Exploring mental health in Iranian children: insights from a cohort dataset by using the strengths and difficulties questionnaire

Abstract

Introduction: This study examines the mental health of Iranian children aged 9–12 by evaluating data extracted from a cohort dataset that includes various variables from pregnancy to the mentioned age. Method: Data from the Fars Birth Cohort (FBC) was used, involving 714 children aged 9–12 in 2021. The study recorded various characteristics, including parental sociodemographics and child health, and assessed behavioral difficulties using the Strengths and Difficulties Questionnaire (SDQ) through parent-reported phone interviews. A multivariate logistic regression model identified factors linked to SDQ scores, categorized as normal or borderline/abnormal. Results: The average age of participants was 10.06 years, with a majority being girls (51.68%). Breastfeeding varied, with 42.30% breastfeeding for 4–6 months. Physical health was generally good, although common diagnoses included allergies (12.04%) and anemia (12.61%). Mental health evaluations indicated that 3.08% of children were diagnosed with depression or anxiety, while 2.52% were identified as having ADHD. Additionally, 94.96% of participants reported using technology for at least one hour daily. In terms of SDQ scores, 10.78% and 13.16% of children fell into the “Borderline” and “Abnormal” categories, respectively. Among subscales, the highest percentage of children scored within the “normal” range for prosocial behavior, while the highest proportion for the “abnormal” was emotional difficulties. Higher education levels of fathers (OR = 6.95), household smoking (OR = 1.89), ADHD diagnoses (OR = 22.87), and frequent technology use (OR = 3.92) were all significantly associated with increased abnormal scores. Also, child’s age was a predictor of higher odds of an abnormal SDQ score (OR = 1.77). Conclusion: The study highlights complex relationships among parental, environmental, and child-specific factors affecting childhood behavioral difficulties. It underscores the need for comprehensive interventions targeting multiple risk factors, particularly household smoking, hyperactivity, and excessive technology use.