فهرست مطالب hadi zarafshan

In current study, we aimed to investigate if Attention Deficit Hyperactivity Disorder (ADHD) is better to be categorized among behavioral or neurodevelopmental disorders, based on some familial and environmental factors. 

We conducted correlation analysis to identify psychiatric disorders in the dataset which have an important impact on ADHD. Also, we used machine learning-based approaches combined with a feature selection algorithm to cluster and classify ADHD as a behavioral or neurodevelopmental disorder.

Model evaluation showed that ADHD is clustered in the group of behavioral disorders with the accuracy of 78%. Furthermore, Support Vector Machine (SVM) classified ADHD as a behavioral disorder with the accuracy of 72.66% and as a neurodevelopmental disorder with the accuracy of 60.07%.

In sum, we can say that our findings support categorizations systems like HiTOP in comparison to DSM-5. However, as biological factors were not included in our analysis, it should be considered with caution and examined in future researches.

 Children from lower socioeconomic status (SES) households are at greater risk for mental illnesses. Socioeconomic status has different dimensions: Objective SES, subjective SES, and contextual SES. Evidence suggests that subjective SES partially mediates the impact of objective SES on mental health. However, these hypotheses have not been tested in Middle Eastern cultures, including Iran.

 We aimed to investigate: (1) If there is an association between parental objective, subjective, and contextual SES measures and their children's mental health in a network of general practitioners' clients, (2) If such an association exists for objective or contextual indicators, is it partially or fully mediated through subjective measure? and (3) if such an association exists, is it affected by children's age?

 We assessed 1,103 parent-child pairs in the general practitioners' network of clients. The child's mental health was assessed by the Strengths and Difficulties Questionnaire (SDQ) and parental objective SES by education level, subjective SES by the MacArthur scale, and contextual SES by the household neighborhood. Linear regression models were used to investigate the impact of different SES measures on the SDQ score both bivariately and adjusted for each other. A mediation analysis was performed for objective SES' indirect effect on SDQ score through subjective SES.

 We found a significant association between objective and subjective SES and the SDQ score, which remained significant after adjusting for each other. Both objective and subjective measures had a small effect size (Cohen's f-squared = 0.03). There was no association between contextual SES and SDQ scores in our sample.

 Socioeconomic status impacts children and adolescents' mental health. However, SES is a multi-dimensional concept. Further research considering different dimensions is needed to understand the interplay of these dimensions in different cultures and contexts. Addressing such exploratory questions may help pave the way for detecting and addressing these social determinants in primary care settings.

social cognition checklist- parent form has been designed assess mind reading skill across childhood. The aim of this study was development and investigate the psychometric characteristics of social cognition check list (SASHA).

the research design was descriptive correlational research based on psychometric analysis. The social cognition checklist consists of 44 statement was carried out on 492 children aged 3 t0 12 years old through random multi- stage cluster sampling in Tehran. for analysis of data, the confirmatory factor analysis was used.

the results of confirmatory factor analysis confirmed the three factors of the checklist. The results of the correlation coefficient provided evidence of the convergent validity of the social cognition checklist with theory of mind quotient. The reliability of the checklist was measured by Cronbach’s alpha coefficient and the correlation of the subscales with the total score of the checklist. Cronbach’s alpha for subscale precursor theory of mind (0/81), elementary theory of mind (0/98), advanced theory of mind (0/97) and total score was (0/98).

generally, social cognition checklist can be used as practical tool for diagnosis, screening, research and other areas of interventions. 

Autism Spectrum Disorder (ASD) is a neurological developmental disorder characterized by impaired social interactions, stereotypic movements and repetitive and limited behaviors and interests. Given the increasing statistics of autism in children in the world and in Iran, the extent of problems and burdens that this disorder creates for the child, family and society, it is a necessity to identify the causes and factors related to ASD. Moreover, data on this disorder are limited nationally and geographical differences are rarely assessed. To conduct great research on autism spectrum disorders requires a large number of samples to identify the epidemiological trend of the disorder. Registrations are one of the efficient methods that can provide this data in a long time and on a large scale. The purpose of this study is to describe the steps of designing and launching an autism registration system in Tehran, which can be a prelude to creating a system at the national level.

