title: Association of socioeconomic status with psychiatric problems and violent behaviours in a nationally representative sample of Iranian children and adolescents: the CASPIAN-IV study.
abstract: The aim of the present study was to evaluate the association between socioeconomic status (SES) and psychiatric problems and violent behaviours in a nationally representative sample of Iranian children and adolescents, based on nationwide surveillance programme data, 2011-2012.
  
  
  
  Overall, 14 880 students, aged 6-18 years, were selected using a multistage cluster sampling method from rural and urban areas of 30 provinces in Iran. SES was estimated based on a main summarised component, extracted from principle component analysis of family assets and parents' jobs and education. For statistical analysis, SES was classified as 'low', 'middle' and 'high'. The WHO-Global School Based Student Health Survey (WHO-GSHS) questionnaire was used to assess psychiatric problems and violent behaviours.
  
  
  
  In total, 13 486 students (participation rate 90.6%) completed the study: 50.8% were boys and 75.6% were urban residents, with a mean age of 12.47±3.36 years. In the multivariate model, the ORs of depression, anxiety, feeling worthless, anger, insomnia, confusion and physical fights were lower in students with high SES compared with those with low SES (p<0.05) but physical fights was lower in the high SES group than in the low SES group (p<0.05). No significant relationship was documented between SES and other variables, including getting worried, history of bullying and being victimised.
  
  
  
  Children and adolescents with low SES were at higher risk for psychiatric problems and violent behaviours. Mental health policies and public interventional strategies should be considered at the public level, notably for low SES families.
authors.affiliation: Chronic Diseases Research Centre, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Heshmat
authors.affiliation: Dietary Supplements and Probiotics Research Centre, Alborz University of Medical Sciences, Karaj, Iran Endocrinology and Metabolism Research Centre, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Qorbani
authors.affiliation: Faculty of Medicine, Islamic Azad University, Tehran, Iran.
authors.forename: Behnaz
authors.initials: B
authors.lastname: Ghoreshi
authors.affiliation: Development of Research and Technology Centre, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Shirin
authors.initials: S
authors.lastname: Djalalinia
authors.affiliation: Chronic Diseases Research Centre, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Omid Reza
authors.initials: OR
authors.lastname: Tabatabaie
authors.affiliation: Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Safiri
authors.affiliation: Substance Abuse and Dependence Research Centre, University of Social, Welfare and Rehabilitation Sciences, Tehran, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Noroozi
authors.affiliation: Department of Paediatrics, Ahvaz Jundishapor University of Medical Sciences, Ahvaz, Iran.
authors.forename: Mohammad-Esmaeil
authors.initials: ME
authors.lastname: Motlagh
authors.affiliation: Chronic Diseases Research Centre, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Ahadi
authors.affiliation: Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Asayesh
authors.affiliation: Department of Paediatrics, Child Growth and Development Research Centre, 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
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000786:Anger; D001007:Anxiety / Q000453:epidemiology; D058445:Bullying / Q000706:statistics & numerical data*; D002648:Child; D002652:Child Behavior; D019548:Crime Victims / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology; D012923:Social Class; D014754:Violence / Q000706:statistics & numerical data*
keywords: EPIDEMIOLOGY; psychiatric distress; socioeconomic status; violent behaviors