Prevalence of Anxiety Disorders among Children and Adolescents in Iran: A Systematic Review


Objective: 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.

American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force. Diagnostic and statistical manual of mental disorders : DSM-5. 5th ed. Washington, D.C.: American Psychiatric Association; 2013

Beesdo K, Knappe S, Pine DS. Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. The Psychiatric clinics of North America. 2009; 32: 483-524.

Essau CA, Petermann F. [Anxiety disorders in children and adolescents. Epidemiology, risk factors and intervention]. MMW Fortschritte der Medizin. 1999 Jul 8;141: 32-35.

Jalenques I, Coudert AJ. [Anxiety disorders in children: do any risk factors exist?]. Annales de pediatrie. 1990;37: 487-495.

Ipser JC, Stein DJ. A systematic review of the quality and impact of anxiety disorder meta-analyses. Current psychiatry reports. 2009 Aug;11:302-309.

Haller H, Cramer H, Lauche R, Gass F, Dobos GJ. The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review. BMC Psychiatry. 2014;14:128.

Abbo C, Kinyanda E, Kizza RB, Levin J, Ndyanabangi S, Stein DJ. Prevalence, comorbidity and predictors of anxiety disorders in children and adolescents in rural north-eastern Uganda. Child and adolescent psychiatry and mental health. 2013;7:21.

Burstein M, Beesdo-Baum K, He JP, Merikangas KR. Threshold and subthreshold generalized anxiety disorder among US adolescents: Prevalence, sociodemographic, and clinical characteristics. Psychol Med. 2014; 44: 2351-2362.

Burstein M, He JP, Kattan G, Albano AM, Avenevoli S, Merikangas KR. Social phobia and subtypes in the national comorbidity survey-adolescent supplement: prevalence, correlates, and comorbidity. Journal of the American Academy of Child and Adolescent Psychiatry 2011; 50: 870-880.

Sharkey L, McNicholas F. Selective Mutism: A prevalence study of primary school children in the Republic of Ireland. Ir J Psychol Med 2012; 29: 36-40.

Bener A, Ghuloum S, Dafeeah EE. Prevalence of common phobias and their socio-demographic correlates in children and adolescents in a traditional developing society. Afr J Psychiatry (South Africa) 2011;14:140-145.

Kim SJ, Kim BN, Cho SC, Kim JW, Shin MS, Yoo HJ, et al. The prevalence of specific phobia and associated co-morbid features in children and adolescents. Journal of anxiety disorders 2010; 24: 629-634.

Esbjørn BH, Hoeyer M, Dyrborg J, Leth I, Kendall PC. Prevalence and co-morbidity among anxiety disorders in a national cohort of psychiatrically referred children and adolescents. Journal of anxiety disorders 2010; 24: 866-872.

Ranta K, Kaltiala-Heino R, Rantanen P, Marttunen M. Social phobia in Finnish general adolescent population: prevalence, comorbidity, individual and family correlates, and service use. Depression and anxiety 2009; 26: 528-536.

Gren-Landell M, Tillfors M, Furmark T, Bohlin G, Andersson G, Svedin CG. Social phobia in Swedish adolescents: Prevalence and gender differences. Social psychiatry and psychiatric epidemiology 2009; 44:1-7.

Adewuya AO, Ola BA, Adewumi TA. The 12-month prevalence of DSM-IV anxiety disorders among Nigerian secondary school adolescents aged 13-18 years. J Adolesc. 2007;30:1071-6.

Rabe-Jabłońska J, Dietrich-Muszalska A, Gmitrowicz A. The prevalence of social phobia in a representative group of adolescents from Łódź. Arch Psychiatry Psychother 2004;6:15-22.

Boyd CP, Gullone E, Kostanski M, Ollendick TH, Shek DTL. Prevalence of anxiety and depression in Australian adolescents: Comparisons with worldwide data. J Genet Psychol 2000;161: 479-492.

Jalali M, Pourahmadi E. Prevalence of anxiety disorders among 10–14 years old children in Gorgan. European Psychiatry 2012 //;27, Supplement 1:1.

Nassi A, Mehrabizadeh Honarmand M, Shehni Yailagh M, Bassaknejad S, Talebpour A. The epidemiology of separation anxiety disorder in Isfahan primary school male students. iranian journal of epidemiology 2012;8: 47-57.

Giannakopoulos NN, Rammelsberg P, Eberhard L, Schmitter M. A new instrument for assessing the quality of studies on prevalence. Clinical oral investigations 2012;16:781-788.

Amirfakhraei A, Alinaghizadeh A. Epidemiology of mental disorders among adolescents in the city of Bandar Abbas, Iran, in 2012. Life Sci J 2012; 9: 976-980.

Shams G, Foroughi E, Esmaili Y, Amini H, Ebrahimkhani N. Prevalence rates of obsessive-compulsive symptoms and psychiatric comorbidity among adolescents in Iran. Acta Med Iran 2011; 49:680-687.

Jenaabadi H, Nastiezaie N. A COMPARISON OF AGGRESSION, ANXIETY AND DEPRESSION IN HIGH SCHOOL STUDENTS IN SARAVAN CITY. Journal of Nursing and Midwifery Urmia University of Medical Sciences. 2011;9.

Hosseinifard SM, Birashk B, Atefvahid MK. Epidemiology of Mental Disorders in High-School Students in Rafsanjan. Iranian Journal of Psychiatry and Clinical Psychology 2005;11:71-80.

Narimani M. Prevalence of anxiety in students and compare the efficacy of cognitive and behavioral therapy and mental securing of Mayknbam in reducing symptoms of anxiety in students. Daneshvar 2001; 8: 101-106.