In this study, the aim was to present a protocol to design and launch a registry for patients with autism spectrum disorders in Tehran for clinical and research purposes. The entered population in this system includes individuals (including children over 6 months and adults) with previous diagnosis or new diagnosis referred to the certain centers (Child Psychiatric Clinic of Tehran Psychiatric Institute, Ali Asghar Children's Hospital, Razi Hospital and Roozbeh Hospital) and also, physicians' offices who are members of the program's strategic committee. Patients are admitted to the program if the diagnosis of ASD is confirmed by a pediatrician, child neurologist, psychiatrist, neurologist, psychiatrist, neurologist, child psychologist according to the DSM-5 diagnostic criteria.Then personal and demographics information and clinical and laboratory findings will be recorded by data entry experts in the system. Patients will be followed up by telephone or through coming back of the patients to the certain centers. Data analysis is done in accordance with the objectives of the registration program and is performed based on conventional statistical methods. Also, an annual report of the profiles of registered patients is sent to the beneficiaries of the program at the end of each year, including the Vice Chancellor for Research of the participating universities, the Ministry of Health, and related associations and groups. Initially, stakeholders in the field of autism spectrum disorders from different and related specialties were identified from partner universities of medical sciences in Tehran (Iran, Tehran, Welfare Sciences) and various centers accepting autism spectrum patients and the Strategic Committee for Autism Registration as a subset of the Vice Chancellor for Research was established in 1398 in Iran University of Medical Sciences. The Strategic Committee is responsible for developing guidelines and executive protocols consisting of experts in the fields of general psychology, child psychology, social medicine, epidemiology, information technology, health informatics and health information management, as well as the executive committee and executive groups for follow-up and conducting decisions of Strategic Committee was considered. Data Management and Information Technology (IT) Department was  Responsible for Software Design; Data collection and quality control group was responsible for data collection, quality control, feedback and data correction; The epidemiology and data analysis team was also responsible for designing and conducting the data analysis program.The population entered in this system includes people (including children over 6 months and adults) with previous diagnosis or new diagnosis of the referral centers. A child is considered to have diagnostic criteria for autism spectrum disorders according to the DSM 5 Diagnostic Guide if he or she has serious impairments in communication and social interactions as well as a limited and repetitive pattern of behavior, interests, and activities. Patients enrolled in the program have been diagnosed with ASD by a pediatrician, child psychiatrist, pediatric neurologist, psychiatrist, or neurologist.Child Psychiatric Clinic of Tehran Psychiatric Institute, Ali Asghar Children's Hospital, Razi Hospital and Roozbeh Hospital and also physicians' offices who are members of the program's strategic committee are covered now. Based on the objectives of the Strategic Committee and literature review for the design of registration systems, the following data collection was considered: Personal and socio-demographic characteristics (such as name, age, gender, ethnicity, parents' relatives, place of birth and residence, birth rank, education) Clinical information (such as history of developmental delay, name of the disorder, presence of seizures, presence of mental retardation and other psychiatric diagnoses, personal and family history of the disorder) Laboratory and imaging

Then personal and demographics information and clinical and laboratory findings will be recorded by data entry experts in the system. Patients will be followed up by telephone or through coming back of the patients to the certain centers. Data analysis is done in accordance with the objectives of the registration program and is performed based on conventional statistical methods. Also, an annual report of the profiles of registered patients is sent to the beneficiaries of the program at the end of each year, including the Vice Chancellor for Research of the participating universities, the Ministry of Health, and related associations and groups.In order to validate and evaluate the feasibility and ease of implementation of the data collection form, this form was piloted in several centers and then based on the results of experimental implementation, the questions were reviewed and finalized. After compiling the final version of the data collection form, the software registry system was designed for the web. In order to maintain data security, a separate access and a specific access level for each user is determined and hosted on the servers of Iran University of Medical Sciences. Data analysis is done in accordance with the objectives of the registry and is performed based on the required statistical methods. Also, an annual report on the profile of registered patients of the registry is sent to the beneficiaries of the program at the end of each year, including the Vice Chancellor for Research of the participating universities, the Ministry of Health and related associations and groups.In 2014, the Deputy Minister of Research at the Ministry of Health and Medical Education (MOHME) of Iran decided to establish registration systems for various diseases and health consequences (4). In this regard, the launch of a clinical-research registry in autism in Tehran was considered. Setting up an autism spectrum disorder information registry in Tehran as a preliminary study for its establishment at the national level can help to integrate research activities and create a research network and prevent incoherence, rework and waste of time and energy in related research activities in the country. In addition to the direct use of data for research activities, such systems can also be used to identify patients eligible for clinical trials. In addition, it is possible to study the natural course of this disorder, track individuals and help increase the country's indigenous knowledge based on local and regional information. In addition, launching a program to record the autism spectrum disorders will help policymakers and health planners in the country to decide and plan for it.In addition, is not possible for policy makers to plan in an integrated, comprehensive, accurate and up-to-date way without having access to such online information systems. In the long run, this study aims to record all ASD information across the country in this system to eliminate the huge challenges of patients, physicians and health decision makers and also Smoothing the way for research further.

