Exploring the tripartite influence model of body image and disordered eating among adolescent girls living in Australia, China, India, and Iran.

The aim of this study was to evaluate the tripartite influence model of body image and disordered eating among 12-18-year-old girls (N = 900) living in Australia (n = 184), China (n = 293), India (n = 223), and Iran (n = 200). Participants completed measures about appearance pressures from family, peers, and media, thin-ideal internalization, appearance comparisons, appearance satisfaction, and disordered eating. Results indicated that media- pressures were most salient in Australia, whereas Iranians perceived family pressures to be the strongest. Indians felt the most pressure to look attractive from their family and peers, whereas Chinese felt similar levels of pressure from family, peers, and media. Path analyses suggested direct associations from one or more sociocultural factors to appearance satisfaction or disordered eating, with indirect paths via thin-ideal internalization and appearance comparisons emerging in all countries. Certain sociocultural factors contributed more strongly to the internalization of ideals and appearance comparisons within some countries. Multigroup path analyses demonstrated some cross-cultural variations in the strength of the pathways. Findings extend cross-cultural support for a modified tripartite influence model emphasizing culture-based specificities that can further guide preventative efforts to improve body image and eating attitudes among young girls in these four countries.

Investigating the relationship between DMFT and mothers' knowledge and attitude about oral health and dmft of 6-12-year-old children with attention-deficit/hyperactivity disorder.

Background: Children with attention-deficit/hyperactivity disorder (ADHD) are more prone to tooth decay. In this regard, parents, especially their mothers, play a major role in the oral health of their children. Materials and Methods: The present study was a cross-sectional descriptive study. The population of this study was 64 children with ADHD referred to pediatric psychiatric clinics in Isfahan. Inclusion criteria include willingness to participate in research. At least 6 months has passed since their child was diagnosed with the disorder and their child is receiving treatment.Lack of obvious physical disorders, psychotic disorders, mental retardation and chronic diseases in children with attention deficit/hyperactivity disorder with the approval of a psychiatrist. Collaboration for dental examination by a dentist. Exclusion criteria include obvious physical and mental disorders in mothers of children with attention-deficit/hyperactivity disorder. Simultaneous participation in a study similar to the present study due to the possibility of errors in the results. Dissatisfaction with participating in the study and leaving the study during the study. The data collection tool was interview-questionnaire-examination. Clinical interviews were conducted using the Kiddie Schedule for Affective Disorders and Schizophrenia to confirm ADHD and rule out other psychiatric illnesses. Information on decayed, missing, and filled teeth (DMFT) of permanent teeth and dmft of deciduous teeth is recorded separately. The score of each index (D, M, F), (f, m, d) as well as the total index (DMFT), (dmft) is calculated for each person. Data were entered into SPSS software version 26 by descriptive statistical methods, one-way analysis of variance, t-test, and calculation of Spearman correlation coefficient. P < 0.05 was considered statistically significant. Results: The oral health status of children with ADHD did not show a significant relationship with the total score of attitude and knowledge of oral health behaviors of mothers (P > 0.05). The results showed a significant positive relationship between the level of knowledge of the participants and their education level (P < 0.05). Conclusion: The results revealed that mothers' knowledge and attitude about oral health and dental health of children with ADHD were generally at an undesirable level.

Metabolic effects of adding Topiramate on Aripiprazole in bipolar patients aged between 6-18 years, a randomized, double-blind, placebo-controlled trial.

