Paediatric Anxiety Disorders
Abstract
Anxiety disorders are highly prevalent among children and are associated with serious morbidity. Lifetime prevalence of paediatric anxiety disorders is about fifteen percent. Social phobia, generalized anxiety disorder and separation anxiety disorder are included in the triad of paediatric anxiety disorders. Specific phobia, obsessive compulsive disorder and post-traumatic stress disorder are also commonly seen in children. Overprotection by parents, parental death or separation, female sex, low educational status, family history of anxiety disorder, financial stress in family and adverse childhood experiences are risk factors for the development of anxiety disorders. If not diagnosed and managed at the earliest, paediatric anxiety disorders can cause life threatening problems in the future. Hence early and scientific management of anxiety disorders is essential. Cognitive behavioural therapy is the effective evidence based treatment for paediatric anxiety disorders.References
1. Campbell MA, Rapee RM, Spence SH. Developmental changes in the interpretation of rating format on a questionnaire measure of worry. Clin Psychol. 2000;5(2):49-59.
2. Rockhill C, Kodish I, DiBattisto C, Macias M, Varley C, Ryan S. Anxiety disorders in children and adolescents. Curr Probl Pediatr Adolesc Health Care. 2010 Apr;40(4):66-99.
3. Chavira DA, Stein MB, Bailey K, Stein MT. Child anxiety in primary care: prevalent but untreated. Depress Anxiety. 2004;20(4):155-64.
4. Zimmermann P, Wittchen H-U, Höfler M, Pfister H, Kessler RC, Lieb R. Primary anxiety disorders and the development of subsequent alcohol use disorder: A 4-year community study of adolescents and young adults. Psychol Med. 2003;33(7):1211–1222.
5. Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill JT, Ginsburg GS, Rynn MA, McCracken J, Waslick B, Iyengar S, March JS, Kendall PC. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med. 2008;359(26):2753-66.
6. Rapp A, Dodds A, Walkup JT, Rynn M. Treatment of pediatric anxiety disorders. Ann N Y Acad Sci. 2013 Nov;1304:52-61.
7. Ramsawh HJ, Chavira DA, Stein MB. Burden of anxiety disorders in pediatric medical settings: prevalence, phenomenology, and a research agenda. Arch Pediatr Adolesc Med. 2010 Oct;164(10):965-72.
8. Wittchen H-U, Fehm L. Epidemiology and natural course of social fears and social phobia. Acta Psychiatr Scand. 2003;108(Suppl 417):4-18.
9. Sakolsky D, Birmaher B. Pediatric anxiety disorders: management in primary care. Curr Opin Pediatr. 2008 Oct;20(5):538-43.
10. Bolton D, Eley TC, O’Connor TG, et al. Prevalence and genetic and environmental influences on anxiety disorders in 6-year-old twins. Psychol Med. 2006;36(3):335-44.
11. Fisher PH, Tobkes JL, Kotcher L, Masia-Warner C. Psychosocial and pharmacological treatment for pediatric anxiety disorders. Expert Rev Neurother. 2006 Nov;6(11):1707-19.
12. Hunot V, Churchill R, Silva de Lima M, Teixeira V. Psychological therapies for generalised anxiety disorder. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD001848.
13. Gillies D, Taylor F, Gray C, O'Brien L, D'Abrew N. Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents. Cochrane Database Syst Rev. 2012 Dec 12;12:CD006726.
14. Hedman E, Hesser H, Andersson E, Axelsson E, Ljotsson B. The mediating effect of mindful non-reactivity in exposure-based cognitive behavior therapy for severe health anxiety. J Anxiety Disord. 2017 May 2;50:15-22.
15. Basco MR, Glickman M, Weatherford P, Ryser N. Cognitive-behavioral therapy for anxiety disorders: why and how it works. Bull Menninger Clin. 2000 Summer;64(3 Suppl A):A52-70.
16. Gilbert AR, Maalouf FT. Pediatric obsessive-compulsive disorder: management priorities in primary care. Curr Opin Pediatr. 2008 Oct;20(5):544-50.
17. Rapp A, Dodds A, Walkup JT, Rynn M. Treatment of pediatric anxiety disorders. Ann N Y Acad Sci. 2013 Nov;1304:52-61.
18. Gillies D, Taylor F, Gray C, O'Brien L, D'Abrew N. Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents (Review). Evid Based Child Health. 2013 May;8(3):1004-116.