Establishing registry systems, especially chronic diseases seems to be a need for work so that health policy makers can make the right policies and plans to improve the level of health. One of the most important features of registries is the enrolling of patients in the time period and the possibility of increasing the collection of patients in the country. Due to the relatively high prevalence large number of causes and increasing high financial burden of autism spectrum disorders that it imposes on society, it is a suitable c case to evaluate prevalence, environmental and genetic factors through recording all clinical and epidemiological information

Psychosis is still among the most debilitating and severe mental disorders. The main objective of the present study was to investigate the estimated prevalence of psychotic disorders and finding the main predictors of psychotic disorders among Iranian children and adolescents.

Our total sample consisted of 30 553 individuals (49% males and 51%females) from 30 provinces of Iran, aged between 6 and 18 years, who were selected via cluster sampling method from urban and rural areas of all provinces. The data were analyzed using descriptive statistical analysis and multiple logistic regression method.

The results of multiple regression analysis showed that prevalence estimate of psychotic disorders was 0.25%. It was 0.3% and 0.2% in males and females, respectively. The age of 10-14 (OR = 2.24; 95% CI, 1.11-4.55) and the age of 15-18 (OR = 3.42; 95% CI, 1.74-6.75) were significant positive predictors, whereas none of the demographic variables were predictors for psychotic symptoms.

This research highlights the main predictors of psychosis in children and adolescents. The study design also allowed a better understanding of predictors of psychotic disorders. The assessment of the prevalence of psychiatric disorders, particularly their comorbidities, may help to prevent mental illnesses in children and adolescents.

Behavioral disorders among children and adolescents are common and incapacitating which cause many problems for the families and the patient themselves and associated with high prevalence of negative social consequences. This study was done to evaluate the prevalence of psychiatric disorders among children and adolescents in Gorgon, north of Iran (2019).

This descriptive-analytical study was performed on 1025 children and adolescents aged 6-18 years in Gorgan, north of Iran (2019). Subjects were selected by Multistage Cluster Sampling. Digital version of K-SADS test was studied for 24 types of child and adolescent psychiatric disorders. Sampling was done by trained psychologists, among general population and by referring to the house of people. Psychiatric disorders included mood disorders, behavioral disorders, neurodevelopmental disorders, substance abuse disorders, and elimination disorders.

The prevalence of psychiatric disorders among children and adolescents was 13.2%. This prevalence was 14.3 % and 12.1% in males and females, respectively. According to age groups, The prevalence of psychiatric disorders was common in 6 to 9 years olds with 17.8% which in comparison with other age groups was significant (P<0.05). Eliminatory disorder with 6.1% was the most common illness followed by behavior (6%), tension disorders (4.8%) and neurodevelopmental disorders (3.3%).

The prevalence of psychiatric disorders among children and adolescents in this area is in a median range compared to other domestic and overseas.

The strengths and difficulties questionnaire (SDQ) is one of the most common screening tools to detect children and adolescents who are at risk of mental health problems or have psychiatric disorders. The standard mode of SDQ completion is on paper; however, some studies used phone administration and argued that this is a feasible and valid method that can substitute in-person administration. However, few studies have investigated the validity and reliability of phone administration of the SDQ.