Background: second-generation antipsychotics (SGAs) are associated with metabolic side effects in child and adolescents. The aim of this study is to evaluate the metabolic effects of adding topiramate on aripiprazole in patients with bipolar disorder (BD) aged between 6 and 18 years. Materials and Methods: A 12-week, double-blind, placebo-controlled, randomized trial was conducted in the child psychiatric units of university hospitals. Forty patients aged between 6 and 18 years with new diagnosis of BD participated in the study. Eleven patients were excluded. Subjects received aripiprazole plus topiramate (Group 1, n = 15) or aripiprazole (Group 2, n = 14) for a 3-month period. Young mania rating scale (YMRS) was used for measuring the manic symptoms severity. Primary outcome measures included weight, height, body mass index (BMI), waist circumference, abdominal circumference, and blood pressure. Secondary outcome measures included fasting blood glucose, hemoglobin A1C, fasting insulin, and fasting lipid profile. Changes in metabolic profile during the study were obtained by using repeated measures of variance. Results: During a 3-month follow-up, YMRS measures decreased significantly in both groups with a significant difference between groups (P < 0.05). The mean of weight, BMI, and high-density lipoprotein levels in group 2 were significantly increased (P < 0.05), and the mean of low-density lipoprotein level in group 1 was decreased (P < 0.05). No significant differences were observed in anthropometric parameters and metabolic indices between groups (P > 0.05). Conclusion: Adding topiramate on aripiprazole is effectivefor controlling bipolar disorder as well as metabolic adverse effects of SGAs in juvenile patients.

Prevalence of elimination disorders and comorbid psychiatric disorders in Iranian children and adolescents.

PURPOSE: Currently, there is a paucity of studies on the prevalence of Elimination Disorders among Iranian children and adolescents. Due to the ongoing need to monitor the health status of these children and adolescents, the present study aims to investigate the prevalence of Elimination Disorders and comorbid disorders in Iranian children and adolescents. METHODS: In this cross-sectional study, 29,781 children and adolescents age 6 to 18 years old were selected and studied from all the provinces in Iran. The sampling was carried out by employing a multistage cluster sampling method, and several clinical psychologists using semi-structured interviews collected the data. Furthermore, clinical psychologists collected demographic information (including information about gender, age, place of residence, education level, and parental education level). The collected data were analyzed using SPSS version 20. RESULTS: Generally, the prevalence of Elimination Disorders was found to be 5.4% covering both enuresis (p= 5.4, 95% CI = 5.1-5.7) and encopresis (p= 0.13, 95% CI = 0.09-0.2). The total prevalence of comorbid disorders was 38%, and among the comorbid disorders, Attention Deficit Hyperactivity Disorder (ADHD) (p= 11, 95% CI = 9.5-12.7) and Separation Anxiety (p= 10.6, 95% CI = 9.1-12.2) were the most prevalent. CONCLUSION: The prevalence of Elimination Disorders in Iranian children and adolescents is moderate compared to similar studies elsewhere. As for comorbid disorders, ADHD and Separation Anxiety were found to be the most prevalent disorders. Since Elimination Disorders coexist with psychiatric disorders in children, further studies of these comorbidities may give better insight into the treatment and prognosis of Elimination Disorders.

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.

Prevalence, comorbidities, and sociodemographic predictors of conduct disorder: the national epidemiology of Iranian children and adolescents psychiatric disorders (IRCAP).

The aim was to evaluate the lifetime prevalence of conduct disorder according to sociodemographic characteristics, determine the sociodemographic predictors of conduct disorder, and estimate the rates of comorbidities of psychiatric disorders in children and adolescents with conduct disorder by age and gender. The National Epidemiology of Iranian Children and Adolescents Psychiatric Disorders was a cross-sectional, general population-based study on 30,532 children and adolescents aged 6-18 years from all provinces of Iran, which was done using multistage cluster sampling. Iranian citizens aged 6-18 years who resided at least 1 year in each province were included, and children and adolescents with severe physical illnesses that prevented them to participate in the study were excluded. The sample weighting adjustment was used, since we had randomly selected the equal number of 1000 participants of each province from the urban and rural areas. Trained psychologists conducted diagnostic interviews with the adolescents and the children's parents using the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). In this study, 54 children aged 6-9 years (0.58%, CI 0.47-0.77), 64 adolescents aged 10-14 years (0.57%, CI 0.47-0.77), and 117 adolescents aged 15-18 years (1.22%, CI 0.96-1.44) met the criteria of the lifetime conduct disorder. Conduct disorder was significantly more common in boys than in girls, and was significantly less prevalent among those participants whose fathers had no history of psychiatric hospitalization. Of the participants with conduct disorder, 83.4% met the criteria for at least one other psychiatric disorder. Conduct disorder had a high rate of comorbidity with oppositional defiant disorder (54.89%, CI 48.50-61.12), attention-deficit/hyperactivity disorder (32.34%, CI 26.68-38.56), tobacco use (20.43%, CI 15.77-26.04), and depressive disorders (18.30%, CI 13.88-23.74). Because of using the diagnostic instrument, we found a low total rate of prevalence for conduct disorder; however, higher rates of it were observed among boys and adolescents. Further studies are needed to explore the nature of comorbidities of conduct disorder and to consider them in a large clinical population.