Saberi H. The epidemiology of affective and behavioral disorders in elementary school children. Andishe va Raftar 2008;2:19-34.

Ghoreishi S, Rahmanpour H, Mousavinasab S. Evaluation of Psychological Problems in Teenagers Suffering from Polycystic Ovary Syndrome. ZUMS Journal 2010;18: 76-83.

Sadeghian E, Moghadari Kosha B, Gorji S. The Study of Mental Health Status in High School Female Students in Hamadan City. Sci J Hamadan Univ Med Sci 2010;17:39-45.

Kheirkhah M, Mokarie H, Nisani Samani L, Hosseini A. Relationship between Anxiety and Self-concept in Female Adolescents. Iran Journal of Nursing 2013; 26:19-29.

Salari H, Sajadi A. Comparing the anxiety between adolescents living in parental home and those living in institutions (Text in Persian). Zahedan Journal of Research in Medical Sciences 2005; 7:15-9.

Movahhedi-rad N, Ajvadi H, Ahmadi M, Fakhar-Moghadam F, Akbarian M, Malmir I. A comparison of prevalence of clear anxiety among the students with different demographic characteristics. JOURNAL OF EDUCATIONAL SCIENCES 2012; 5: 131-146.

Ahmadi A, Mohammadi-Sartang M, Nooraliee P, Veisi M, Rasouli J. Prevalence of anxiety and it's relationship with consumption of snacks in high school students in Shiraz. Journal of Shahrekord University of Medical Sciences 2013;15: 83-90.

Mozafari M, Ghanizadeh A, Ashkani H, Firouzabadi A, Alishahi M, Dehbozorgi G, et al. Prevalence of deppression and anxiety disorders in in children of veterans and control group in Shiraz city. Qom University of Medical Sciences Journal 2009; 3:19-24.

Ranjbar F, Nabdel Y, Fakhari A, DAdashzadeh H. prevalence of psychiatric disorders among children and adolescents in north west of Tabriz. Medical Journal of Tabriz University of Medical Science & Health Service 2003; 25: 56-60.

Assarian F, Biqam H, Asqarnejad A. An epidemiological study of obsessive-compulsive disorder among high school students and its relationship with religious attitudes. Arch Iran Med 2006; 9:104-107.

Massoudzadeh A. A survey of Obsessive-Compulsive Disorder prevalence among High school girl students in Sari. Journal of Mazandaran University of Medical Sciences 2007;17: 95-101.

Lashkaripour K, Bakhshani N, Solaimani M. The relationship between test anxiety and academic achievement in students of guidance schools in Zahedan in 2006. Tabibe Shargh 2006; 8 :253-259.

Nilchiyan F, Mohammadi A. Assessment of the level of dental anxiety in 10-12 year-old students in Shahr-e-kord city in 2012. J Isfahan Dent Sch 2013; 9: 451-458.

Ghafarinejad A. Prevalence of social phobia disorder and related factors in high school students in Kerman city in 1998. Scientific Journal of Hamedan University of Medical Sciences. 2001;8:9-12.

Abdkhodaie M, Sadeghi Ardobadi A. Prevalence of Separation Anxiety in Children and Effect of Cognitive Behavioral Play Therapy on Reducing it. Journal of Clinical Psychology 2012;3:51-8.

Qamari Givi H, Abolghasemi A, Falah-zadeh M. Study of prevalence of generalized anxiety disorder among Fifth the grade pupils and the effectiveness of inner and outer self statement on its treatment. Quarterly Journal of Psychological Studies. 2009;5:9-26.

Hajiamini Z, Mohamadi A, Ebadi A, Fathi- Ashtiani A, Tavousi M, Montazeri A. The School Anxiety Scale-Teacher Report (SAS-TR): translation and psychometric properties of the Iranian version. BMC psychiatry. 2012;12.

Seyyed Nozadi M, Behdani F, Jarahi L, Erfanian M, Miri M. Comparison of anxiety levels in rural and urban high school students in Mashhad-Northeastern part of Iran. Journal of Fundamentals of Mental Health 2013;14:294-301.

Cartwright-Hatton S, McNicol K, Doubleday E. Anxiety in a neglected population: prevalence of anxiety disorders in pre-adolescent children. Clinical psychology review. 2006 Nov;26:817-33.

Akbay Oba A, Dülgergil CT, Şaroǧlu Sönmez I. Prevalence of dental anxiety in 7- to 11-year-old children and its relationship to dental caries. Med Princ Pract 2009; 18: 453-457.

Bedi R, Sutcliffe P, Donnan PT, McConnachie J. The prevalence of dental anxiety in a group of 13- and 14-year-old Scottish children. Int J Paediatr Dent 1992; 2:17-24.

De Carvalho RWF, De Carvalho Bezerra Falcão PG, De Luna Campos GJ, De Souza Andrade ES, Do Egito Vasconcelos BC, Da Silva Pereira MA. Prevalence and predictive factors of dental anxiety in brazilian adolescents. J Dent Child 2013; 80: 41-46.

Lee CY, Chang YY, Huang ST. Prevalence of dental anxiety among 5- to 8-year-old Taiwanese children. J Publ Health Dent. 2007; 67:36-41.

Somers JM, Goldner EM, Waraich P, Hsu L. Prevalence and incidence studies of anxiety disorders: a systematic review of the literature. Canadian journal of psychiatry Revue canadienne de psychiatrie 2006; 51: 100-113.

IssueVol 10 No 1 (2015) QRcode
Adolescents Anxiety Children Iran Prevalence

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Zarafshan H, Mohammadi M-R, Salmanian M. Prevalence of Anxiety Disorders among Children and Adolescents in Iran: A Systematic Review. Iran J Psychiatry. 10(1):1-7.