinical follow up. Their demographic characteristics were recorded at first. WHOQOL-BREF and Depression-Anxiety-Stress Scale [DASS] were used to assess quality of life, depression, anxiety and stress in participants. Data analysis was performed using SPSS-11.5 statistical software. A total number of 49 caregivers were enrolled for the study. The mean age of participants and their children were 35.63 +/- 8.82, and 9.84 +/- 6.62 respectively. Of the participants, 59.2% were mothers and 40.8% were fathers. Of the children, 51% were girls and 49% were boys. According to the results, 57.1, 50.1 and 57.1 percent of the participants had mild to severe levels of depression, anxiety and stress scores respectively. The most associated factors with quality of life were as follows: caregivers' occupation; anxiety; and depression mean scores. Results of the current study showed that caregivers of children with PKU have lower levels of quality of life in comparison with the general population; and the most correlated factors with quality of life were the caregivers' occupation [especially unemployment], and high levels of depression and anxiety

Initial orientation of attention towards emotional faces in children with attention deficit hyperactivity disorder

Early recognition of negative emotions is considered to be of vital importance. It seems that children with attention deficit hyperactivity disorder have some difficulties recognizing facial emotional expressions, especially negative ones. This study investigated the preference of children with attention deficit hyperactivity disorder for negative [angry, sad] facial expressions compared to normal children. Participants were 35 drug naive boys with ADHD, aged between 6-11 years, and 31 matched healthy children. Visual orientation data were recorded while participants viewed face pairs [negative-neutral pairs] shown for 3000ms. The number of first fixations made to each expression was considered as an index of initial orientation. Group comparisons revealed no difference between attention deficit hyperactivity disorder group and their matched healthy counterparts in initial orientation of attention. A tendency towards negative emotions was found within the normal group, while no difference was observed between initial allocation of attention toward negative and neutral expressions in children with ADHD. Children with attention deficit hyperactivity disorder do not have significant preference for negative facial expressions. In contrast, normal children have a significant preference for negative facial emotions rather than neutral faces

Assessment of pubertal development in Iranian girls

We estimated pubertal development of 7,493 normal Iranian girls aged 6 to 20 years in a cross-sectional study. Pubertal stages were assessed according to Tanner. The mean ages to achieve secondary sexual characteristics as well as the mean age at menarche were estimated. Weight and height were measured and body mass index [BMI] was calculated. Reference curves for different breast stages and menarche were constructed. The percentiles for attaining each stage were compared to data proposed by Tanner. The mean age at breast bud stage [B2] was 10.10, pubic hair stage [P2] was 9.83, and menarche age was 12.55 years. The anthropometric variables were interpreted in different maturity stages. The mean age at attainment of puberty was compared with those of other populations. Not only the onset of puberty in Iranian girls but also the duration of puberty is similar to data from most other countries. A lower age limit for the definition of precocious puberty than the traditional 8 years is documented for Iranian girls. However, it should be noted that considering the rate of evolution of pubertal findings is more important than the age of their appearance

Association of premorbid adjustment with symptom profile and quality of life in first episode psychosis in a tertiary hospital in Tehran, Iran

Poor premorbid adjustment has been reported to be a predictor of more severe psychotic symptoms and poor quality of life in such psychotic disorders as schizophrenia. However, most studies were performed on chronic schizophrenic patients, and proposed the likelihood of recall biases and the effect of chronicity. The aim of this study was to investigate these factors in a sample of first episode psychotic patients, as a part of Roozbeh first episode psychosis project [RooF]. Premorbid adjustment was assessed using Premorbid Adjustment Scale [PAS] in 48 patients with the first psychotic episode who were admitted to Roozbeh Psychiatric Hospital. The severity of symptoms was measured using Positive and Negative Scale [PANSS] in three subgroups of positive, negative and general subscales. Quality of life was measured using WHO QOL, and Global Assessment of Functioning [GAF] was also measured. The mean age was 24 years. Poor Premorbid adjustment in late adolescence was significantly associated with more severe symptoms according to PANSS negative symptoms [p=0.019, r=0.44]. Furthermore, sociability and peer relationship domains had a positive correlation with PANSS negative subscale scores [r=0.531, p=0.002 and r=0.385, p=0.03, respectively]. There were no significant differences between males and females in premorbid adjustment. Furthermore, this study failed to show any differences between affective and non-affective psychosis in premorbid functioning. Our study confirms poor premorbid adjustment association with more severe negative symptoms and poor quality of life in a sample of Iranian first episode psychotic patients

Frequency of psychological disorders amongst children in Urban Areas of Tehran

To evaluate the frequency of different psychiatric disorders among 7 to 12 years old children in urban areas of Tehran. A sample of 799 children [6 to 11 years old] were selected from 250 clusters of the entire 22 municipality areas of Tehran using a multistage sampling method from 250 clusters from the entire 22 municipality areas of Tehran.. After responding to a Persian version of the Strengths and Difficulties Questionnaire [SDQ] parent-report form, the Persian version of Kiddie Schedule for Affective Disorders and Schizophrenia - Present and Lifetime [K-SADS-PL] was administered to 241 children and their families. The frequency of child psychological disorders was determined using the results of K-SADS-PL. The overall frequency of any psychological disorders in the sample of children was 17.9 percent. Among the interviewed children childrenwho were interviewed, the most prevalent diagnoses were Attention-Deficit/Hyperactivity Disorder [ADHD] [8.6 percent] 8.6%, Oppositional Defiant Disorder [ODD] [7.3 percent] 7.3%, and separation anxiety disorder [SAD] [5.9 percent] 5.9%. There were not any statistically significant differences between sexes in the frequency of psychological disorders except enuresis that was more frequent in the boys and anorexia nervosa that was observed more frequently in the girls. Higher frequency of ADHD and ODD and SAD among the studied children warrants more specific evaluation of frequency and possible causes of these high frequency rates. The frequency of psychological disorders in the studied children was comparable to the that of other studies

Post traumatic stress disorder and general symptoms of anxiety in adolescent survivors of Bam earthquake

Reports of the prevalence of PTSD has been variable between 28-70% after the earthquake disaster in the city of Bam, among children. Several studies in adults have shown a high comorbidity of anxiety disorders as well. In this study we evaluated the frequency of PTSD and anxiety symptoms among adolescents in the period of 7-9 months after a large scale disaster [Bam earthquake]. In an epidemiologic study, we evaluated the PTSD and the severity of general symptoms of anxiety in adolescent survivors of Bam earthquake who had been directly exposed to the traumatic event. We used DSM-IV criteria and Posttraumatic Stress Scale [ASS] for PTSD diagnosis and Hamilton Anxiety Rating Scale for evaluation of the anxiety symptoms. 284 adolescents at the ages of 11 to 18 with a mean age of 14.8 [SD=2.1] were recruited. 45.1% had PTSD and there were no statistical differences between boys and girls for PTSD symptoms. The girls had more anxiety symptoms than the boys. One half of the adolescent survivors of Bam earthquake had post traumatic stress disorder. The girls had more anxiety symptoms