The current study aimed to compare the telephone versus paper-and-pencil administration of the SDQ among Iranian child and adolescent outpatients.

Sixty six parents with children aged 3 to 15 years completed the SDQ questionnaire using paper-and-pencil and telephone interview techniques. The study was performed in 2016, and participants were from the city of Tehran (capital of Iran). Participants were first divided into two groups. Then, one of them first completed the questionnaire using the face-to-face interviews, and 3 to 4 days later, they again completed the questionnaire using the telephone interview. And the vice versa occurred for the other group. The Pearson correlation analysis was used to calculate the correlation between the two methods in each group separately. Intra-class correlation (ICC) analysis was used to investigate the association between the two administration methods.

A significant positive correlation was found between the two types of administration in both groups (P < 0.05). Intra-class correlation coefficients indicated a good correlation between the scores obtained from each method of administration (all P values were < 0.001).

Telephone administration of SDQ is a reliable method for collecting data when studying emotional and behavioral symptoms in children and adolescents attending outpatient psychiatric centers.

The aim of the present study was to screen the toddlers who are suspected to be autistic in their well-child visits at age 18 to 24 months via the Quantitative-Checklist for Autism in Toddlers (Q-CHAT).

After the screening, the screen-positive cases were clinically assessed by a child psychiatrist and a child developmental psychologist. The total sample included 2467 toddlers; the mean total score of Q-CHAT was 30.64 (SD: 9.133).

According to the clinical examinations, 6 cases met the criteria for autism (equal to 5.8% of screen-positive cases and 0.25% of the total sample), and 18 cases had a high probability of autism or other neurodevelopmental disorders.

This study showed that the toddlers who were at risk of autism could be screened in PHC. Also, Q-CHAT could be used as a screening tool in Iran.

The aim of the present study was to develop a self-report questionnaire to assess the level of perceived risks and safety behaviors during pandemics.

We went through recommended phases and their corresponding steps to create a valid and reliable scale: (a) item development (including 1. domain identification and item generation, 2. content validity), (b) scale development (including 1. pretesting questions, 2. sampling and survey administration, 3. item reduction, and 4. extraction of factors), and (c) scale evaluation (including 1. tests of dimensionality, 2. tests of reliability, and 3. tests of validity).

We found four factors with eigenvalues greater than 1 that were accounted for 0.63 of the total variance. The 4-factor solution showed all items had factor loading greater than 0.4 and each belonged to one factor. The fit indices indicated the 4-factor solution model was fitted to our data.

In sum, the Pandemic Risk and Reaction Scale (PRRS) is a valid and reliable self-reported scale to assess the level of perceived risk and safety behaviors during pandemics.

Health care systems and professionals worldwide are relying on technology as an essential partner to manage the COVID-19 epidemic. This paper explains how digital technologies can benefit the public, medical workers, and health care systems.

This nonsystematic literature review was conducted on different technologies and their impact and applications in the COVID-19 epidemic using proper search keywords on the PubMed, Google Scholar, and Science Direct databases.

We found various helpful technologies, which can help us to appropriately contain and manage the COVID-19 pandemic through broad areas of clinical care, logistics, maintenance of socioeconomic activities, and inspection. However, main challenges still need to be addressed for obtaining the full capacities of the technologies to support health care systems.

Technologies can offer many innovative ideas and solutions against global and local emergencies. In this time of great vagueness and danger, we require all the resources we can collect to rescue ourselves and our patients. Barriers and challenges, such as lack of technology proficiency, confidentiality requirements, and reimbursement matters, need to be recognized and resolved rapidly, accurately, and compassionately.

We investigated the level of psychological problems, perceived risk, safety behaviors, and the potential roles of demographic variables, public trust, media, and prior anxiety to illness during the COVID-19pandemic among Iranians.

In this cross sectional study, using a convenient and snowball sampling method, we distributed an online questionnaire to participants and collected data on their demographic variables, mental health status, the consumption of and level of trust to various media, the level of public trust, and perceived risk and safety behaviors regards COVID-19. Our final sample consisted of 1881 Iranian residents. We used descriptive analysis, bivariate correlation, univariable and multivariable linear regression analysis, and univariable and multivariable logistic regression analysis for data analysis.