Prevalence of Autism and its Comorbidities and the Relationship with Maternal Psychopathology: A National Population-Based Study.

BACKGROUND: There is no clear picture regarding the prevalence rates of autism and its comorbidities among Iranian children and adolescents. The present study aimed to estimate these rates as part of a large national population-based study on epidemiology of psychiatric disorders in Iranian children and adolescents. METHODS: The total sample consisted of 31000 children and adolescents between 6 to 18 years of age. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Present and Life time version (K-SADS-PL) was used as the diagnostic tool. RESULTS: The prevalence of autism in the total sample is equal to 0.1% (10 per 10000), with a 2:1 male-to-female ratio. In total, 86% of people with autism had at least one comorbid condition. Intellectual disability, epilepsy, enuresis and attention deficit and hyperactivity disorder (ADHD) with prevalence rates of 70.3%, 29.7%, 27% and 21.62%, respectively, were the most prevalent comorbid conditions in people with autism. Maternal personality disorders were also shown to be associated with increasing risk of autism. CONCLUSION: The present study shows high prevalence rates for autism and its comorbid conditions among Iranian children and adolescents. It also reveals that there is a relationship between some maternal psychiatric disorders and the risk of autism.

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.

Efficacy of Group Cognitive-behavioral Therapy in Maintenance Treatment and Relapse Prevention for Bipolar Adolescents.

BACKGROUND: Despite conducting wide-ranging of pharmacotherapy for bipolar adolescents, many of them are showing a deficit in functioning with high relapse rate. The aim of the current study was to develop a manual and investigate the efficacy of group cognitive-behavioral therapy (G-CBT) for female bipolar adolescents. MATERIALS AND METHODS: During the first qualitative phase of a mixed-methods study, a manual of G-CBT was developed. Then, 32 female bipolar adolescents aged 12-19 years old, receiving usual maintenance medications (UMM), were selected. Participants were randomized to the control (UMM) and intervention group (5, 2 h weekly sessions based on G-CBT manual with UMM). The parents in intervention group participated in three parallel sessions. All participants filled the following questionnaires before 1, 3, and 6 months after the initiation of the study: Young Mania Rating Scale, Children Depression Inventory and Global Assessment of Functioning. The results were analyzed using SPSS 21 software. The concurrent qualitative phase was analyzed through thematic analysis. RESULTS: The results showed no significant differences in all questionnaires' scores through intervention and follow-up sessions (P > 0.05). However, using cutoff point of CDI, G-CBT was effective for intervention group (relapse rate: 25% vs. 44.4%). Two themes were extracted from the second qualitative phase: emotion recognition and emotion regulation, especially in anger control. CONCLUSIONS: The results showed that the addition of G-CBT to UMM leads to decrease in the depressive scores but has no effect on manic symptoms and relapse rate.

Parenting Styles and Psychiatric Disorders in Children of Bipolar Parents.

