Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents

Objective: Considering the impact of rapid sociocultural, political, and economical changes on societies and families, population-based surveys of mental disorders in different communities are needed to describe the magnitude of mental health problems and their disabling effects at the individual, familial, and societal levels. Method: A population-based cross sectional survey (IRCAP project) of 30 532 children and adolescents between 6 and 18 years was conducted in all provinces of Iran using a multistage cluster sampling method. Data were collected by 250 clinical psychologists trained to use the validated Persian version of the semi-structured diagnostic interview Kiddie-Schedule for Affective Disorders and Schizophrenia-PL (K-SADS-PL). Results: In this national epidemiological survey, 6209 out of 30 532 (22.31%) were diagnosed with at least one psychiatric disorder. The anxiety disorders (14.13%) and behavioral disorders (8.3%) had the highest prevalence, while eating disorders (0.13%) and psychotic symptoms (0.26%) had the lowest. The prevalence of psychiatric disorders was significantly lower in girls (OR = 0.85; 95% CI: 0.80-0.90), in those living in the rural area (OR = 0.80; 95% CI: 0.73-0.87), in those aged 15-18 years (OR = 0.92; 95% CI: 0.86-0.99), as well as that was significantly higher in those who had a parent suffering from mental disorders (OR = 1.96; 95% CI: 1.63-2.36 for mother and OR = 1.33; 95% CI: 1.07-1.66 for father) or physical illness (OR = 1.26; 95% CI: 1.17-1.35 for mother and OR = 1.19; 95% CI: 1.10-1.28 for father). Conclusion: About one fifth of Iranian children and adolescents suffer from at least one psychiatric disorder. Therefore, we should give a greater priority to promoting mental health and public health, provide more accessible services and trainings, and reduce barriers to accessing existing services

Evaluation of outpatient care educational environment in Ayatollah Taleghani Hospital of Shahid Beheshti University of Medical Sciences from the perspective of medical students in winter 1398

Letter to edito

Memantine versus Methylphenidate in Children and Adolescents with Attention Deficit Hyperactivity Disorder: A Double-Blind, Randomized Clinical Trial

Objectives: The aim of this randomized clinical trial was to assess the efficacy of memantine versus methylphenidate in the treatment of children with attention deficit hyperactivity disorder. Method: Forty participants (34 boys and 6 girls) aged 6-11 who were diagnosed with attention deficit hyperactivity disorder based on (DSM-IV-TR) criteria were selected for this study. The participants were randomly assigned to two groups: group one (n = 22) received memantine and the other group (n = 18) received methylphenidate for six weeks. Treatment outcomes were assessed using the Attention Deficit Hyperactivity Rating Scale and Clinical Global Impression- Severity Scale administered at baseline and at weeks 3 and 6 following the treatment. Also, a two-way repeated measures analysis of variance (time- treatment interaction) was used. Results: At 6 weeks, methylphenidate produced a significantly better outcome on the Parent Rating Scale scores and Clinical Global Impression- Severity than memantine. Side effects were observed more often in the memantine group. However, with respect to the frequency of side effects, the difference between the memantine and methylphenidate groups was not significant. The most common side effects associated with memantine are appetite suppression, headache, vomiting, nausea and fatigue. Conclusion: The results of this study revealed that although memantine was less effective than methylphenidate in the treatment of attention deficit hyperactivity disorder, it may be considered as an alternative treatment

Development of a clone from established Bovine Kidney (BK) cell line and evaluation of its sensitivity to Parainfluenza type 3 and Herpes Simplex type 1 viruses.

Background: Application of continuous cell lines has got a special place in the virological researches. These cells are immortal and their chromosomes are aneuploid. Therefore, they can be passage without any limitation. The aim of this research was to choose the best way of producing clone of cells. Methods: in this study, Bovine Kidney (BK) cell line was used to be cloned through limiting dilution method in which Vero cells were used as feeder layer. Vero cells were first cultured in DMEM supplimented with 7% heat inactivated calf serum and after a monolayer were formed, their growth was arrested by Mitomycin C. The cloned cells after incubation were separated and cultured in a new flask. After several experiments different clones were obtained and cultured for further studies. Results: Karyotype of clone cells were determined and compared with original cells. It was shown that cloned cells were more homogenous in early passages and their karyotypes showed less variability than original ones. Cloned and original cells were inoculated with HSV-1 and Parainfluenza virus 3 in order to evaluate its biological abilities. Tissue culture of infectious dose 50 (TCID50) of each virus was calculated and it was shown that there was no significant different between the HSV-1 titers before and after cloning whereas the titer of the Parainfluenza virus 3 was significantly higher in the original cells. Conclusions: Cloned cells of BK showed more stable karyotype and were less sensitive to parainfluenza type-3 virus infection than original BK cells

Prevalence, comorbidities, and sociodemographic predictors of conduct disorder: the national epidemiology of Iranian children and adolescents psychiatric disorders (IRCAP)