The mental health problems have increased in comparison to past national survey; 24.1% vs 10.39% for depression, 37.93% vs 16.7% for social dysfunction, and 41.33% vs 29.5% for anxiety, and 31.12% vs 29.08% for somatization. We also found high percent of acute stress 52.71% (95% CI: 50.45-54.96). Being female, married, and having a higher educational level increased the odds of safety behaviors. Public trust and national media can regulate the negative effect of the pandemic, while increasing perceived risk and appropriate safety behaviors can decrease psychological problems and disorders. However, social media increases perceived risk, safety behaviors, and psychological problems, especially severe acute stress.

We are in the early stages of the COVID-19 pandemic and its negative effects will increase. Many people have lost their relatives, their jobs, their social contacts, and are faced with a surge of negative news. Authorities should consider these critical issues and adopt appropriate communicative and supportive approaches to prevent their negative effects at both individual and societal levels.

 Early interventions can play an important role in alleviating or eliminating many of the major symptoms of Autism Spectrum Disorder (ASD) and enhancing new skills. Parental education can reduce the parents' depression and stress and increase their empowerment. This study aimed to evaluate the effect of a parental education program the mental health of parents, behavioral problems of their children with ASD. 

 A group of 30 parents of children with ASD in Tehran, Iran were selected by a convenience sampling and were randomly divided into intervention and control groups. The parents in the intervention group received psychoeducational program according to Tonge et al.'s (2006) method in 10 sessions each for 90 min in Tehran Psychiatric Institute. Data collection tools were the Family Assessment Device, the Childhood Autism Rating Scale, Billings and Mouse's Coping Strategies Scale, and 28-item General Health Questionnaire. All participants were evaluated at three stages of pretest, posttest, and 3-month follow-up.

 The effect of parental education program on the clinical symptoms and its dimensions was significant at three measurement phases. In the 3-month follow-up duration, the results remained unchanged. There were a significant difference between the two study groups in general health, family function, coping strategies, and child behavior (F=4.859, P=0.023). 

 Parental education can improve the mental health of parents and reduce the behavioral problems of their ASD children.

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.

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.

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.

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.

The number of children with autism, who have many unmet needs, is increasing dramatically. However, the existing evidence shows that early identification and intervention are effective in reducing the later costs and burdens of autism spectrum disorder (ASD). Thus, the present study aimed to develop evidence-based services for children with autism in Iran to reduce its impacts on the affected children and their families and to decrease its burden on the society.

A 3-step study was conducted based on a modification of the Replicating Effective Programs (REP) framework (step 1: need assessment and situation analysis; step 2: identifying current evidence-based services; step 3: designing the first draft of the package and its core elements). Each step was conducted by a specific methodology.

By considering the obtained data, it was found that a package of services with 4 core components to respond to the perceived needs in Iran was needed: (1) early detection of at-risk children; (2) care coordination and facilitation of access to current services; (3) implementation of an evidence-based early intervention program; and (4) training interventionists using an effective educational framework based on evidence-based material.

REP framework was used in the present study, which has been shown to be effective in adapting and implementing health care services. By considering the preconditions of REP, a comprehensive package of services, with 4 components was designed for toddlers with autism in Iran. The next step will be to study this package using a multicenter hybrid effectiveness-implementation randomized control trial.

Considering people with autism, early screening is necessary for early intervention. Parents report that questionnaires are effective tools for screening autism. The short version of the Checklist for Autism in Toddlers (Q-CHAT-10) is a new scale for screening autism in toddlers. 

The aim of this study was to evaluate the psychometric properties of the Persian version of Q-CHAT-10.

We analyzed the data of the full version of Q-CHAT. We only selected data regarding 10 items, which consisted of the short version of Q-CHAT.

The typically developing group included 50 children with the mean age of 29.62 months, and the autism spectrum disorder group included 50 children with the mean age of 27.14 months. The mean total score was 2.1 and 6.46 for the typically developing group and the autism spectrum disorder group, respectively, which was significantly different (t[98]=-11.52, P=0.000). The Cronbach’s alpha coefficient of the checklist was 0.78, and the test-retest reliability was 0.951 (P<0.001). The estimated area under curve was 0.935.