BACKGROUND: Bipolar disorders (BD) in parents can have different effects on children and perhaps as a reason of the incidence of various psychiatric disorders in them and they may show a particular parenting style due to features of their disease. Given a crucial role of parenting style in upbringing children, this study aimed to evaluate different styles of parenting and its relationship with psychiatric disorders in children of parents with bipolar disorder (PBD) compared with controls. MATERIALS AND METHODS: In this case-control study, 500 parents with children aged 6-17 years were included that 250 of them with BD were selected as the case group and 250 of them were healthy as control group. The parents were selected according to the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) by a physician. Psychiatric disorders in children were assessed by The Kiddie Schedule for Affective Disorders and Schizophrenia for school-age children (KSADS). The collected data were analyzed with SPSS (version 20). RESULTS: According to KSADS, there was significant difference between two groups of children in depression, mania, attention-deficit hyperactivity disorder, and posttraumatic stress disorder (P < 0.05). In authoritative dimension, parenting styles were effective in the incidence of psychosis (odds ratio [OR] [95% confidence interval (CI)]: 0.775 [0.63-0.95]) and led to a decrease of 0.320 times in the chance of oppositional defiant disorder incidence (OR [95% CI]: 0.320 [0.21-0.74]; P = 0.043) but an increase of 1.129 times in the chance of cigarette/tobacco use (OR [95% CI]: 1.129 [1.02-1.25]; P = 0.016). CONCLUSION: The chance of psychiatric disorder's incidence in children of PBD was so far more than children of healthy parents. Hence, the incidence of some psychiatric disorders in children can be associated with parenting styles.

The Efficacy of Augment of D-Cycloserine and Cognitive-behavioral Therapy on Adolescent with one Type of Anxiety Disorders: A Double-blind Randomized Controlled Trial.

BACKGROUND: This study was designed to investigating the effect of combining D-cycloserine (DCS) and cognitive-behavioral therapy (CBT) on adolescent with at least one type of anxiety disorders. MATERIALS AND METHODS: The present study was conducted as a double-blind randomized controlled trial on 36 adolescent with anxiety disorders. Patients were assessed in two groups. In addition to 4 sessions of weekly CBT in both groups; case group, received a 50-mg DCS capsules, control group, received Placebo daily for a month. Patients received DCS capsules or placebo 1 h before sessions of CBT. Age, sex, kind of anxiety disorders "screen for child anxiety related disorders (SCARED)" and "cognitive abilities test (CATS)" scores were evaluated and compared between groups. RESULTS: The mean age of the studied patients (29 females (80.6%) and 7 males (19.4%)) was 14.1 ± 1.8 years. The most frequent anxiety disorder among the study population was generalized social disorder (GAD) (77.7%). Age, sex and the frequency of anxiety disorders were not statistically significant between the study groups (P > 0.05). The mean score of "SCARED" and "CATS" at before starting the treatment, after treatment and three month after the treatment were not statistically significant between groups (P > 0.05). Also, decrease in values of "SCARED" and "CATS" during the evaluation time periods was not statistically significant between groups (P > 0.05). CONCLUSIONS: Findings of this study showed that there has been no difference in symptoms improvement in adolescent with anxiety disorder who received treatment protocol including 4 sessions of CBT, weekly, together with 50 mgs of DCS compared to the patients of the control group.

Psychiatric Disorders in Iranian Children and Adolescents.

OBJECTIVE: The aim of the present study was to investigate the epidemiology of psychiatric disorders in children and adolescents in five provinces of Iran: Tehran, Shiraz, Isfahan, Tabriz and Mashhad. METHOD: In the present study, we selected 9,636 children and adolescents aged 6-18 years through multistage cluster random sampling method from Tehran, Shiraz, Isfahan, Tabriz and Mashhad. We instructed the clinical psychologists to complete the Strengths and Difficulties Questionnaire (SDQ) for the participants, andthose who received a high score on SDQ, completed the Persian version of Kiddie-SADS-Present and Lifetime Version (K-SADS-PL). We used descriptive analysis and 95% confidence interval to investigate the relationship between scores of the K-SADS questionnaire and demographic factors. We used one-way ANOVA to test the significant differences among the disorders according to sex, age and province of residence. RESULTS: Based on the results, oppositional defiant disorder (ODD) (4.45%) had the highest prevalence of psychiatric disorders in the five provinces and substance abuse and alcohol abuse (0%) had the lowest prevalence. In addition, attention deficit hyperactivity disorder (ADHD) had the most prevalence in boys (5.03%) and ODD had the most prevalence in girls (4.05%). Among the three age groups, 6 to 9 year olds had the highest rates of ADHD (5.69%); 10 to 14 and 15 to 18 year olds had the highest rates of ODD (4.32% and 4.37% respectively). Among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of ADHD; and Tabriz had the highest rates of social phobia. CONCLUSION: The current study revealed that the overall frequency of psychiatric disorders based on Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) was higher than a similar study. Moreover, in this study, among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of ADHD; and Tabriz had the highest rates of social phobia. Therefore, these percentage of psychiatric disorders in Iran lead us toward a greater use of consultation and mental health services.