19. Brewer S, Sarvet B. Management of anxiety disorders in the pediatric primary care setting. Pediatr Ann. 2011 Nov;40(11):541-7.
20. Hirschfeld-Becker DR, Masek B, Henin A, Blakely LR, Pollock-Wurman RA, McQuade J, DePetrillo L, Briesch J, Ollendick TH, Rosenbaum JF, Biederman J. Cognitive behavioral therapy for 4- to 7-year-old children with anxiety disorders: a randomized clinical trial. J Consult Clin Psychol. 2010;78(4):498-510.
2. Rockhill C, Kodish I, DiBattisto C, Macias M, Varley C, Ryan S. Anxiety disorders in children and adolescents. Curr Probl Pediatr Adolesc Health Care. 2010 Apr;40(4):66-99.
3. Chavira DA, Stein MB, Bailey K, Stein MT. Child anxiety in primary care: prevalent but untreated. Depress Anxiety. 2004;20(4):155-64.
4. Zimmermann P, Wittchen H-U, Höfler M, Pfister H, Kessler RC, Lieb R. Primary anxiety disorders and the development of subsequent alcohol use disorder: A 4-year community study of adolescents and young adults. Psychol Med. 2003;33(7):1211–1222.
5. Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill JT, Ginsburg GS, Rynn MA, McCracken J, Waslick B, Iyengar S, March JS, Kendall PC. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med. 2008;359(26):2753-66.
6. Rapp A, Dodds A, Walkup JT, Rynn M. Treatment of pediatric anxiety disorders. Ann N Y Acad Sci. 2013 Nov;1304:52-61.
7. Ramsawh HJ, Chavira DA, Stein MB. Burden of anxiety disorders in pediatric medical settings: prevalence, phenomenology, and a research agenda. Arch Pediatr Adolesc Med. 2010 Oct;164(10):965-72.
8. Wittchen H-U, Fehm L. Epidemiology and natural course of social fears and social phobia. Acta Psychiatr Scand. 2003;108(Suppl 417):4-18.
9. Sakolsky D, Birmaher B. Pediatric anxiety disorders: management in primary care. Curr Opin Pediatr. 2008 Oct;20(5):538-43.
10. Bolton D, Eley TC, O’Connor TG, et al. Prevalence and genetic and environmental influences on anxiety disorders in 6-year-old twins. Psychol Med. 2006;36(3):335-44.
11. Fisher PH, Tobkes JL, Kotcher L, Masia-Warner C. Psychosocial and pharmacological treatment for pediatric anxiety disorders. Expert Rev Neurother. 2006 Nov;6(11):1707-19.
12. Hunot V, Churchill R, Silva de Lima M, Teixeira V. Psychological therapies for generalised anxiety disorder. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD001848.
13. Gillies D, Taylor F, Gray C, O'Brien L, D'Abrew N. Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents. Cochrane Database Syst Rev. 2012 Dec 12;12:CD006726.
14. Hedman E, Hesser H, Andersson E, Axelsson E, Ljotsson B. The mediating effect of mindful non-reactivity in exposure-based cognitive behavior therapy for severe health anxiety. J Anxiety Disord. 2017 May 2;50:15-22.
15. Basco MR, Glickman M, Weatherford P, Ryser N. Cognitive-behavioral therapy for anxiety disorders: why and how it works. Bull Menninger Clin. 2000 Summer;64(3 Suppl A):A52-70.
16. Gilbert AR, Maalouf FT. Pediatric obsessive-compulsive disorder: management priorities in primary care. Curr Opin Pediatr. 2008 Oct;20(5):544-50.
17. Rapp A, Dodds A, Walkup JT, Rynn M. Treatment of pediatric anxiety disorders. Ann N Y Acad Sci. 2013 Nov;1304:52-61.
18. Gillies D, Taylor F, Gray C, O'Brien L, D'Abrew N. Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents (Review). Evid Based Child Health. 2013 May;8(3):1004-116.
19. Brewer S, Sarvet B. Management of anxiety disorders in the pediatric primary care setting. Pediatr Ann. 2011 Nov;40(11):541-7.
20. Hirschfeld-Becker DR, Masek B, Henin A, Blakely LR, Pollock-Wurman RA, McQuade J, DePetrillo L, Briesch J, Ollendick TH, Rosenbaum JF, Biederman J. Cognitive behavioral therapy for 4- to 7-year-old children with anxiety disorders: a randomized clinical trial. J Consult Clin Psychol. 2010;78(4):498-510.