The Persian version of Q-CHAT-10 has good reliability and predictive validity and it can be used for screening autism.

 Social capital is described on the basis of the quality of social relations between individuals and it includes the capacity of quantifying or solving the problems that are usually experienced. It is a means to improve the quality of life and facilitate community progress through the provision of social communication resources. By considering the importance of monitoring the process of social capital and informing about its functions, and the changes related to its components and paying attention to the results in terms of mental health programs, we examined the status of social capital among the residents of Tehran province who were over the age of 18.

 This cross-sectional analytical study is part of The Iranian Children and Adolescents’ Psychiatric Disorders Research (IRCAP) which is being carried out in various urban and rural areas of Iran. IRCAP includes different background features such as social capital, culture, ethnicity and economic status from different provinces. In our community-based study, 29776 men and women over the age of 18 years were selected by multistage cluster sampling (cluster sampling and random sampling). They were examined by Social Capital Questionnaire. One-sample t-test and multivariate analysis were used to analyze the data.

 In Tehran province from a total of 2065 participants, 1841 remained in the study for examination of all variables. Based on the one-sample t-test the results show that all variables for province of Tehran was higher than those for the other provinces (p<0.001). The average social capital of trust in the province of Tehran was 18.77 while it was 17.52 for other provinces (with minimum and maximum range of 5-25) (p<0.001). However the social capital status in Tehran   was above the average for all variables, it was still far from optimal level.

 Our results show that social capital in Tehran is higher than other provinces in Iran. This includes both total social capital and its all components. However, the province of Tehran is above the average level in all components of social capital, it is still far from optimal level.

The present study is a part of a larger study that aimed at developing a comprehensive model of service delivery for individuals with autism in Iran based on the local needs and characteristics. In this study, the status of the services provided to those with autism in Iran was investigated based on the perspectives of parents of children with autism. A semi-structured interview was used to qualitatively investigate the status of the services with regards to autism in Iran based on the perspectives of parents of children with autism. This study revealed several barriers, including shortness of eligible professionals, difficulty in access to care for families, high costs, and lack of formal and informal supports, in providing services to those with autism in Iran. Early detection and diagnosis are of prime importance. We also need to train our specialists to diagnose autism based on the standard protocols and tests. In sum, we need a comprehensive program that involves different sectors in charge of health and education in Iran.

Context: We aimed to conduct a scientometric study by investigating published papers of Iranian researchers on autistic disorders.Evidence Acquisition: We conducted a systematic review of the literature to retrieve all relevant studies on autism that are published by Iranian researchers. Seven databases were searched, of which three were local Iranian databases (Magiran, SID and Irandoc), and four were widely used English language databases (PubMed, Scopus, ProQuest and PsycInfo). Bibliometric information of all papers was extracted. Two hundred and six (95 Persian and 111 English) papers published between 1979 and 2015 were retrieved. Comparison between subject areas showed that non-pharmacological intervention and biological studies had the largest number with 64 and 61 papers, respectively. Among universities, Tehran University of Medical Sciences with 81 articles was most productive, and among the research centers, psychiatry and psychology research center (Tehran University of Medical Sciences) with 32 articles was the most productive research center. The trends of research in the field of autism among Iranian researchers have the same patterns as the global trends. However, some important topics, such as prevalence, causes, services, and life span issues and the infrastructures have been studied less and should be considered in future studies. Moreover, it was revealed that we are faced with shortness of sources for research in this field, and the policy makers should consider this problem. We need to conduct researches that take into account our inner context, and the subject and quality of the research should be given more importance than the number.

