Iranian Journal of Psychiatry and Behavioral Sciences
Volume:17 Issue: 2, Jun 2023

 In many developing countries, most patients referred for hospitalization for high suicide risk are deprived of adequate care, mainly because of limited psychiatric facilities.

 We aimed to investigate the short-term outcomes of an outpatient psychiatric crisis intervention (PCI) service enhanced with case management for patients with suicide risk where hospital admission was impossible because of the bed shortage.

 We developed a service model provided by a team of psychiatry residents, psychologists, and social workers supervised by a faculty psychiatrist. We piloted it in Roozbeh Psychiatry Hospital for patients when hospitalization was indicated for suicidality, but admission was not possible due to the bed shortage. This study followed an action research design and methodology. The sample was selected from individuals referred to Roozbeh Hospital. All subjects who fulfilled the inclusion criteria were included in the study. Convenience sampling was used for the satisfaction assessments.

 The PCI provided the service to 173 patients. The suicide risk was resolved in 48 (27.7%) patients. The remaining consisted of individuals finally hospitalized when beds were available (73 patients, 42.2%) or dropped out of the service (52 patients, 30.1%). Most patients (86%) were satisfied with the service. Only one non-lethal suicide attempt was reported in the two-month follow-up.

 An outpatient crisis service for suicidality enhanced with case management may reduce the need for hospitalization. However, randomized controlled studies are needed to establish its effectiveness.

 Job burnout is among the most important determinants of employee productivity. Numerous factors affect the function of employees and burnout.

 Based on the available studies on healthcare providers, resilience and burnout are directly related to employee productivity. This study aimed to investigate the effect of resilience training on job burnout in hospital staff.

 Forty-six hospital staff were divided into case and control groups (23 in each group) and enrolled in the present pre-and post-intervention study. Each group completed the pre-test to assess resilience and burnout based on the Connor-Davidson Resilience Scale (CD-RISC) and Maslach Burnout Questionnaire (MBQ). The case group received six one-hour training sessions. During these sessions, some resilience and coping skills were provided. At the end of the sessions, the participants in both groups completed the resilience and burnout questionnaires. After one month, the staff filled in these questionnaires again, and the results of the questionnaires were compared before and after the intervention. The data were analyzed using descriptive statistics and Mann-Whitney and Kruskal-Wallis tests using SPSS version 19 software.

 The mean age of study participants was 38.47 and 36 years in the case and control groups, respectively, and demographic features were not significantly different between the study groups. The total score of the burnout scale decreased after the intervention in the case group and increased in the control group. In addition, after the intervention, the mean score of the total burnout scale was significantly lower in the intervention group than in the control group. All subscales in the case group significantly decreased after the intervention, while all subscales increased in the control group. This increase was significant in the emotional exhaustion subscale in the control group. Only emotional exhaustion after the intervention was significantly reduced in the case group. The resilience score in the case group increased significantly one month after the intervention.

 Resilience training as 6 one-hour training sessions significantly improved job burnout, and health officials can use this training method to improve the health and function of employees.

Children with autism spectrum disorder (ASD) face some challenges with performing self-care. Many performance components, including sensory and cognitive functions, are effective in performing self-care.

This study aimed to compare the role of sensory processing and executive functions in performing self-care among preschool children with ASD.

In this cross-sectional study, 70 children with ASD aged 3-6 years were selected and investigated by adopting convenience sampling. The instruments included the Short Sensory Profile-2 (SSP-2), Behavior Rating Inventory of Executive Function (BRIEF), and Pediatric Evaluation of Disability Inventory (PEDI). The data were analyzed using Pearson correlation and linear regression tests.

The results of the correlation revealed that executive functions (P≤0.01) and sensory processing (P ≤ 0.005) had a small yet significant inverse relationship with performing self-care activities. The results of stepwise linear regression showed that executive functions and sensory processing were equally capable of predicting self-care activities.

It was recommended that therapists should pay enough attention to both executive functions and sensory processing in order to solve the self-care problems of preschool children with ASD. Due to the low correlation between variables, it was also suggested that a multifactorial approach to self-care activities should be employed as well as the role of other factors along with sensory processing and executive function should be considered.

