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Prevalence of Psychiatric Disorders and Associated Factors Among the Youth in Ravansar, Iran

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Prevalence of Psychiatric Disorders and Associated Factors Among the Youth in Ravansar, Iran ARCHIVES OF Arch Iran Med. August 2019;22(8):435-442 IRANIAN http www.aimjournal.ir MEDICINE Open Original Article Access Prevalence of Psychiatric Disorders and Associated Factors among the Youth in Ravansar, Iran Habibolah Khazaie, MD1; Behrooz Hamzeh, PhD2*; Farid Najafi, PhD3; Azita Chehri, PhD4; Afarin Rahimi-Movaghar, MD5; Masoumeh Amin-Esmaeili, MD5; Mehdi Moradi-Nazar, PhD2; Ali Zakiei, PhD1; Saeid Komasi, PhD6; Yahya Pasdar, PhD2 1Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran 2Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran 3Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran 4Department of Psychology, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran 5Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran 6Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran Abstract Background: Mental disorders contribute significantly to the burden of diseases in Iran. Therefore, the current study aims to assess the prevalence of psychiatric disorders and their associated factors among youth in Kermanshah province of Iran. Methods: The current study is a part of the first phase of Ravansar Cohort (a part of the PERSIAN Youth Cohort) including 2991 participants aged 15 to 34 from Ravansar district in western Iran. Enrollment and data collection for this phase were performed from end April 2015 to early April 2017. The data were gathered using structured interviews and national and international standard questionnaires. Data analysis was carried out using multinomial logistic regression and chi-square test. Results: The prevalence of any psychiatric disorder among the selected population was 31.3%. Major depressive disorder (MDD) (21.6%), followed by generalized anxiety disorder (GAD) (6.4%) and dysthymia (1.9%) were the most prevalent disorders among the study individuals. The prevalence of alcohol and opioid/stimulant use disorders was 4.6% and 5.1%, respectively. Moreover, there was significant relationship between location of residence (city or village) and marital status with prevalence of the disorders. Conclusion: Based on the results of the current study, it can be concluded that the prevalence of mental and psychiatric disorders among the youth in Ravansar district, western Iran is relatively high and needs specific plans and interventions to control it Keywords: Mental disorders, Mental health, Prevalence Cite this article as: Khazaie H, Hamzeh B, Najafi F, Chehri A, Rahimi-Movaghar A, Amin-Esmaeili M, et al. Prevalence of psychiatric disorders and associated factors among the youth in Ravansar, Iran. Arch Iran Med. 2019;22(8):435–442. Received: March 4, 2019, Accepted: May 15, 2019, ePublished: August 1, 2019 Introduction meta-analysis have shown that the prevalence of mental Mental disorders and substance abuse are considered as disorders is generally high and people around the world major problems of the global health.1 These disorders will are affected by these disorders, This study emphasized the often lead to disability and human burden.2,3 Previous importance of regional studies on the prevalence rate of studies have been shown that mental disorders impose huge mental disorders.12 financial burden on the community.4-6 It is claimed that the During the recent decades, Iran has faced major and costs of mental disorders are increasing as it could account rapid social, economic, and demographic changes, for 15% of the healthcare costs.7 The complications and currently, studies have shown that more than 70% of consequences of mental disorders for community members the total population are urban and youth make up a can impact on quality of life and disrupt the functioning of large share of the total population.13 Assessing the effects afflicted individuals. For instance, according to the World of these changes on the young people can help improve Health Organization (WHO), depression is the fourth the planning process. Studies in Iran have reported a leading cause of disability and morbidity worldwide due prevalence rate of 11% to 24% for mental and psychiatric to its multifaceted consequences and it is predicted that disorders.14,15 Another study has reported the prevalence this ranking will climb to the second in 2020.8 rate of psychiatric disorders in Iran as 23.6%.16 These The most common of psychiatric disorders are statistics have been obtained around the country; however, depressive disorders (with a prevalence rate of 10%−25 in order to perform more accurate planning, we require %, 5%−12%, and 12% among women, men and the specific statistics of various regions of the country. general population respectively),9,10 and anxiety disorders Kermanshah province is located in west of Iran and based (with a prevalence rate of 3.4−7.5%).11 The results of a on the 2015 national census, the Kermanshah province *Corresponding Author: Behrooz Hamzeh, MD; Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. Email: [email protected] Khazaie et al has a population of 1 952 434, which consists of 2.44% well as 32 additional active health houses in this city. Given of the country population. The average household size in the fact that the target population of the “Youth” cohort Kermanshah is 3.4, and about 76% of the population is includes 15 to 34-year-old individuals in urban and rural living in the urban areas.13 areas of this region, 3000 of those were entered into the According to the results of a study in Kermanshah city, study. This sample size was determined using 80% power 39.1% of randomly selected individuals were positive if alpha equals 0.05 (incidence in non-exposed = 0.03; for psychiatric disorders.17 The results of another study exposed = 0.02). These randomly selected subjects include showed an increase in suspected cases of mental disorders the majority of the young population in this region. There in Iran from 1999 to 2015.18 According to the study was a full list of young people, so, a random sample of that was performed by Noorbala et al,18 the prevalence 3000 people was selected. After selecting the subjects, they of mental disorders in Kermanshah province was 19.2% were invited to attend the study. The purpose of the study in 1999, while increased to 26.2% in 2015. Appropriate was explained to them, and they came to the centers to planning for providing mental healthcare services in the interview and complete the questionnaires. community requires basic information, epidemiological The age range between 15 to 34 along with at least six studies, and understanding the consequences. The purpose months of residence in this city before interview, as well of this project is to conduct an epidemiological study on as having Iranian nationality and being available during mental disorders in the Ravansar, to draw the attention recruitment, were the inclusion criteria for the study. of healthcare, educational and social care providers to the Individuals who lived in the city temporally (e.g. for importance of psychological problems as well as providing study or temporary job) and those with severe medical or the basic mental healthcare services for residents of this psychiatric illness have been excluded. There was no limit area. Moreover, it seems that there is need for identification for illiterate. of the populations who are susceptible to mental illness However, 9 individuals were excluded from the study in order to take the necessary measures to prevent these due to failure to successfully complete the questionnaires. disorders. Therefore, the current study was conducted to evaluate the prevalence of psychiatric disorders and its Data Collection associated factors among the young people in Ravansar Individuals’ enrollment and data collection for the first district in Kermanshah province of Iran. phase of the study were carried out from April 2015 to April 2017. In order to assess the prevalence of psychiatric Materials and Methods disorders including major depressive disorder (MDD), Design and Background persistent depressive disorder (PDD or dysthymia), The “Youth” cohort is one of subsets the Prospective generalized anxiety disorder (GAD), and obsessive- Epidemiological Research Studies in Iran (PERSIAN) compulsive disorder (OCD), as well as substance use cohort, which is a national cohort study that started in disorders (including opioids, stimulants and alcohol use 2014. The PERSIAN “Birth”, “Youth” and “Elderly” cohort disorders), a structured interview (Composite International are carried out along with the PERSIAN cohort (http:// Diagnostic Interview [CIDI], version 2.1) based on DSM- www.persiancohort.com/aboutus/). The “PERSIAN IV-TR was used. Another instrument used in the current Youth” cohort is a longitudinal study, which aims to study was the socio-demographic information collection. assess the incidence of mental disorders and its correlated Data collection and interviews were performed by two factors. Common mental disorders, suicide, substance psychologists who were fully trained different subjects use disorders, aggression, injuries, and service utilization all related subjects of study objectives, general interview have been focused in this cohort. In this prospective study,
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