Report Cites Need for More Research On Anxiety Disorders in Children
A recent report released by the Anxiety Disorders Association of America shows that despite advances in diagnoses, more research is needed on the efficacy of current and promising treatments in children.
Psychiatrists now know more about anxiety disorders in children and adolescents than they did a decade ago, but research on prevention and treatment in this population lags behind that on adults, according to a consensus report released last month by the Anxiety Disorders Association of America (ADAA) and the National Institute of Mental Health (NIMH).
"We know that anxiety disorders exist in about 13 percent of children and adolescents and causes significant impairment in their relationships, daily life, and school performance. If left untreated, these disorders, which include panic, phobias, obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD), can become chronic in adulthood," said John March, M.D., one of the authors of the report. He is also director of programs for pediatric anxiety disorders and psychopharmacology in the department of psychiatry at Duke University Medical Center in Durham, N.C.
The report points out that anxiety disorders are greatly underdiagnosed in children and adolescents despite improved diagnostic instruments.
"We now have valid and reliable ways of identifying children with anxiety disorders," March said in an interview. "For example, we can distinguish between separation anxiety disorder and social phobia in a 7- or 8-year-old. We also have effective treatments for some anxiety disorders. Cognitive behavioral therapy [CBT] works well in children with OCD, social phobias, and specific phobias. There is very good evidence that selective serotonin reuptake inhibitors [SSRIs] are effective in the short-term treatment of OCD and social anxiety disorders in youth."
Nonetheless, the authors of the report called for more research on the diagnosis, prevention, and treatment of anxiety disorders in youth.
"We still lack randomized controlled trials of SSRIs in conditions other than OCD," said March. "We also need to know more about the long-term risks and benefits of using medication and CBT alone or a combination of the two in children and adolescents."
Another area that needs further attention is translating best practices developed in academic research settings into community practice, said March.
The consensus report, titled "Conference on Treating Anxiety Disorders in Youth: Current Problems and Future Solutions," is posted on the ADAA Web site at <www.adaa.org/dyna/view.cfm?ID=40>.