Some side effects and effcts on physical activity of second-generation antipsychotics: A study in children and adolescents.

BACKGROUND: This study was designed to investigate the metabolic adverse effects (AEs) of second-generation antipsychotics (SGAs) and their relationship with physical activity and non-metabolic AE in children and adolescents. MATERIALS AND METHODS: After exclusion of patients with metabolic syndrome, 62 patients (34 children, 28 adolescents) of both genders who were candidates for SGA therapy were selected. Metabolic parameters included fasting blood glucose (FBG), triglyceride (TG), blood pressure (BP), and waist circumference (WC); non-metabolic AEs and physical activity were evaluated at baseline, 1 month, and 3 months after starting the treatment. RESULTS: Mean of post-treatment FBG and TG were significantly higher than the baseline values (P < 0.0001). Compared to the baseline value, significantly more patients developed abnormally high (AbH) FBG at the end point (P = 0.02). There was no significant difference in the frequency of patients with AbH-FBG either at the baseline or at the end point (P > 0.05). The frequency of patients with AbH-TG at the end point was not significantly higher than those with baseline AbH-TG (P = 0.10). Although no patient was obese at baseline, 11 (18%) patients developed abdominal obesity at the end point (P < 0.0001). There was no significant difference in the frequency of non-metabolic AE (P > 0.05). There was no significant correlation between metabolic and non-metabolic AE (P > 0.05). Frequency of inactive patients was significantly more than the baseline value (P-0.008), and abdominal obesity was significantly more prevalent in less active participants (P = 0.03). CONCLUSION: The present study showed the AE of SGA on FBG and TG, but no effect on BP and WC. We also found that children are more prone to develop abnormally high FBG.

Comparison of parent adolescent scores on Strengths and Difficulties Questionnaire.

BACKGROUND: Child and adolescent psychiatry has benefited from the application of self-report questionnaires because it is short, less costly and easy to apply. So we select the Strengths and Difficulties Questionnaire (SDQ) and evaluate the agreement between the self-report and parent report form. MATERIALS AND METHODS: Subjects were 1934 Adolescents, 11-18 years old. After obtaining the samples consent, SDQ parent rated form and self-rated form were filled. The collected data were analyzed using the STATA statistical package version 9. RESULTS: The adolescents obtained higher total difficulty scores than their parents, but it was not significant (P = 0.203). Boys had higher total difficulty scores than girls by parent informant (P = 0.001), but by self-report girls had higher total difficulty scores than boys (P = 0.42). 11-14 years had higher total difficulty scores by parent report than self-report (P = 0.42), but 15-18 years had higher total difficulty scores by self-report than parent report (P = 0.36). CONCLUSION: SDQ self-rating from adolescents may contribute better to the diagnostic process in the clinical setting.

Effect of aromatherapy with orange essential oil on salivary cortisol and pulse rate in children during dental treatment: A randomized controlled clinical trial.

