Pediatric anxiety disorders

Burden of Anxiety Among School-Going Adolescents in Urban Bhopal: A Cross-Sectional Study

INTRODUCTION

Adolescence is a critical developmental stage marked by physical, emotional, and psychological changes, making individuals vulnerable to mental health challenges, particularly anxiety. Anxiety during adolescence can significantly impact daily functioning, school performance, and relationships. In India, the prevalence of anxiety among adolescents is rising, exacerbated by academic pressures, social expectations, and limited mental health services. This study aimed to assess the prevalence of anxiety among school-going adolescents in Bhopal and to identify the associated factors.

MATERIALS AND METHODS

A community-based cross-sectional study was conducted from May 2019 to May 2021 among 1,500 adolescents aged 14-19 years who attended secondary and higher secondary schools in urban Bhopal, Madhya Pradesh, India. Multistage cluster sampling was used, and data were collected using the Depression, Anxiety, and Stress Scale (DASS-42), with a focus on the anxiety subscale. Statistical analyses, including descriptive statistics, chi-square tests, and logistic regression, were conducted to determine associations between anxiety levels and various demographic and socioeconomic factors using R software version 4.1.0 (R Foundation for Statistical Computing, Vienna, Austria, https://www.R-project.org/).

RESULTS

The study found that 749 (53%) of adolescents experienced some level of anxiety. Among them, 150 (10.6%) had mild anxiety, 304 (21.5%) had moderate anxiety, 195 (13.8%) had severe anxiety, and 100 (7.1%) had extremely severe anxiety. No significant associations were found between anxiety and factors such as age, gender, or screen time. However, a statistically significant association was observed with the father's occupation, where adolescents whose fathers were engaged in government or private services exhibited higher levels of anxiety (p = 0.007). Regression analysis revealed that gender, frequency of outdoor activities, and father's education level were not significantly associated with anxiety. However, paternal occupation showed significant effects, with participants whose fathers were in jobs other than business having lower odds of anxiety.

CONCLUSIONS

Anxiety is highly prevalent among school-going adolescents in Bhopal, with the father's occupation being a significant determinant. Early identification and interventions involving both parents and teachers are crucial to addressing anxiety in adolescents. Schools should promote emotional well-being by establishing support systems and fostering open discussions about mental health.

Sociodemographic Characteristics, Anxiety, Depression Levels, and Emotional and Behavioral Problems in Hospitalized COVID-19-Positive Children and Adolescents

ABSTRACT

This study aimed to investigate anxiety, depression levels, and emotional/behavioral problems of children and adolescents while being treated in the COVID-19 unit. The present study included 50 children who were COVID-19 positive, aged 7-18 years, and 50 age- and gender-matched healthy controls. The sociodemographic data form and Revised Child Anxiety and Depression Scale-Child Version (RCADS-C) were applied to all children, and all families were asked sociodemographic data form, Revised Child Anxiety and Depression Scale-Parent Version (RCADS-P), and Strengths and Difficulties Questionnaire (SDQ). There was no significant difference between the patient and control groups in terms of anxiety, depression levels, and emotional/behavioral problems. The conduct problems subscale score of SDQ in the patient group was found to be significantly lower than the control group (p = 0.037). Separation anxiety subscale scores of RCADS (p = 0.034) and the rate of accompanying companions (p = 0.01) in the patient group were found to be significantly higher in preadolescents than in adolescents. In conclusion, this study demonstrated that children and adolescents who were COVID-19 positive were not different from healthy children in terms of anxiety and depression levels, and emotional and behavioral problems in the acute period during inpatient treatment.

Oxidative Imbalance in Pediatric Anxiety Disorders: A Preliminary Comparative Study

Background It is important to determine the possible related factors of anxiety disorder, one of the common psychiatric disorders of childhood. Our aims in this study were to compare oxidative stress markers between anxiety disorders in pediatric patients and healthy controls and to examine the relationship between anxiety symptom severity and oxidative stress indicators. Methods The study included 25 patients and 25 healthy controls. We measured the total oxidant capacity (TOS) and total antioxidant capacity (TAS) from the collected serum samples and calculated the oxidative stress index (OSI). We evaluated the clinical severity of the anxiety symptoms by the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV). Results The groups did not exhibit a noteworthy distinction in terms of TOS (p=0.128) and TAS (p=0.329). However, OSI was markedly elevated in the group with anxiety disorder (p=0.044). In the correlation analysis between anxiety symptom severity and oxidative stress indicators in the group with anxiety disorder, we found a positive correlation between TOS and RCADS total anxiety score (p=0.08). Conclusion These results may point to an oxidative dysfunction in anxiety disorders and the potential role of oxidative stress in their aetiology. Prospective, large-scale, randomized studies are needed to investigate if oxidative stress indicators can be used in the diagnosis of anxiety disorders and as new treatment targets.

Generalized anxiety disorder in Berlin school children after the third COVID-19 wave in Germany: a cohort study between June and September 2021

BACKGROUND

During the COVID-19 pandemic, children and adolescents worldwide have disproportionally been affected in their psychological health and wellbeing. We conducted a cohort study among German school children, aiming at assessing levels of general anxiety disorder (GAD) and identifying associated factors in the second pandemic year.