 The coronavirus disease 2019 (COVID-19) pandemic is a threatening and potentially traumatic event, causing psychological problems among communities. So far, few studies have evaluated the long-term psychological impact of COVID-19 on mental health.

 This study aimed to assess the frequency of posttraumatic stress disorder (PTSD) among people living in Kurdistan province, Iran, more than two years after the beginning of the pandemic, and to determine factors related to adverse mental outcomes.

 Using the convenience sampling method, a web-based cross-sectional survey was conducted from 21 March to 21 May 2022. A total of 2,705 respondents completed the Post Traumatic Stress Disorder Checklist for DSM-5 (PCL-5), and 2,669 cases were included in the study. We used the multivariable logistic regression analysis to detect factors associated with PTSD.

The mean age of the participants was 34.98 ± 10.84 years, and the overall prevalence of PTSD was 38.9%. The potential factors associated with PTSD included younger age, the history of isolation, previous psychiatric disorders, and loss of relatives or friends due to COVID-19 (P < 0.05).

 According to our results, the COVID-19 pandemic had a negative effect on the mental health of a relatively high percentage of the general population in Kurdistan, Iran. Given the possible long-term mental health effects of the outbreak of acute infectious diseases, planning to improve mental health in vulnerable groups should be considered for the post-COVID-19 era.

 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.

 The Behavioral Emotion Regulation Questionnaire (BERQ) has been designed to assess the adaptive and maladaptive strategies for emotion regulation.

 The current investigation aimed to study the psychometric properties of the BERQ in a sample of Iranian students.

 To assess the psychometric properties of the BERQ (2020 - 2021), 301 students (150 males and 151 females) at Kermanshah University of Medical Sciences (KUMS) were selected using convenience sampling. In addition to the BERQ, the participants completed the Cognitive Emotion Regulation Questionnaire (CERQ), the Penn State Worry Questionnaire (PSWQ), and the Depression Anxiety Stress Scales (DASS). Afterward, Cronbach's alpha coefficient, convergent and divergent validity, and confirmatory factor analysis were calculated and applied using LISREL V 8.80 and SPSS V 20.

 The results of factor analysis supported the five-factor structure of the BERQ (including seeking distraction, seeking social support, actively approaching, withdrawal, and ignoring) in the Iranian student sample (RMSEA = 0.08, comparative fit index (CFI) = 0.90, normed fit index (NFI) = 0.90). Furthermore, the positive subscales of the BERQ were significantly and positively correlated with the positive cognitive emotion regulation strategies in the CERQ. They also had a significant negative correlation with depression, anxiety, stress, and worry. Moreover, withdrawal and ignoring were significantly and positively correlated with anxiety, stress, worry, depression, and negative emotion regulation strategies of the CERQ (P < 0.05).

 The Persian version of the BERQ has suitable psychometric properties. This questionnaire could be utilized for assessing the healthy and unhealthy reactions of individuals.

 According to the Wagnild model, resilience as an initial trait is critical in overcoming challenges and protecting wellbeing.

 This study aimed to investigate the psychometric properties and cultural adaptation of the Persian version of the Resilience Scale (RS), including validity, reliability, and factor analysis in the adolescent population.

 The scale was translated and adapted using a standard method and a pilot study after receiving permission from the original author. This cross-sectional study investigated the face, content, criterion validity, construct validity, and reliability of RS. A sample of 419 adolescents aged 12 - 18 was selected by convenient sampling in Tehran, Iran. The subjects completed the RS, Beck Depression Inventory-II, and Mental Health Continuum Questionnaire.

 The quantitative and qualitative analyses of scale items and modifying them based on the feedback of participants and experts showed that face and content validity was acceptable. Factor analysis confirmed the two-factor structure described by Wagnild and Young, including personal competence and acceptance of self and life. Moreover, Cronbach’s alpha exceeded 0.84, showing the scale has strong internal consistency. There was also a significant negative correlation between RS and the total score of the depression inventory. At the same time, there was a positive correlation between RS and the score of the mental health questionnaire, indicating acceptable criterion validity.

