title: Regional disparities in psychiatric distress, violent behavior, and life satisfaction in Iranian adolescents: the CASPIAN-III study.
abstract: OBJECTIVE
  The purpose of this study was to assess the prevalence of violence behaviors, psychiatric distress, and life satisfaction among 10- to 18-year-old Iranian adolescents at national and regional disparities.
  
  
  METHODS
  In this national survey, 5570 students of age 10 to 18 years from urban and rural regions of 27 provinces of Iran were selected through stratified multistage sampling method. Violence behaviors, psychiatric distress, and life satisfaction were assessed by a questionnaire that was prepared based on WHO global school-based student health survey and the WHO-stepwise approach to noncommunicable diseases (Tools version 9.5). The country classification into 4 subnational regions was done based on combination of geography and socioeconomic status (SES). The data were analyzed by the SPSS software.
  
  
  RESULTS
  The prevalence of emotional, depressive, and anxiety problem among Iranian students was 17.7%, 16.3%, and 5.7%, respectively. The percentage of emotional and depressive problem differed significantly between different SES distress (p value <.001). The prevalence of bullying, victim, and physical fight was 27.1%, 32.7%, and 50.6% among students aged 10 to 18 years, respectively. Bullying and victim experience were linearly associated with regions' SES. Students who were living in the north-northeast region had maximum self-rated health and life satisfaction in Iran.
  
  
  CONCLUSIONS
  The results declared that psychiatric distress was more frequent in high SES distress, whereas violence behavior was more frequent in the lowest SES distress. Therefore, in communities with large variations in health and SES in regional level, health policies for primordial and primary prevention of mental and behavioral distress have to be made at regional levels.
authors.affiliation: *Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; †Department of Public Health, Alborz University of Medical Sciences, Karaj, Iran; ‡Pediatrics Department, Child Growth and Development Research Center and Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; §Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; ‖Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran; ¶Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Ahadi
authors.forename: Mostafa
authors.initials: M
authors.lastname: Qorbani
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.forename: Gelayol
authors.initials: G
authors.lastname: Ardalan
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Taslimi
authors.forename: Minoosadat
authors.initials: M
authors.lastname: Mahmoudarabi
authors.forename: Mohammad Esmaeil
authors.initials: ME
authors.lastname: Motlagh
authors.forename: Hamid
authors.initials: H
authors.lastname: Asayesh
authors.forename: Gita
authors.initials: G
authors.lastname: Shafiee
authors.forename: Bagher
authors.initials: B
authors.lastname: Larijani
authors.forename: Ramin
authors.initials: R
authors.lastname: Heshmat
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000208:ethnology*; D002648:Child; D003863:Depression / Q000208:ethnology*; D005260:Female; D006801:Humans; D007492:Iran / Q000208:ethnology; D008297:Male; D010549:Personal Satisfaction; D012923:Social Class; D013315:Stress, Psychological / Q000208:ethnology*; D014754:Violence / Q000208:ethnology*