Anxiety Disorders among Adolescents referred to General Psychiatry for Multiple Causes: Clinical Presentation, Prevalence, and Comorbidity

Abstract

Background: Reports of anxiety disorder characteristics among youth in clinical settings typically include descriptions of patients who have been specifically referred for anxiety treatment. At odds with a large body of evidence which demonstrates these disorders to be most common among young people, prevalence studies in samples referred to general psychiatry for multiple causes are scarce and report highly discrepant estimates. Methods: For this study and regardless of their presenting symptoms, 125 adolescents (57.6% girls) between the ages of 12 and 18 years who were consecutively referred to two child and adolescent general psychiatry clinics in Sweden were assessed for anxiety disorders and comorbidity using the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Self-ratings of anxiety symptoms and difficulties with family, school, friends, sleep, and body aches were also obtained. Results: At least one anxiety disorder was found in 46% of participants. Among anxious adolescents, homotypic comorbidity (concurrent anxiety) was observed in 43%, and heterotypic comorbidity (concurrent non-anxiety psychiatric disorders) was observed in 91%. No comorbidity was observed in 5%. Trauma, ache, and difficulties making friends were more common among anxious adolescents as compared with psychiatrically referred adolescents without anxiety. Conclusions:The finding that only 21% of adolescents diagnosed with anxiety disorders were referred for anxiety further supports the routine use of standardized and structured instruments-irrespective of referral cause-to improve both precision and detection rates in the clinical setting. Comprehensive assessments are of utmost importance to fully address the complexity of the symptoms in this patient group.

Probable risk factors in children and adolescents with neurodevelopmental and non neurodevelopmental psychiatric disorders in a large Turkish clinical sample

“…It was shown that internalizing disorders, such as depression, anxiety, and somatic symptoms, were seen more commonly in girls than boys in many studies, similar to our study. [14] Olofsdotter et al [10] reported that girls had three times more anxiety disorders than boys. In another study, disruptive behavior disorders were found to be three times more common in boys than in girls.…”

“…[8] Apart from NDD, the most common psychiatric diagnoses in children and adolescents are disruptive behavior disorders, such as oppositional defiant disorder and conduct disorder and internalizing disorders, such as anxiety disorder and depression. [9][10][11] Previous studies have investigated the risk factors of non-neurodevelopmental psychiatric disorders (NNDD), which represent internalizing and/or externalizing disorders. Studies have shown that low socioeconomic level, maternal anxiety disorder, and female gender are risk factors for internalizing disorders.…”

“…[12][13][14] Perinatal complications, maternal depression, and male gender are risk factors for externalizing disorders. [10,15] It is acknowledged that the effects of mental problems that start in childhood are not limited to childhood and adolescence; they also extend into adulthood. [2] Gaining information about the distribution, prevalence, and risk factors of mental problems in children and adolescents have major importance for taking preventive measures and determining treatment areas.…”

Psychometric validation of two versions of the adolescent Depression Self-Rating Scale (DSRS-A and DSRS-A Screener)

“…Symptoms of MDD are one of the most common reasons for help-seeking among adolescents in child and adolescent psychiatric services [1]. In the community-based adolescent population, the lifetime-and 12-month prevalence of major depression disorder (MDD) is 11% and 7.5% respectively [2].…”