The aim was to evaluate the lifetime prevalence of conduct disorder according to sociodemographic characteristics, determine the sociodemographic predictors of conduct disorder, and estimate the rates of comorbidities of psychiatric disorders in children and adolescents with conduct disorder by age and gender. The National Epidemiology of Iranian Children and Adolescents Psychiatric Disorders was a cross-sectional, general population-based study on 30,532 children and adolescents aged 6–18 years from all provinces of Iran, which was done using multistage cluster sampling. Iranian citizens aged 6–18 years who resided at least 1 year in each province were included, and children and adolescents with severe physical illnesses that prevented them to participate in the study were excluded. The sample weighting adjustment was used, since we had randomly selected the equal number of 1000 participants of each province from the urban and rural areas. Trained psychologists conducted diagnostic interviews with the adolescents and the children’s parents using the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Present and Lifetime Version (K-SADS—PL). In this study, 54 children aged 6–9 years (0.58%, CI 0.47–0.77), 64 adolescents aged 10–14 years (0.57%, CI 0.47–0.77), and 117 adolescents aged 15–18 years (1.22%, CI 0.96–1.44) met the criteria of the lifetime conduct disorder. Conduct disorder was significantly more common in boys than in girls, and was significantly less prevalent among those participants whose fathers had no history of psychiatric hospitalization. Of the participants with conduct disorder, 83.4% met the criteria for at least one other psychiatric disorder. Conduct disorder had a high rate of comorbidity with oppositional defiant disorder (54.89%, CI 48.50–61.12), attention-deficit/hyperactivity disorder (32.34%, CI 26.68–38.56), tobacco use (20.43%, CI 15.77–26.04), and depressive disorders (18.30%, CI 13.88–23.74). Because of using the diagnostic instrument, we found a low total rate of prevalence for conduct disorder; however, higher rates of it were observed among boys and adolescents. Further studies are needed to explore the nature of comorbidities of conduct disorder and to consider them in a large clinical population

Prevalence of elimination disorders and comorbid psychiatric disorders in Iranian children and adolescents

PURPOSE: Currently, there is a paucity of studies on the prevalence of Elimination Disorders among Iranian children and adolescents. Due to the ongoing need to monitor the health status of these children and adolescents, the present study aims to investigate the prevalence of Elimination Disorders and comorbid disorders in Iranian children and adolescents. METHODS: In this cross-sectional study, 29,781 children and adolescents age 6 to 18 years old were selected and studied from all the provinces in Iran. The sampling was carried out by employing a multistage cluster sampling method, and several clinical psychologists using semi-structured interviews collected the data. Furthermore, clinical psychologists collected demographic information (including information about gender, age, place of residence, education level, and parental education level). The collected data were analyzed using SPSS version 20. RESULTS: Generally, the prevalence of Elimination Disorders was found to be 5.4% covering both enuresis (p = 5.4, 95% CI = 5.1-5.7) and encopresis (p = 0.13, 95% CI = 0.09-0.2). The total prevalence of comorbid disorders was 38%, and among the comorbid disorders, Attention Deficit Hyperactivity Disorder (ADHD) (p = 11, 95% CI = 9.5-12.7) and Separation Anxiety (p = 10.6, 95% CI = 9.1-12.2) were the most prevalent. CONCLUSION: The prevalence of Elimination Disorders in Iranian children and adolescents is moderate compared to similar studies elsewhere. As for comorbid disorders, ADHD and Separation Anxiety were found to be the most prevalent disorders. Since Elimination Disorders coexist with psychiatric disorders in children, further studies of these comorbidities may give better insight into the treatment and prognosis of Elimination Disorders

Prevalence, Demographic Characteristics and Comorbid Psychiatric Disorders in Children and Adolescents with Substance Use Disorder in Iran

Background: The present study aimed to investigate the prevalence of substance use disorder in Iranian children and adolescents and its relationship with demographic characteristics and psychiatric comorbidities. Methods: The data were taken from a national survey on the prevalence of psychiatric disorders in Iranian children and adolescents. The national survey was conducted on 30,532 children and adolescents aged 6-18 years which were selected using multistage cluster sampling. The psychiatric disorders were assessed by employing k-SADS-PL questionnaire and interviews carried out by 240 clinical psychologists with the participants and their parents. Data were analyzed by Chi-square test and logistic regression. Results: A total of 277 (0.97%) were diagnosed as people with substance use disorder that were further studied for comorbid disorders. Among the various types of drugs, hypnotic/sedative/anti-anxiety drugs were abused by 84 people (46.15%), cannabis by 68 (37.36%) and stimulants by 43 (23.63%). The variables of gender, place of residence, and father's occupation and parents' education level were identified as predictors of substance use disorder in children and adolescents. At the same time, 42.50% substances and alcohol abusing people had at least one comorbid psychiatric disorder and the highest comorbidity was observed in oppositional defiant disorder, attention deficit and hyperactivity disorder and separation anxiety disorder (p≤0.05). Conclusion: The findings can be used in the prevention and treatment of substance use disorder and promotion of mental health in children and adolescents by focusing on the psychiatric comorbidities of people with substance use disorder

Prevalence, comorbidity and predictors of anxiety disorders among children and adolescents

Childhood anxiety may lead to serious health consequences in later life. The present study provides the prevalence, comorbidity, and predictors of anxiety disorders among children and adolescents. This was a cross-sectional national project that was implemented on 28,698 children and adolescents in Iran. Participants entered the study by multistage cluster sampling with an equal number of each gender and three age groups (6-9, 10-14, and 15-18 years) within each cluster. The tools used in this research were the demographic questionnaire and K-SADS-PL. To analyze the data logistic regression and chi-square tests were used in SPSS (ver. 16). The prevalence of anxiety disorder in children and adolescents was 13.2 in boys and 15.1 in girls. Furthermore, gender, age, place of residence and history of psychiatric hospitalization of parents could predict anxiety disorders. Anxiety disorders had comorbidity with behavioral disorders, neurodevelopmental disorders, mood disorders, psychotic disorders, substance abuse disorders, and elimination disorders. According to our findings in this study, anxiety disorders affect the performance, health and life of children and adolescents, identifying the childhood anxiety, as well as finding diseases that are associated with anxiety disorders, can help in the prevention of the disorder. Keywords: Anxiety disorder; Children and adolescents; Comorbidity; Predictors; Prevalence