 Persian version of the RS can be considered a valid and reliable instrument to measure resilience in adolescent populations. Therefore, researchers and mental health professionals can use it for therapeutic, preventive, and research purposes.

 Suicide risk factors can be used to develop tools for suicide attempt prediction and prevention.

 We aimed to design a model to evaluate the risk of suicide related to socio-economic, demographic, health, and drug dependency factors.

 This case-control study was conducted in a 15-65-year-old population of Golestan province, Iran. The case group included 414 individuals with a history of suicide in 2019, and the control group had 408 individuals without suicide attempts. Demographic, psychosocial health, and drug dependency data were collected. Modeling was carried out using multivariate logistic regression. The performance of suicide-predicting models was assessed, and a nomogram for the probability of suicide was drawn.

 A multivariate logistic regression model with age, gender, education level, mother's education level, marital status, life satisfaction, membership in cyberspace, sleep disorders, alcohol abuse, having suicidal thoughts, the interaction of gender with life satisfaction, and the interaction of gender with mother's education level was the best predicting model of suicide attempt (AUC = 0.934, CI: 0.91 - 0.95). The variables of father's education level, occupation, job satisfaction, household size, financial status, regular exercise, guardianship status, history of self-harm, history of suicide attempt in the family, smoking and drug abuse had no significant relationship with suicide attempt.
5.1.

 The results suggest that designed models can help mental health service providers to identify high-risk individuals early. So we can better manage suicide and reduce its economic, social, and health burdens.

 Currently, adolescent victimization is introduced as the most important social injury in schools.

 The present study aimed to assess the role of emotional intelligence (EI), loneliness, and empathy in the prediction of victimization among senior high school students.

 A structural equation modeling approach was used in this study. A total of 365 students were selected via random cluster sampling from high schools in the second municipal area of Yasouj, Iran. These students completed Victimization Scale, Schulte Emotional Intelligence Scale, Baron-Cohen’s Empathy Scale, and Loneliness Scale. The design of the present study was descriptive and correlational using structural equation modeling. The study population included all adolescents in secondary schools in Yasouj from 2020 - 2021. A total of 365 subjects were selected using random cluster sampling and completed the research questionnaires. Finally, the data were collected and analyzed by Pearson correlation and structural equation modeling using SPSS software (version 19) and AMOS software (version 20).

 The results showed that EI directly affected adolescents’ feelings of loneliness (-0.58), empathy (0.53), and victimization (-0.24) (P < 0.01). Additionally, feelings of loneliness (0.41) and empathy (-0.19) had a direct and significant effect on adolescent victimization (P < 0.01). Moreover, EI due to feelings of loneliness (-0.30) and empathy (-0.14) had an indirect and significant effect on adolescent victimization.

 The results of this study showed that the model fits the data. Therefore, the awareness of teachers, parents, adolescents, counselors, psychologists, and other professionals to promote empathy and EI and reduce loneliness and victimization of adolescents can be helpful.

 Mental health is a serious concern for burn survivors. Burn injuries can bring long-term complications that begin at the moment of injury and last throughout a burn victim’s life.

 This study aimed to determine the effectiveness of a home care plan in the mental health status of burn survivors six months after hospital discharge.

 This randomized clinical trial with intervention and control groups was conducted in Kermanshah, Iran. Eligible samples (n = 90) were allocated into the two groups by a randomized block design. The intervention group received a home care plan for six months. The General Health Questionnaire-28 (GHQ-28) was responded to by the samples at three time points, baseline (T1: hospital discharge) and 3 (T2), and six months (T3) after the intervention.

 The mean scores of the GHQ-28 showed a descending trend in the intervention group during six months (T1: 32.48 ± 15.83, T2: 25.15 ± 15.11, and T3: 19.37 ± 14.11). However, the mean scores of the GHQ-28 were increased in the control group (T1: 32.29 ± 17.66, T2: 39.35 ± 14.59, and T3: 40.44 ± 15.59). There were significant differences between the two groups in 3- and 6-month measurements (P < 0.001).