The present study aimed to review the literature on non-pharmacological interventions used to treat stereotyped and repetitive behaviors by a systematic method.
Two authors independently performed a search strategy on Medline/PubMed, Scopus and PsycINFO on English articles published up to April 23, 2014 with relevant search keywords. We also reviewed the bibliographies of retrieved articles and conference proceedings to obtain additional citations and references. We used those articles that address any non-pharmacological interventions on reducing stereotyped and repetitive behaviors in preschool children with autism. Four independent reviewers screened relevant articles for inclusion criteria and assessed the quality of eligible articles with CONSORT checklist.
In our search, 664 relevant articles were found. After removing duplicates and screening based on title, abstract, and full text, 15 high quality studies were finally included in data analyses. The included articles were published from 1987 to 2013. Three studies were designed as A-B, two as A-B-A and reminders as A-B-A-B. The data and results of 3 clinical trials were synthesized; two of them were parallel randomized clinical trial and another one was designed as cross-over. Interventions were completely heterogeneous in case studies, including non-contingent auditory stimulation, response interruption and redirection, teaching the children to request assistance on the difficult tasks, family-implemented treatment for behavioral inflexibility with treatment approach, vocal or motor response interruption and redirection, brushing, water mist treatment, exposure response prevention, tangible reinforcement or social reinforcement, and music. Interventions in clinical trials included touch therapy, kata techniques training program, and aerobic exercise.
The results of our review indicate that different kinds of non-pharmacological interventions can be used to treat repetitive behaviors in children with autism, however, sufficient evidence for their effectiveness does not exist. Future research using more precise methods (RCTs) can clarify that which methods and techniques are effective in reducing repetitive behavior of children with autism.

Electrophysiological studies have identified abnormal oscillatory activities in the cerebral cortex in schizophrenia and mood disorders. Biological and pathophysiological evidence suggests specific deficits in serotonin (5-HT) receptor function in schizoaffective disorder (SA), a clinical syndrome with characteristics of both schizophrenia and bipolar disorder. This study investigated alpha oscillations in patients with SA.
Electroencephalography was used to measure ongoing and evoked alpha oscillations in 38 adults meeting Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition (DSM–IV) criteria for SA, and in 39 healthy controls.
Spontaneous alpha power of the participants with SA was significantly lower than that of healthy participants [F (1, 75) = 8.81, P A strong reduction of alpha power in the posterior regions may reflect abnormality in the thalamocortical circuits. It is shown that hypoxia and reduced cerebral blood flow is associated with reduced alpha activity among different regions of the brain. Therefore, it can be concluded that greatly decreased alpha activity, particularly in centro-parietal and occipital regions, is related to SA symptoms such as hallucinations.

The present study investigates the relationship between attention deficit hyperactive disorder (ADHD) and the severity of symptoms in children with autistic spectrum disorder.
The study was conducted on 80 patients with autistic spectrum disorder visiting Child Psychiatric Clinic of Tehran Psychiatric Institute. The severity of autistic symptoms was measured by sensory profile questionnaire. The Conner's Adult ADHD Rating Scales–Self Report: Screening Version (CAARS–S:SV) and CSI questionnaire were used to determine the severity of ADHD. The data were analyzed using Pearson correlation coefficient through SPSS v.20.
Findings: There is a significant correlation between total scores of Sensory profile and its subscales and total scores of CAARS and CSI (r >.5, P There is a significant correlation between ADHD and severity of symptoms of autistic spectrum disorder. Both disorders can increase the severity of symptoms and exacerbate the patients’ recovery process.

The need for mental health care among children and adolescents in Iran, as in other low and middle income countries (LAMIC) remains mostly unmet. In this paper, we sought to provide an overview of the extent of unmet need and mental health services in Iran. We also aimed to propose approaches to address this gap.
We reviewed the published epidemiologic studies of child and adolescent mental and behavioral health problems in Iran. We also examined the current status of child mental health services and the gaps between current needs and available services based on published literature that included papers published in scientific journals, as well as governmental and other administrative reports. The contextual issues relevant to child mental health care were also explored, as well as the possibilities to introduce new or scale up promising services.
Child and adolescent mental and behavioral health problems are highly prevalent in Iran. Different studies have estimated that 16.7% to 36.4% of children and adolescents suffer from one or more mental health problems. However, there is a serious scarcity of resources to meet this need. Available services are delivered by independent public organizations (e.g., Ministry of Health, Welfare Organization, and Ministry of Education) or private sector with inefficient communication and collaboration among them and no mandatory national mental health policy. Available specialized child and adolescent services are mostly confined to small inpatient units and university outpatient facilities in larger cities, and there is a scarce evidence for the effectiveness of the available services.
Expansion of primary care’s role in timely detection and management of child and adolescent mental health problems, implementation of task-shifting and -sharing initiatives, as well as improved collaboration among responsible governmental and non-governmental sectors are some of the most promising future venues to improve mental health care for the Iranian youth.

