Prevalence of behavioral inhibition among preschool aged children in Tehran, Iran

One of the identified risk factors for anxiety disorders in adolescence and adulthood is inhibited behaviors in childhood. The present study sought to examine the relationship between behavioral inhibition with some of the internal [personal] and external [family environment] factors in a sample of preschool children in kindergartens. In a cross sectional study in 2009, data was collected trough a structured questionnaire completed by parents and teachers in day-care centers. A total of 1403 children were assessed. Analysis was performed through complex sample analysis. The results showed that 7.4% [CI95%= 6.1%-9.1%] of children according to parents' and 8.1% [CI95%= 6%- 10.7%] according to teachers' evaluation classified as behaviorally inhibited. The higher levels of behavioral inhibition were shown by girls, first children, single parent families and older children. Birth year before 2004, birth rank, living in a single parent family and maternal level of education were independent predictors for behavioral inhibition in logistic regression modeling. There is relatively high prevalence of inhibited behaviors among Iranian children. Further examination of diagnosed children with behavioral inhibition by experienced psychiatrists is needed. Also establishing consultation centers for behaviorally inhibited children and instructing their parents and teachers are recommended

Prevalence of attention-deficit/hyperactivity disorder symptoms in preschool-aged Iranian children

The aim of this study was to determine the prevalence of attention-deficit/hyperactivity disorder [ADHD] symptoms in Iranian preschool children based on evaluations by parents and teachers because a thorough understanding of epidemiologic features of ADHD symptoms in preschool children is important for prevention and management. Children between the ages of three and six attending kindergarten participated in this study. For the survey, 37 kindergartens were selected by multistage [stratified cluster random] sampling, consisting of 2213 children with a design effect equal to 1.5. A 19-item observer-rating questionnaire was generated to assess ADHD symptoms in children within the last 6 months. This questionnaire was used by both teachers and parents to assess ADHD behavior in participating children. Of 1403 children aged 3-6 years, 362 were classified as having ADHD symptoms according to their parent evaluation [25.8% [23.6-28.1%]] and 239 according to their teachers evaluation [17% [14.1-20.4%]]. Child rank among siblings, mother's education level, and interest in aggressive television programs were all independent explanatory variables according to parents' evaluation. Gender, parent education, child rank, single parent and interest in aggressive television programs were all independent explanatory variables according to teachers' evaluation. Our findings reveal a large discrepancy in the prevalence of ADHD symptoms in preschool children based on evaluation by parents and teachers. Thus, it seems that the ADHD screening should be performed in multiple settings in order to identify children who need further investigations

[Pre-hospital delay among patients with acute myocardial infarction]

To determine the prevalence and predictors of patient delay among patients with myocardial infarction. In this cross-sectional study, a sample of 95 admitted patients with confirmed diagnosis of myocardial infarction were included. They were asked about symptoms, the time from presentation to admission and the reason for delay, if any. Delay was defined as arrival to hospital after 3 hours from initiation of symptoms. The mean age of patients was 60.4 +/- 1.1 years and mostly were male [76.8%]. Half of the patients had visited the doctor 9 hours after the pain started or later [median]. About 70 percent of patients had delayed seeking medical care after myocardial infarction. The risk factors for delay in the descending order of importance [OR] were: lacking sweat as a symptom, heart attack at midnight, lacking previous history of heart disease, visiting a general practitioner, gradual onset and lower educational level. Education of the general public especially individuals with lower educational status can lead to better recognition of symptoms and decrease patient delay