Depression and aggression scores, reported sleep disorders status and their associated factors among adolescent girls in Northern Iran

  • Afsane Bahrami
  • Davoud Salarbashi
  • Mohammad Mohammad-Zadeh
  • Maryam Tayefi
  • Seyed Jamal Mirmoosavi
  • Gordon A. Ferns
  • Hamidreza Bahrami-TaghanakiEmail author
  • Majid Ghayour-MobarhanEmail author


Depressive disorders are a common cause of morbidity, globally. We have evaluated the prevalence of depression, aggression and sleep disorders, and their associations with each other and socio-economic characteristics, in adolescent girls from northern Iran. This cross sectional study was performed in 940 adolescent students, aged 12–18 years old. The Beck Depression Inventory II, Buss-Perry Aggression, Insomnia Severity Index, Epworth Sleepiness Scale and STOP-Bang sleep apnea questionnaires were used to evaluate depression, aggression, insomnia, sleepiness and sleep apnea among the participants, respectively. A total of 634 (67.4%), 216 (23.0%), 222 (23.6%) and 2 (0.2%) of subjects had some degree of depression, insomnia, sleepiness or sleep apnea, respectively. Girls who lived in a small family group had a significantly higher depression score than those living in a larger family group. Girls from families in which their parents were divorced had higher depression and sleepiness scores compared to their peer group. Participants with high depression scores had higher aggression, insomnia, sleepiness and sleep apnea scores than subjects without (P < 0.05). In female adolescents, emotional, behavioral and sleep disorders appear to be related to their demographic and socio-economic characteristics. Aggression score, insomnia, day time sleepiness and sleep apnea were significantly more common in individuals with a high depression score, and may be causally related, although this could not be formally assessed in this study. Individuals at risk of depression need to be identified, as this may allow interventions that may improve their quality of life outcomes.


Depression Aggression Insomnia Adolescents Iran 



Buss-Perry Aggression Questionnaire


Body mass index


Excessive daytime sleepiness


Epworth Sleepiness Scale


Insomnia Severity Index


Major depressive disorder


obstructive sleep apnea syndrome


Self-rated depression scale



We also want to thank all the school personnel, students and their parents for their cooperation.

Authors’ Contributions

Concept: M.G.; Design: A.B.; S.j. M. Data Collection or Processing: D.S., GA. F.

Analysis or Interpretation: M.T.; Literature Search: M.M., H.B.T; Writing: A.B.

All authors read and approved the final manuscript.


This study was funded by Mashhad University of Medical Sciences (931188).

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Mashhad University of Medical Science (Code: 931188) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

Not applicable.

Competing Interests

The authors declare that they have no competing interests.


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Authors and Affiliations

  • Afsane Bahrami
    • 1
  • Davoud Salarbashi
    • 2
    • 3
  • Mohammad Mohammad-Zadeh
    • 4
  • Maryam Tayefi
    • 5
  • Seyed Jamal Mirmoosavi
    • 6
  • Gordon A. Ferns
    • 7
  • Hamidreza Bahrami-Taghanaki
    • 8
    Email author
  • Majid Ghayour-Mobarhan
    • 9
    Email author
  1. 1.Cellular and Molecular Research CenterBirjand University of Medical SciencesBirjandIran
  2. 2.Social Development & Health Promotion Research CenterGonabad University of Medical SciencesGonabadIran
  3. 3.Nutrition and Biochemistry Department, School of MedicineGonabad University of Medical SciencesGonabadIran
  4. 4.Department of Physiology & Pharmacology, Cellular and Molecular Research CenterSabzevar University of Medical SciencesSabzevarIran
  5. 5.Clinical Research UnitMashhad University of Medical SciencesMashhadIran
  6. 6.Community Medicine Department, Medical SchoolSabzevar University of Medical SciencesSabzevarIran
  7. 7.Brighton & Sussex Medical School, Division of Medical EducationSussexUK
  8. 8.Chinese and Complementary Medicine Research CenterMashhad University of Medical SciencesMashhadIran
  9. 9.Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran

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