Nocturnal enuresis is an important developmental problem for school age children and it can cause emotional and social problems for children and their families. This study was aimed to determine the prevalence of enuresis in school children aged 6-8 years in Rafsanjan, Iran, during 2014. In this cross-sectional study, 1080 school children aged 6-8 were selected using a random cluster sampling method. Questionnaires were distributed among the children to be answered by their parents. The overall prevalence of nocturnal enuresis was10.6% (CI 95%: 8.76 – 12.44); 91.3 % of them had primary and 8.7% had secondary nocturnal enuresis. Prevalence in girls and boys were 8.44% and 12.3% respectively. Factors such as parental education, family income, and age were significantly associated with nocturnal enuresis. The results showed that the prevalence of nocturnal enuresis in our study is average. Since a minority of families seek medical advice and treatment for their children, family education and awareness is essential in this regard.

Early screening of autism increases the chance of receiving timely intervention. Using the Parent Report Questionnaires is effective in screening autism. The Q-CHAT is a new instrument that has shown several advantages than other screening tools. Because there is no adequate tool for the early screening of autistic traits in Iranian children, we aimed to investigate the adequacy of the Persian translation of Q-CHAT. At first, we prepared the Persian translation of the Quantitative Checklist for Autism in Toddlers (Q-CHAT). After that, an appropriate sample was selected and the check list was administered. Our sample included 100 children in two groups (typically developing and autistic children) who had been selected conveniently. Pearson’s r was used to determine test-retest reliability, and Cronbach’s alpha coefficient was used to explore the internal consistency of Q-CHAT. We used the receiver operating characteristics curve (ROC) to investigate whether Q-CHAT can adequately discriminate between typically developing and ASD children or not. Data analysis was carried out by SPSS 19. The typically developing group consisted of 50 children with the mean age of 27.14 months, and the ASD group included50 children with the mean age of 29.62 months. The mean of the total score for the typically developing group was 22.4 (SD=6.26) on Q-CHAT and it was 50.94 (SD=12.35) for the ASD group, which was significantly different (p=0.00).The Cronbach’s alpha coefficient of the checklist was 0.886, and test-retest reliability was calculated as 0.997 (p<0.01). The estimated area under the curve (AUC) was 0.971. It seems that the total score equal to 30 can be a good cut point to identify toddlers who are at risk of autism (sensitivity= 0.96 and specificity= 0.90). The Persian translation of Q-CHAT has good reliability and predictive validity and can be used as a screening tool todetect18 to 24 months old children who are at risk of autism.

We aimed to conduct a review to investigate the prevalence of anxiety disorders among Iranian children and adolescents. We systematically reviewed the literature up to June 2014. We searched three Persian databases (Magiran, IranMedex and SID) and three English databases: PubMed, Scopus and PsycINFO. All original studies that investigated the current prevalence of anxiety in a sample of Iranian children and adolescents were entered into the study. All studies conducted on special samples or in special settings were excluded. By searching English databases, we obtained 124 original studies. After removing duplicate papers, 120 articles remained. In the next step, we screened the articles based on their title. In sum, 95 Persian and English articles had relevant titles. After screening based on the abstract and full text, 26 studies remained. After screening based on the full text, all selected studies were qualitatively assessed by two evaluators separately. Twenty five studies were eligible and reported different types of anxiety disorders (i.e., generalized anxiety, separation anxiety, obsessive-compulsive disorder, phobias and panic disorder). The samples varied from 81 to 2996 among studies and their age range was 5 to 18 years. These studies were conducted in different cities of Iran. SCL-90 is a frequently used questionnaire. All anxiety disorders were mostly investigated with the prevalence rates ranging from 6.8% in Saravan to 85% in Bandar Abbas. OCD was the second common study with prevalence rates ranging from 1% in Tabriz to 11.9% in Gorgan. Our findings revealed considerable amount of anxiety disorder among Iranian children and adolescents. Given the fact that anxiety disorder has negative effects on the well-being and function of individuals and can lead to severe problems, this disorder should be considered in mental health programs designed for children and adolescents.