title: The association of vitamin D deficiency with psychiatric distress and violence behaviors in Iranian adolescents: the CASPIAN-III study.
abstract: BACKGROUND
  Subtle effects of vitamin D deficiency on behavior have been suggested. We investigated the association of vitamin D status with mental health and violence behaviors in a sample of Iranian adolescents.
  
  
  METHODS
  This nationwide study was conducted in 2009-2010 in 1095 Iranian school students with mean age 14.7 ± 2.6 years. Items were adapted from the Global School-based Student Health Survey (GSHS). Psychiatric distress was considered as the self-reported anger, anxiety, poor quality sleep, confusion, sadness/depression, worry, and violence-related behaviors (physical fight, having bully, or getting bullied).
  
  
  RESULTS
  Forty percent had serum 25(OH)D values below 10 ng/mL (vitamin D deficient), and 39 % had levels 10-30 ng/mL (vitamin D insufficient). The prevalence of self-reported anger, anxiety, poor quality sleep, sadness/depression, and worry was significantly lower (P < 0.05) in vitamin D sufficient participants compared with their other counterparts. The odds of reporting anger, anxiety, poor quality sleep, and worry, increased approximately 1.5 to 1.8 times in vitamin D insufficient compared with normal children and adolescents (P < 0.05). Risk estimates indicated that vitamin D insufficient and deficient subjects had higher odds of reporting worry compared to normal vitamin D group [OR = 2.417 (95 % CI: 1.483-3.940) for vitamin D insufficient students, and OR = 2.209 (95 % CI: 1.351-3.611) for vitamin D deficient students] (P-trend = 0.001). Violence behaviors did not show any association with vitamin D status (P > 0.05).
  
  
  CONCLUSIONS
  Some psychiatric distress such as anger, anxiety, poor quality sleep, depression, and worry are associated with hypovitaminosis D in adolescents. The clinical significance of the current findings should be determined in future longitudinal studies.
authors.affiliation: Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.|Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran.
authors.forename: Asal
authors.initials: A
authors.lastname: Ataie-Jafari
authors.affiliation: Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.|Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Qorbani
authors.affiliation: Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Heshmat
authors.affiliation: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Gelayol
authors.initials: G
authors.lastname: Ardalan
authors.affiliation: Department of Pediatrics, Faculty of Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IraN.
authors.forename: Mohammad Esmaeil
authors.initials: ME
authors.lastname: Motlagh
authors.affiliation: Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Asayesh
authors.affiliation: Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Masoud
authors.initials: SM
authors.lastname: Arzaghi
authors.affiliation: Department of Biotechnology, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammad Hasan
authors.initials: MH
authors.lastname: Tajadini
authors.affiliation: Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Nejatinamini
authors.affiliation: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Parinaz
authors.initials: P
authors.lastname: Poursafa
authors.affiliation: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
keywords: Adolescents; Anger; Anxiety; Depression; Mental health; Violence behaviors; Vitamin D