Effect of video games on preoperative anxiety in 3- to-6-year-old of a sample of Iranian children undergoing elective surgery.

BACKGROUND: As pediatric surgeries are rising and current methods to reduce perioperative anxiety are lacking in preschool children. The purpose of this study was to determine the effect of video games on preoperative anxiety in 3- to-6-year old of a sample of Iranian children undergoing elective surgery children. MATERIALS AND METHODS: In the current quasi-experimental pretest posttest design, after standard translation, the modified Yale preoperative anxiety scale was administered to 102 children undergoing surgery from December 2016 to August 2017 in Kermanshah, Iran. Children are assigned to an intervention or control group. Each child's anxiety was measured at two points at the time of arrival and after waiting for 20 min in the holding area. Data were analyzed by SPSS, version 22. The Chi-square, independent t-test, and paired t-test at the significance level of P < 0.05 were performed. RESULTS: There was no significant difference between the mean anxieties in control group (42.58 ± 18.54) and intervention group (46.11 ± 14.09) before the game (P = 0.282). However, after playing the video game in control groups (53.26 ± 18.00) and game groups (34.88 ± 10.81), there was a significant difference in favor of the video game (P < 0.001). CONCLUSION: Findings of the present study suggest that approved video game by experts to decrease mean preoperative anxiety in 3- to-6-year-old children. Therefore, video games recommended to be implemented at the preventive level in hospital.

Effects of vitamin D supplementation on core symptoms, serum serotonin, and interleukin-6 in children with autism spectrum disorders: A randomized clinical trial.

OBJECTIVES: Children with autism spectrum disorders (ASD) have lower serum vitamin D and higher serotonin and interleukin (IL)-6 levels compared with healthy children. The aim of this study was to evaluate the effect of vitamin D on core symptoms and serum levels of serotonin and IL-6 in these children. METHODS: This parallel randomized double-blind, placebo-controlled trial was conducted with 43 children with ASD (7 girls and 36 boys; 8.91 ± 2.87 y of age). Children were randomly allocated to receive either vitamin D drop (300 IU/kg up to a maximum of 6000 IU daily) or placebo for 15 wk. Serum levels of 25-hydroxyvitamin (OH)D, IL-6, and serotonin were measured at baseline and at the end of the trial. Also, the severity of autism and the social and individual maturity of the children were measured by the Childhood Autism Rating Scale (CARS), the Autism Treatment Assessment Checklist (ATEC), and Aberrant Behavior Checklist-Community (ABC-C) questionnaires before and after intervention. Randomization and allocation to groups were done using computer-generated numbers. RESULTS: More than 86% of patients had vitamin D deficiency at the beginning of the study. Serum levels of 25(OH)D increased significantly in the vitamin D group (P = 0.001). The clinical symptoms of autism measured by CARS and ATEC scales were alleviated significantly (P = 0.021 and P = 0.020, respectively); however, the serum levels of serotonin and IL-6 and the scale of ABC-C remained without a significant change. CONCLUSION: These findings suggest that vitamin D supplementation may improve ASD symptoms; however, more studies with longer duration are indispensable to confirm our results.

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.

Lifetime prevalence, sociodemographic predictors, and comorbidities of oppositional defiant disorder: the National Epidemiology of Iranian Child and Adolescent Psychiatric disorders (IRCAP)

Objective: This was the first national epidemiological study on oppositional defiant disorder (ODD) in Iran, which provided new information about the prevalence, comorbidities, and sociodemographic predictors of ODD. Methods: Data from a face-to-face household survey of 30,532 children and adolescents aged 6-18 years were collected from across all 31 provinces of Iran using a multistage cluster sampling design. The Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime Version (K-SADS-PL) was used in this study. Results: The lifetime prevalence of ODD was found to be 3.9%. ODD was significantly more common in boys than girls and appeared in late adolescence more frequently than in childhood. A lower prevalence of ODD was found among participants who lived in rural areas. ODD is highly likely to co-occur with attention deficit hyperactivity disorder, separation anxiety disorder, generalized anxiety disorder, and depressive disorders. Conclusions: The findings of this national population-based study confirm and extend previous findings on the prevalence, comorbidities, and sociodemographic predictors of ODD.

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.

Risk Factors of Nocturnal Enuresis in Children with Attention Deficit Hyperactivity Disorder.

BACKGROUND: Presence of attention deficit hyperactivity disorder (ADHD) has a negative effect on the resolution of incontinence; however, there are few studies which investigated the risk factors of nocturnal enuresis (NE) in patients with ADHD. AIMS: This study was conducted to investigate the prevalence of NE and its risk factors in children with ADHD. METHODS: 331 children, aged 6 to 10 years, diagnosed as having ADHD were enrolled in this study. The diagnosis of ADHD was confirmed by an experienced child and adolescent psychiatrist according to DSM-IV-TR. NE was defined as nighttime wetting with or without daytime incontinence, at least twice a week over a period of 3 months or longer in children 5 years old and older without anatomical abnormalities. Details on demographic data, perinatal history, medical history and developmental history were collected from parents or medical records. RESULTS: Most of the ADHD patients with inattentional subtype (77.5%) had NE, compared to 31.7% in the hyperactive/Impulsive subtype and 22.5% in the combined subtype (p<0.001, t=42.71). Among children with enuresis, there were significantly higher rates of history of familial enuresis (26% vs. 18 %, p<0.001, t=16.9), cesarean delivery (47% vs. 33%, p=0.019, t=5.84) and history of neonatal sepsis (16% vs. 7%, p=0.018, t=5.62) than non-NE children. Moreover, patients with NE had lower birth weight than non-NE patients (2.93(0.65) vs. 3.09 (0.46), p=0.026, t=2.51). Also, low parental education was associated with increase in the rate of NE. CONCLUSION: Children with ADHD have a high prevalence of NE. Male sex, low education level of parents, history of neonatal sepsis, positive family history of NE, low birth weight and caesarian delivery may be risk factors for NE in ADHD children. Most ADHD patients with inattentional subtype had NE.