 A 6-month home care plan improved the mental health of burn survivors in the intervention group in comparison to the controls; nevertheless, there were still survivors who needed help. Therefore, it is suggested to develop a home care plan with longer regular follow-ups for burn survivors based on their needs in the healthcare system of Iran.

 Depression symptoms are among the most common psychological problems in students. Short-term treatments are important in preventing depression from turning into a disorder.

 The current study aimed to investigate the effectiveness of interpersonal counseling (IPC) in depression symptoms, emotional expression, and social skills of students in comparison to interpersonal psychotherapy (IPT).

 A pretest and posttest design with follow-up was used in this study, with two experimental groups and a control group conducted in Mashhad, Iran, in 2021. A total of 51 subjects who scored 14 or higher on the Beck Depression Inventory-Second Edition (BDI-II) were randomly assigned to two experimental and control groups. Finally, the information obtained from 41 subjects was analyzed. The experimental groups underwent 7 sessions of 45 minutes of IPC and 12 sessions of 90 minutes of IPT every week. At the beginning of the study, after the end of the intervention, and after one- and three-month follow-up periods, all the subjects were evaluated with the BDI-II, emotional expressiveness, and social skills questionnaires. The findings were analyzed using the repeated measurement method and Kruskal-Wallis and Mann-Whitney U tests. All the analyses were carried out with SPSS software (version 23).

 Both IPC and IPT treatments were effective in depression symptoms (M: 31.76, 20.41, 22.94, and 24), emotional expression (M: 32.94, 40.26, 38.47, and 37.23), and social skills (M: 224.9, 265.2, 254.4, and 253.7) (P < 0.05). The comparison of the two treatments showed no significant difference in the variables (P > 0.05).

 The findings of the present study can be considered a useful step in the field of short-term and effective interventions.

 Psychiatric disorders frequently accompany comorbid conditions, which can have negative prognostic effects. The etiological and phenomenological distinctions between these conditions may have significant implications for their therapeutic approach and clinical course.

 Our study aimed to investigate the symptomatic and therapeutic significance of comorbid generalized anxiety disorder (GAD) on obsessive-compulsive disorder (OCD).

 This cross-sectional study included OCD patients referred to private and institutional psychiatric clinics in Rasht, Guilan, in 2021. All participants were divided into two groups: those with OCD and those with both OCD and GAD (OCD-GAD). The diagnoses were determined using structured clinical interviews that followed the DSM-5-research version (DSM-5-RV) criteria and included psychiatric histories. Patients were assessed using the Hamilton anxiety rating (HAM) scale, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and Global Assessment of Functioning (GAF). The data were analyzed using SPSS version 20.

 Out of the 146 participants, 80 had only OCD, while 66 had both OCD and GAD. Both groups demonstrated significant improvements in GAF scores throughout the treatment period (P < 0.0001); however, there was no significant difference between the groups in terms of these improvements. The Y-BOCS score was significantly higher in the OCD group at baseline (P < 0.0001), and it decreased more during the first 3 months in the OCD-GAD group (P = 0.006). The severity of obsessive-compulsive symptoms related to symmetry (P = 0.014), hoarding (P = 0.034), taboo thoughts (P = 0.023), and aggression (P = 0.002) was significantly higher in the group with OCD. Both HAM-A and Y-BOCS scores decreased over time, but HAM-A showed a greater decline at the first follow-up, while Y-BOCS showed a greater decline at the second follow-up.

 Considering our findings, OCD-GAD diagnosis is not a unique subcategory of current psychiatric disorders, and it is not necessarily beneficial to regard it as such. However, we found that the comorbidity of GAD did not harm the prognosis of patients with OCD. Further investigations are recommended to evaluate the clinical significance of OCD-GAD comorbidity.

 Regarding the patients’ critical conditions and various tools and pieces of equipment used in intensive care units (ICUs), the provision of critical care nursing seems complicated. Therefore, nurses’ achievements in making adaptations to critical care nursing are of utmost importance, especially in ICUs.

 The present study aimed to illuminate the facilitators of adaptation to nursing care among ICU nurses.

