Does the socioeconomic status affect the prevalence of psychiatric distress and violent behaviors in children and adolescents? The CASPIAN-IV study.
BACKGROUND
This nationwide study aims to investigate the prevalence of psychiatric distress and violent behaviors in a nationally-representative sample of Iranian children and adolescents according to the socioeconomic status (SES) of their living region.


METHODS
In this study, 14,880 school students, aged 6-18 years, were selected from 30 provinces in Iran. The World Health Organization Global School-based Health Survey questionnaire was used. Data were compared at national and subnational levels according to the SES of the living region.


RESULTS
Overall, 13,486 students (49.2% girls) with mean (SD) age of 12.47 (3.36) years completed the study. At national level, the prevalence of psychiatric distress ranged between 9 to 38%; the most and least prevalent psychiatric distresses were angriness (37.73%, 95% CI: 36.5-38.99) and confusion (8.65%, 95% CI: 8.04-9.29), respectively. Students living in regions with highest SES experienced angriness (41.24%, 95% CI: 38.94-43.59) more than in those from the regions with lowest SES (31.18%, 95% CI: 26.71-36.02). The prevalence of bullying, being bullied and physical fight was 17.56% (95% CI: 16.73-18.42), 27.36% (95% CI: 26.34-28.42), and 39.94% (95% CI: 38.69-41.20), respectively. The prevalence of violent behavior did not differ significantly in various regions of Iran.


CONCLUSIONS
The relatively high prevalence of psychiatric distress in Iranian children and adolescents necessitates paying more attention to mental health of this vulnerable age group. Differences in the prevalence of such disorders according to the SES of the living area should be considered in planning evidence-based preventive programs and in international comparisons.
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.
Roya
R
Kelishadi
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.
Mohsen
M
Jari
Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran - mqorbani1379@yahoo.com.|Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Mostafa
M
Qorbani
Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Mohammad E
ME
Motlagh
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.
Gelayol
G
Ardalan
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.
Maryam
M
Bahreynian
Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.|Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Amir
A
Kasaeian
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.
Zeinab
Z
Ahadi
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Fereshteh
F
Najafi
Department of Medical Emergency, Qom University of Medical Sciences, Qom, Iran.
Hamid
H
Asayesh
Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Ramin
R
Heshmat
D000293:Adolescent; D000786:Anger; D058445:Bullying / Q000706:statistics & numerical data*; D002648:Child; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012574:Schools; D012923:Social Class; D013315:Stress, Psychological / Q000453:epidemiology*; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014754:Violence / Q000706:statistics & numerical data*