Psychiatric disorders in Iranian children and adolescents

Objective: The aim of the present study was to investigate the epidemiology of psychiatric disorders in children and adolescents in five provinces of Iran: Tehran, Shiraz, Isfahan, Tabriz and Mashhad. Method: In the present study, we selected 9,636 children and adolescents aged 6-18 years through multistage cluster random sampling method from Tehran, Shiraz, Isfahan, Tabriz and Mashhad. We instructed the clinical psychologists to complete the Strengths and Difficulties Questionnaire (SDQ) for the participants, and those who received a high score on SDQ, completed the Persian version of Kiddie-SADS-Present and Lifetime Version (K-SADS-PL). We used descriptive analysis and 95 confidence interval to investigate the relationship between scores of the K- SADS questionnaire and demographic factors . We used one-way ANOVA to test the significant differences among the disorders according to sex, age and province of residence. Results: Based on the results, oppositional defiant disorder (ODD) (4.45) had the highest prevalence of psychiatric disorders in the five provinces and substance abuse and alcohol abuse (0) had the lowest prevalence. In addition, attention deficit hyperactivity disorder (ADHD) had the most prevalence in boys (5.03) and ODD had the most prevalence in girls (4.05). Among the three age groups, 6 to 9 year olds had the highest rates of ADHD (5.69); 10 to 14 and 15 to 18 year olds had the highest rates of ODD (4.32 and 4.37 respectively). Among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of ADHD; and Tabriz had the highest rates of social phobia. Conclusion: The current study revealed that the overall frequency of psychiatric disorders based on Kiddie- SADS-Present and Lifetime Version (K-SADS-PL) was higher than a similar study. Moreover, in this study, among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of ADHD; and Tabriz had the highest rates of social phobia. Therefore, these percentage of psychiatric disorders in Iran lead us toward a greater use of consultation and mental health services

Psychological problems of Iranian children and adolescents: Parent report form of Strengths and Difficulties Questionnaire

Objective: The aim of this study was to evaluate the degree of psychological problems Iranian children and adolescents have, using parent report form of the Strengths and Difficulties Questionnaire (SDQ). Methods: In a community-based study, 9636 children and adolescents aged 6-17 years were selected using the multistage cluster random sampling method from five provinces of Iran: Tehran, Isfahan, Fars, Razavi Khorasan and East Azerbaijan. The parents completed the SDQ, which consisted of five subscales including emotional problems, conduct problems, hyperactivity, peer problems and prosocial behaviors. Result: The results revealed 21.4 of emotional problems, 32.9 of conduct problems, 20 of hyperactivity, 25.6 of peer problems, 7.6 of problems in prosocial behaviors and 16.7 of total difficulties among Iranian children and adolescents. We found that emotional problems were more prevalent among girls, while conduct problems, hyperactivity, total difficulties and problems in prosocial behaviors were more prevalent among boys. High educational level of parents was a protective factor against some psychological problems. Conclusion: Considering the proportion of psychological problems in Iranian children and adolescents, we need to develop and implement special policies and programs to provide appropriate mental health services. © 2014 Shadowfax Publishing and Informa UK Limited

Psychiatric disorders in Iranian children and adolescents

Objective: The aim of the present study was to investigate the epidemiology of psychiatric disorders in children and adolescents in five provinces of Iran: Tehran, Shiraz, Isfahan, Tabriz and Mashhad. Method: In the present study, we selected 9,636 children and adolescents aged 6-18 years through multistage cluster random sampling method from Tehran, Shiraz, Isfahan, Tabriz and Mashhad. We instructed the clinical psychologists to complete the Strengths and Difficulties Questionnaire (SDQ) for the participants, and those who received a high score on SDQ, completed the Persian version of Kiddie-SADS-Present and Lifetime Version (K-SADS-PL). We used descriptive analysis and 95 confidence interval to investigate the relationship between scores of the K- SADS questionnaire and demographic factors . We used one-way ANOVA to test the significant differences among the disorders according to sex, age and province of residence. Results: Based on the results, oppositional defiant disorder (ODD) (4.45) had the highest prevalence of psychiatric disorders in the five provinces and substance abuse and alcohol abuse (0) had the lowest prevalence. In addition, attention deficit hyperactivity disorder (ADHD) had the most prevalence in boys (5.03) and ODD had the most prevalence in girls (4.05). Among the three age groups, 6 to 9 year olds had the highest rates of ADHD (5.69); 10 to 14 and 15 to 18 year olds had the highest rates of ODD (4.32 and 4.37 respectively). Among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of ADHD; and Tabriz had the highest rates of social phobia. Conclusion: The current study revealed that the overall frequency of psychiatric disorders based on Kiddie- SADS-Present and Lifetime Version (K-SADS-PL) was higher than a similar study. Moreover, in this study, among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of ADHD; and Tabriz had the highest rates of social phobia. Therefore, these percentage of psychiatric disorders in Iran lead us toward a greater use of consultation and mental health services

Six week open-label reboxetine treatment in children and adolescents with attention deficit hyperactivity disorder

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a common psychiatric disorder among children and adolescents. This disorder causes difficulties in academic, behavioral, emotional, social and family performance. Stimulants show robust efficacy and a good safety profile in children with this disorder, but a significant percent of ADHD children do not respond adequately or cannot tolerate the associated adverse effects with stimulants. Such difficulties highlight the need for alternative safe and effective medications in the treatment of this disorder. This open-label study assessed the effectiveness of reboxetine, a selective norepinephrine reuptake inhibitor, in children and adolescents with attention deficit hyperactivity disorder (ADHD)."nMethods: Fifteen child and adolescent outpatients, aged 7 to 16 (Mean± SD=9.72±2.71) years, diagnosed with ADHD were enrolled in a six open-label study with reboxetine 4-6 mg/d. The principal measure of the outcome was the teacher and parent Attention Deficit Hyperactive Disorder Rating Scale (ADHD Rating Scale). Patients were assessed by a child psychiatrist at baseline, 2, 4 and 6 weeks of the medication started. Side effects questionnaire was used to detect side effects of reboxetine. Repeated measures Analysis of variance (ANOVA) was done for comparison of Teacher and Parent ADHD Rating Scale scores during the intervention."nResults: Twelve of 15 (80%) participants completed the treatment protocol. A significant decrease in ADHD symptoms on teacher (p=0.04) and parent (p=0.003) ADHD rating scale was noted. Adverse effects were mild to moderate in severity. The most common adverse effects were drowsiness/sedation and appetite decrease."nConclusion: The results of the current study suggest the effectiveness of reboxetine in the treatment of ADHD in children and adolescents. Double-blind, placebo-controlled studies and larger sample size with long duration of intervention are indicated to rigorously test the efficacy of reboxetine in ADHD. It is important that future studies complete our knowledge about safety and side effects of reboxetine