 This qualitative study was conducted using the conventional content analysis approach through semi-structured face-to-face interviews within December 2019 to April 2021. A total of 13 nurses working at a trauma center were selected to participate in this study using purposive sampling in Imam Hossein Hospital in Shahroud, Iran.

 Based on the results, the facilitators of adaptation to nursing care in ICU nurses consisted of three main categories of psychological capital, professional capital, and social capital.

 It was concluded that focusing on determining the facilitators of adaptation to critical care nursing and attempting to redouble them can promote the quality of nursing care. Much more attention should be paid to this issue because further adaptation affects society’s health conditions.

 Children's sexual development and behavior are important aspects of their overall development and education and are a significant concern for parents. These behaviors can lead to harm to children. The emotional climate and sexual environment within a family can influence the development of sexual behaviors.

 This study aimed to predict sexual behavior problems in children, both with and without pre-existing sexual problems, based on their family's emotional climate and exposure to sexual environments.

 The present study was an applied and descriptive-correlational study that utilized discriminant analysis as its primary analysis method. The study population consisted of parents with children between the ages of 6 and 12 in Ahvaz in 2021. A total of 294 parents were selected for the study using voluntary sampling. The data were collected using the Child Sexual Behavior Inventory (CSBI), the Family Emotional Atmosphere Scale, and the Family Sexuality Scale (FSS). The data collected were analyzed using discriminant analysis.

 The study's findings indicate that the emotional climate within a family and exposure to sexual situations within the family, both individually and in combination, can distinguish children who exhibit sexual behavior problems and those who do not. The conventional linear discriminant analysis (LDA) results indicated a significant combined power of the two variables (WL = 0.70; Kappa = 0.49; P = 0.001). The discriminant analysis results were significant for the family emotional climate (WL = 0.79; Kappa = 0.34) and exposure to the family sexual environment (WL = 0.80; Kappa = 0.36; P = 0.001).

 Based on the findings of the present study, it can be argued that the emotional climate within a family and exposure to sexual behavior within the family environment significantly impact the development of problematic sexual behaviors in children.

 Borderline personality disorder (BPD) has been considered a psychiatric disorder, the effective pharmacological treatments for which have not been well established.

 This study aimed to assess the efficacy of memantine (10 mg/day) in reducing BPD severity and cognitive impairment.

 The BPD patients diagnosed by psychologists were included and divided into the placebo (n = 19) and memantine (n = 20) groups. Included participants were randomized, double-blinded, and stabilized on the medication and psychotherapy for at least four weeks. The patients in the memantine group received oral memantine (10 mg/day) for four weeks. The severity of BPD was assessed by a self-reported questionnaire named Borderline Evaluation of Severity Over Time (BEST). Moreover, the Wisconsin test was carried out to assess executive function.

 The mean score of the BEST test significantly decreased in week eight post-treatment in the memantine group. In addition, a significant decrease in this score was indicated in the memantine group compared to the placebo group in week eight. The mean total score of the BEST test was not significantly different before and after the placebo administration. There was no significant difference in the Wisconsin subscales, including the number of wrong answers and categories achieved after memantine or placebo administration. Perseverative errors rose after the administration of memantine. Adverse side effects did not occur in any of the participants.

 Our findings suggested the potential therapeutic effects of memantine for BPD. Furthermore, we found that a low dose of meantime might be preferable to prevent the side effects.

 Cognitive impairments are common in bipolar disorder, which can negatively impact patients' psychological and psychosocial functioning, but there are no tools for assessing cognitive deficits, especially in patients with bipolar disorder in Iran.

 This study assessed the psychometric properties of the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) scale in Iranian patients with bipolar disorder (BD).

 Eighty patients diagnosed with bipolar spectrum disorder were selected from Tehran's major psychiatric facilities: Razi Psychiatric Hospital and Taleghani Hospital. A purposive sampling method was followed to select 80 non-patient control individuals from the general population in Tehran. Participants were evaluated using the Beck Depression Inventory-II (BDI-II), the Bech-Rafaelsen Mania Scale (BRAMS), the Mini-Mental State Examination (MMSE), and the COBRA. The data were analyzed using SPSS-24 to evaluate convergent and discriminant validity, test-retest reliability, and internal consistency.

