Anxiety disorders in children and adolescents

This article summarizes various aspects of anxiety disorder in children and adolescents using the latest research findings. Anxiety is an emotion, an unpleasant feeling of tension or apprehension accompanied by physiological changes and worries or fears. It can become maladaptive if excessive or developmentally inappropriate; if it also causes significant functional impairment, it can be considered to be an anxiety disorder. The type of disorder depends on age of onset, the symptomatology, and the presence or not of a specific feared situation. Anxiety disorders are among the most prevalent categories of psychopathology in children. Making an early diagnosis is important; anxiety disorders may impede academic and social functioning. At least one-third of children with anxiety disorders meet the criteria for two or more anxiety disorders. General comorbidity with other psychiatric disorders is 40%. Various aetiological factors include: temperament, genetics, neurobiological changes, parent–child interactions, negative life events, and social adversity. The prognosis of anxiety disorders depends on several factors, including comorbidity, age of onset, severity at baseline and type of disorder. As well as psycho-education, evidence-based treatments include cognitive–behavioural therapy and, in more severe cases, medication such as selective serotonin-reuptake inhibitors. Other comorbid disorders need to be assessed for and treated as appropriate. Recent research has demonstrated the effectiveness of prevention strategies.