BACKGROUND: Essential oils have been used as an alternative and complementary treatment in medicine. Citrus fragrance has been used by aromatherapists for the treatment of anxiety symptoms. Based on this claim, the aim of present study was to investigate the effect of aromatherapy with essential oil of orange on child anxiety during dental treatment. MATERIALS AND METHODS: Thirty children (10 boys, 20 girls) aged 6-9 years participated in a crossover intervention study, according to the inclusion criteria, among patients who attended the pediatric department of Isfahan Dental School in 2011. Every child underwent two dental treatment appointments including dental prophylaxis and fissure-sealant therapy under orange aroma in one session (intervention) and without any aroma (control) in another one. Child anxiety level was measured using salivary cortisol and pulse rate before and after treatment in each visit. The data were analyzed using t-test by SPSS software version 18. RESULTS: The mean ± SD and mean difference of salivary cortisol levels and pulse rate were calculated in each group before and completion of treatment in each visit. The difference in means of salivary cortisol and pulse rate between treatment under orange odor and treatment without aroma was 1.047 ± 2.198 nmol/l and 6.73 ± 12.3 (in minutes), which was statistically significant using paired t-test (P = 0.014, P = 0.005, respectively). CONCLUSION: It seems that the use of aromatherapy with natural essential oil of orange could reduce salivary cortisol and pulse rate due to child anxiety state.

Psychological problems in Iranian adolescents: application of the self report form of strengths and difficulties questionnaire.

OBJECTIVE: The aim of the present study was to investigate the epidemiology of psychological problems in adolescents in five provinces of Tehran, Khorasan Razavi, Isfahan, East Azerbaijan and Fars in Iran. METHODS: In the present cross-sectional and descriptive - analytical study, 5171 adolescents aged 12 to 17 years were selected through multistage cluster sampling method from Tehran, Isfahan, Fars, Khorasan Razavi and East Azarbaijan provinces. The self-report form of Strengths and Difficulties Questionnaire (SDQ) was used to obtain the demographic data of each adolescent. Descriptive analysis and 95% confidence interval were used to investigate the relationship between scores of the SDQ questionnaire and demographic factors. RESULT: Based on the results, the highest prevalence of psychological problems in the five provinces was related to conduct problems (24%), and the lowest prevalence was related to social problems (5.76%). Also, comparison of 95% confidence interval of prevalence of psychological problems between the two genders suggested a significant difference only in emotional problems of the self-report version of the SDQ between the two genders. The result revealed no significant difference in the psychological problems of the self-report version of the SDQ between the two age's groups and between the middle and high school graduates (p≤0.05). Among the 5 provinces, Fars allocated the highest rates of conduct problems (28.4), hyperactivity problems (21.5%) and overall criterion problems (17.3%); Esfahan had the highest rates of emotional problems (9.1%) and problems with peers (8.1%); and Khorasan Razavi had the highest rates of social problems (7.6%). CONCLUSION: In this study, the highest prevalence of psychological problems in the five provinces was related to conduct problems, and the lowest prevalence was related to social problems. It was determined that girls have more emotional problems than boys. Also, no significant difference was found in the psychological problems of 12 to 14 and 15 to 17 year old adolescents or between middle and high school graduates. In the current study, the prevalence of psychological problems in adolescents in the urban population in Fars province was higher than expected.

The effectiveness of cognitive behavioral stress management training on mental health, social interaction and family function in adolescents of families with one Human Immunodeficiency Virus (HIV) positive member.

BACKGROUND: This study evaluated stress management training to improve mental health, social interaction and family function among adolescents of families with one Human Immunodeficiency Virus (HIV) positive member. METHODS: There were 34 adolescents (13-18 years old) with at least one family member living with HIV from whom finally 15 attended the study and participated in 8 weekly sessions of stress management training. The tests used in this study were: Strengths and Difficulties Questionnaire (self and parent report), General Health Questionnare-28 (GHQ-28) and Family Assessment Device (FAD), conducted before, after and three months after the intervention. The collected data were analyzed by repeated measure test using SPSS software (Version 18.0). RESULTS: Adolescents with one HIV positive family member showed high level of emotional problem (40%) and conduct problem (33.3%). There was a significant difference between before, after and 3months after intervention based on GHQ-28 mean scores and FAD mean sores (p < 0.001). There was a significant difference between mean scores of peers' relationship based on SDQ (self report and parents report forms) before and after intervention, but there was no significant difference between mean scores of pro social behavior based on SDQ (self report and parents report forms) in all three stages (before, after and three months after intervention). CONCLUSIONS: Stress management training is effective in improving mental health, family function and social interaction among adolescents living with parents infected with HIV/AIDS.