 The convergent validity was examined by calculating the correlation between the scores on the COBRA and those on the MMSE; the results were significant (r = - 63, P < 0.001). Discriminant validity was assessed by comparing the COBRA total scores between the patients with BD and the control group; the results indicated a significant difference between the two groups (t = 6.413, P = 0.001). The CFA and EFA showed that the one-factor structure of COBRA was the best model. The Cronbach's alpha of 0.72 indicated an internal consistency. A test-retest reliability estimate of 0.84 indicated the high reliability of the scale. The current investigation suggested a cutoff score of 28, with 0.72 sensitivity and 0.69 specificity.

 Our translated version of the COBRA in Persian in this study showed adequate psychometric properties. This test can be considered an applicable instrument in investigating cognitive complaints in patients with bipolar disorder in Iran.

Attention-deficit/hyperactivity disorder (ADHD) is the most common psychiatric disorder in childhood. Concurrent anxiety disorders have turned into a challenging issue for psychiatrists. Numerous medications have been applied with controversial responses.

The current study aimed to compare the efficacy of the combination of methylphenidate (MPH) and fluoxetine (FLX) versus atomoxetine (ATX) in the symptoms and function of ADHD children with concurrent anxiety disorders.

The current randomized clinical was conducted on 76 outpatient children with concurrent ADHD and anxiety disorder within 2020 - 2021. The patients were divided into two equal groups. The first group was treated with MPH (5 mg twice daily) plus FLX (10 - 20 mg daily); nevertheless, the second group received ATX with a dose of 1.4 mg/kg. The Conner’s Parents Rating Scale (CPRS), Screen for Child Anxiety Related Emotional Disorders (SCARED), and Children’s Anxiety Impact Scale-Child (CAIS-C) were applied to assess anxiety at the baseline and 1 month and 4 months after the interventions.

The mean age of the studied population was 9.26 ± 1.92 years (range: 6 - 12 years), and 46 subjects (57.89%) were male. The significant trends of improvement in both groups, regardless of the interventions in the assessments of all the scales, were noted (P < 0.001 for all the scales); however, the comparison of the groups revealed no differences in the CPRS (P = 0.397), SACRED (P = 0.663), and CAIS-C (P = 0.683).

Based on the findings of this study, as ATX alone was as effective as MPH plus FLX for controlling anxiety disorders among ADHD children, ATX is preferred to apply fewer daily medications.

 Increasing studies suggest that the microbiome-gut-brain axis plays a fundamental role in developing autism spectrum disorder (ASD).

 We aimed to explore biomarkers from gut bacteria in ASD and the dietary vitamin A (VitA) relationship with intestinal bacteria of autistic children and provide a theoretical basis for dietary regulation of ASD.

 Ten autistic children aged 2 to 6 from special training facilities were enrolled from 2017 to 2018. At the same time, 10 healthy children aged 2 to 6 from a kindergarten were collected as a control. All participants were from Chongqing, China. The 16sRNA amplicon sequencing was used to analyze children's intestinal bacteria. The serum retinol level was detected by high-performance liquid chromatography (HPLC), and children's dietary intake was analyzed using three-day 24-hour dietary recalls.

 There were significant differences in alpha diversity between the groups. Also, a higher relative abundance of Prevotellaceae, Prevotella 9, and Roseburia was observed among ASD children. We also found decreases in 9 bacteria (Enterobacteriales, Gammaproteobacteria, Enterobacteriaceae, Clostridiaceae 1, Clostridium sensu stricto 1, Escherichia-Shigella, Bacteroides fragilis, Escherichia coli, and Clostridium neonatale). Dietary VitA intake and serum retinol concentration were lower in the ASD group than in the control group. Meanwhile, serum VitA had a significantly negative correlation with the abundance of intestinal Prevotella 9.

 Our study helps identify some bacterial biomarkers for ASD, as in previous reports. Meanwhile, the study suggests that dietary VitA may be involved in the clinical symptoms of ASD by regulating the intestinal bacteria Prevotella. It may provide a new way to treat ASD in the future. Further studies are needed to identify the results by expanding the sample size and developing animal experiments.