Journal of Preventive Medicine

Introduction
The novel coronavirus disease was first reported in China in December 2019. The fear of COVID-19 created many psychiatric disorders in people. Despite the many advantages of quarantine in preventing more and more cases of corona disease and reducing the number of cases and deaths in people, preventive measures by the method of social distancing caused an increase in mental stress in society. Despite the many advantages of quarantine in preventing or reducing the number of cases and deaths in people, social distancing caused an increase in mental stress in society. Being quarantined at home as well as the closure of schools, reduced outdoor activity, and incorrect eating and sleeping habits, raised the possibility of disrupting the normal lifestyle. All these changes can cause various neuro-psychological effects on the children. Psychological problems were exacerbated when children were living in areas where the prevalence of COVID-19 was higher. Behavioral problems in children are mainly divided into two categories: Externalizing and internalizing problems. Externalizing problems include verbal and physical aggression, and internalizing problems include anxiety, depression, social withdrawal, and nail-biting. If these problems are not paid attention to, children and adolescents will suffer from more problems such as low self-esteem, dropping out of school, depression, and delinquency. Considering that a person›s personality is formed during childhood, most behavioral disorders are caused by insufficient attention to this sensitive period. Due to the necessity of investigating the occurrence of behavioral problems in children during the COVID-19 pandemic, this study aims to determine the behavioral problems in preschool children in Abadan, Iran during home quarantine due to the COVID-19 pandemic.

Methods
This is a descriptive-analytical study. Participants were 234 preschool children from kindergartens in Abadan city in the spring 2021. The sampling method was a convenience method. Of 1800 preschool children aged 4-6 years, 324 were selected, but after removing incomplete questionnaires, a total of 234 were included in the study. The entering criteria included: Consent to participate in the study, age 4-6 years, and no obvious mental or physical problems. The exclusion criteria was the return of an incomplete questionnaire.

Results
Based on the descriptive information in Table 1, the mean total behavioral problems score was 23.12±7.96.


Based on its level, 230 children (98.3%) had low to moderate behavioral problems, and 4 children (1.7%) had high behavioral problems. Among the components of the behavioral problems scale, aggression with a mean of 12.23±4.6 had a higher score than anxiety and withdrawal variables. According to the results in Table 2, there was no significant difference in the mean scores of aggression and anxiety between boys and girls, but the mean score of withdrawal in boys was significantly higher than in girls (P=0.023).


Also, there was no significant difference in the mean of aggression between children with housekeeper and employed mothers, but the scores of withdrawal (P=0.013) and anxiety (P=0.008) were significantly different, which were higher in children with employed mothers. It was also found that the score of anxiety was significantly different based on birth rank, such that the anxiety of first-born children was significantly higher than other children (P=0.000).

Conclusion
Among preschool children in Abadan, 97.3% experience low to moderate behavioral problems during quarantine, and 1.7% experience high behavioral problems. According to the results, it is recommended that due to the key importance of early childhood in the social and cognitive development of a person, plans for the prevention and intervention of psycho-social crises should be developed by the Ministry of Health or healthcare centers for children during the pandemic, and a suitable platform should be provided for holding educational courses on healthy lifestyle as well as psychosocial support programs for families, children and child educators By psychiatrists, psychologists or pediatricians, to learn about children’s behavioral problems and how to solve them properly.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Abadan University of Medical Sciences (Code: IR.ABADANUMS.REC.1399.221).

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.

Authors' contributions
Study design, Research: Tara Borzoo; Sampling and writing the article: Mehsa Tafzoli and Tara Borzoo; Statistical analysis: Fatemeh Maqsoodil; Review of texts: Sajedeh Mousavi Asal; Final approval: Tara Borzoo and Sajdeh Mousavi Asal.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
This research was conducted under the supervision of Abadan University of Medical Sciences and with the cooperation of the Department of Education in the kindergartens of Abadan city. The authors hereby thank all those who have helped in carrying out this research project.


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