Background: Anxiety and psychosomatic disorders are the most common mental health problems among children and adolescents. Such disorders could have negative effects on lifestyle habits. 
Objective: To examines the clustering of anxiety and psychosomatic disorders in Iranian children and adolescents, and its association with their lifestyles.
Methods: This cross-sectional survey was conducted as the fifth survey of a national school-based program in Iran in 2015. Participants were 14,400 students, aged 7 to 18 years old, who were selected by a multi-stage cluster random sampling method, from 30 provinces across the country. Data were obtained from a World Health Organization–Global Student Health Survey questionnaire (WHO-GSHS). A two-step cluster analysis was performed and clusters of anxiety and psychosomatic disorder were identified. The logistic regression model was applied to predict the association between identified clusters and lifestyle variables including dietary habits, sedentary behavior, and sleep duration. The reference category of this model was considered as clusters including students with low anxiety and low psychosomatic disorder symptoms. In order to determine the relation between demographic characteristics and other variables with lifestyle habits in identified clusters, one-way analysis of variance (ANOVA) and Pearson Chi-square tests were used. Analyses were performed in SPSS v 18 (PASW Statistics for Windows). The statistical significance level was set at p<0.05.
Results: The mean (SD) of the age of the participants was 12.29 (3.15). The prevalence of high anxiety with recurrent mental disorders was 20.4%. This group of students had a higher frequency of sadness than other students did (43.8% vs. 25.8%, p<0.001). They had a higher frequency of prolonged screen time (>2 hr/day) (OR: 2.00, 95% CI: 1.79 2.24), skipping breakfast (OR: 1.83; 95% CI:1.59-2.11), as well as daily consumption of candy (OR: 1.15; 95% CI: 1.001-1.31), salty snacks (OR: 1.81, 95% CI: 1.52-2.16), and soft drinks (OR: 6.68, 95% CI: 4.86-9.18). Moreover, they had a lower frequency of consuming fruits/vegetables (OR: 0.79, 95% CI: 0.69-0.88) and milk (OR: 0.76, 95% CI: 0.69-0.84) than their counterparts.
Conclusion: This study showed that risk of unhealthy lifestyle behaviors in children and adolescents with high anxiety and psychosomatic disorders higher than others, should be considered in health promoting programs.
Keywords: Psychophysiological disorders; Anxiety; Lifestyle; Child; Adolescent


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