Perceived impact of socially anxious behaviors on individuals' lives in Western and East Asian countries.

The current study compared the predicted social and career impact of socially withdrawn and reticent behaviors among participants from Western and East Asian countries. Three hundred sixty-one college students from 5 Western countries and 455 students from 3 East Asian countries read hypothetical vignettes describing socially withdrawn and shy behaviors versus socially outgoing and confident behaviors. Participants then answered questions following each vignette indicating the extent to which they would expect the subject of the vignette to be socially liked and to succeed in their career. Participants also completed measures of their own social anxiety and quality of life. The results indicated significant vignette-by-country interactions in that the difference in perceived social and career impact between shy and outgoing vignettes was smaller among participants from East Asian countries than from Western countries. In addition, significant negative correlations were shown between personal level of shyness and experienced quality of life for participants from both groups of countries, but the size of this relationship was greater for participants from Western than East Asian countries. The results point to the more negative impact of withdrawn and socially reticent behaviors for people from Western countries relative to those from East Asia.

The efficacy of attendance and semi-attendance group cognitive-behavioral therapy (CBT) on the anxiety disorders of adolescent girls.

BACKGROUND: Anxiety disorders are one of the most psychiatric disorders in children and adolescents that can cause long life functional disability. The first line treatment for this disorder is cognitive behavioral therapy that has primary, secondary and tertiary preventive effect, but is expensive and long time. Today there is some effort to find short term, group, semi-attendance and low cost therapies. METHODS: Subjects were 42 girls (12- 17 y) with at least one anxiety disorder according to DSM-IV-TR with their parents who were divided into two groups randomly: group A which participated in 8 sessions and group B which participated in 4 sessions and the contents of sessions 3, 4, 6, and 7 were recorded on a CD for them. The tests used in this study were: SCARED, CATS, CAIS-C, CAIS-P, conducted before (T0), just after (T1) and three months after the treatment (T2). The collected data were analyzed by multivariate analysis of covariance test using SPSS software package, version 15.0. RESULTS: There was no significant difference between efficacy of semi-attendance group CBT and attendance group CBT in T0, T1 and T2 according to 4 tests (p = 0.311). The difference between the scores of these tests between T0 andT1 and T0 and T2 was significant in both groups (p < 0.001) but the difference between T1 and T2 was not significant. (p = 0.771). CONCLUSIONS: The efficacy of semi-attendance group CBT and attendance group CBT is similar and would sustain after 3 months.

The evaluation of relationship between group A streptococcal infection with tic disorders in children.

OBJECTIVE: To evaluate the relationship between group A beta hemolytic streptococcus infection (GABHS) and tic disorders in children. METHODS: This is a case-control study that was conducted in Child and Adolescent Psychiatric Clinic, Isfahan, Iran, between May 2008 and February 2009. Thirty-six children (aged 5-15) with tic and 36 children without tic and obsessive-compulsive disorder (OCD) were investigated for clinical and laboratory signs of GABHS. The tools utilized in this research were clinical interview according to the DSM IV-TR and laboratory tests (throat culture, rapid antigen detection test [RADT], anti streptolysin O [ASO] and yale global tics severity scale [YGTSS]). The control group was of the same gender and age as the tic group who had come to the clinic for other illnesses and was in need of blood test. None of the subjects in the case and control groups had a clinical history of GABHS infection. RESULTS: The relationship between tic disorder and GABHS infection (if any of these laboratory tests takes place: throat culture, RADT, ASO > or = 250) in the tic group was 16 (44.4%) and in the control group was 9 (25%), there were significant differences (p<0.05). No significant correlation was found between ASO titer and YGTSS scores. The specificity of RADT was 100%. CONCLUSION: The result showed correlation between GABHS infection and tic disorder, but it does not mean that GABHS infection caused tic disorder.