METHODS

A cohort of 660 students from 24 Berlin schools was recruited to fill in questionnaires including the GAD-7 tool on anxiety symptoms at three time points between June and September 2021. To adjust for non-random attrition, we applied inverse probability weighting. We describe reported GAD levels stratified by time point, sex, and school type and report odds ratios from univariate logistic regression.

RESULTS

In total, 551 participants (83%) filled in at least one questionnaire at any time point. At the first time point in June 2021, 25% of the children and adolescents reported anxiety symptoms with a GAD-7 score ≥ 5, decreasing to 16% in August 2021 directly after the summer holidays and rising again to 26% in September 2021. The majority of reported anxiety levels belonged to the least severe category. Being female, attending secondary school, coming from a household with lower education or with lower income level, and being vaccinated against COVID-19 were significantly linked with reporting anxiety symptoms. Preceding COVID-19 infection and anxiety were negatively associated.

CONCLUSION

Overall, anxiety in school children was lower in mid-2021 than in the first pandemic year, but still double compared to pre-pandemic data. Reporting of anxiety symptoms during the second pandemic year was especially high in females and in secondary school students. Policy makers should pay additional attention to the mental health status of school children, even as the pandemic situation might stabilize.

Prevalence, comorbidities and mediators of childhood anxiety disorders in urban Turkey: a national representative epidemiological study

PURPOSE

The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children.

METHODS

This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years 2014-2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7 years.

RESULTS

The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis.

CONCLUSION

Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment.

Assessment of anxiety disorders in students starting work with coronavirus patients during a pandemic in Podlaskie Province, Poland

Background

Anxiety disorders are considered the sixth most important factor resulting in non-fatal health loss in the world. Moreover, they are among the first ten causes of years lived with disability (YLD) across the globe. Important clinical disorders include e.g., panic disorder, social anxiety disorder, generalized anxiety disorder and specific phobia.

Objectives

The study aimed to analyse the occurrence of level anxiety in students who start work at the time of the COVID-19 pandemic, with relation to the socio-demographic factors and health status, vaccination, conovirus infection, assistance of a psychologist or psychiatrist in the past, and using tranquilizers.

Methods

The study involved 255 students from Poland starting work with coronavirus patients during the pandemic. It was conducted using our own questionnaire, the Liebowitz Social Anxiety Scale (LSAS) and the State-Trait Anxiety Inventory (STAI).

Results

Fifty-one percent of subjects demonstrated symptoms of mild to severe social phobia. Level of trait anxiety among students correlated significantly with age and gender (females). The level of social anxiety in the evaluated students was significantly correlated with marital status, the self-assessment of the experienced fear, self-perceived health status, having had a coronavirus infection, fear of deterioration of one's health after starting work with coronavirus patients, and fear of contracting the disease while working with coronavirus patients, and using tranquilizers. Level of state anxiety significantly correlated with state anxiety, the self-assessment of professional preparedness for work with coronavirus patients, self-perceived health status, vaccination against coronavirus, and the assistance of a psychiatrist in the past.

Conclusions

The proportion of students showing social anxiety is alarming. Anxiety among the evaluated students during the COVID-19 pandemic was correlated with many factors.

Anxiety symptoms in regular school students in Mumbai City, India

Aim

Anxiety disorders usually remain undiagnosed in school students owing to the internalized nature of their symptoms. The present study was conducted with the primary objective of evaluating the prevalence of anxiety symptoms in school students in Mumbai. A secondary objective was to assess the impact of variables (age, gender, presence of sibling, and type of school curriculum or school) on anxiety symptoms.

Materials and Methods

Study cases (8-15 year olds) were recruited by nonprobability sampling from four English-medium schools. Anxiety was measured using Spence Children's Anxiety Scale (SCAS)-child self-report questionnaire. T-scores (total and subscales) were calculated and cut-off scores of> 60 were considered as significant.

Results

Symptoms of overall anxiety were present in 10.8% (53/493) of the students. Older students (12-15 year olds) had greater odds of having overall anxiety symptoms (crude OR = 4.36, 95% CI 2.27 to 8.39, P < 0.0001). Symptoms of all anxiety disorders were present in the 493 participants, with obsessions/compulsions and fears of physical injury being the most common (in 29.6% and 27.2%, respectively). Older students and boys had greater odds of having obsessions/compulsions (crude OR = 2.32, 95% CI 1.56 to 3.44, P < 0.0001; and crude OR = 1.54, 95% CI 1.04 to 2.27, P= 0.035, respectively]. Students with sibling (s) had greater odds of having fears of physical injury (crude OR = 0.48, 95% CI 0.30 to 0.78, P= 0.003).

Conclusions

There is an urgent need to screen school students in our city for anxiety disorders.

Epidemiology of psychiatric disorders in children and adolescents; in Tehran, 2017

OBJECTIVE

This survey was conducted to investigate the prevalence of various psychiatric disorders among children and adolescents aged 6-18 years in urban areas of Tehran.

METHODS

In the study, which was done with random sampling method, 2095 children and adolescents in the range seniors aged 6-18 years, have been studied and based on Persian version of K-SADS-PL, we reviewed the psychiatric disorders related to them.

RESULTS

The overall prevalence of psychiatric disorders in children and adolescents was 28.2%. The most commonly diagnosed disorders were anxiety disorders (21.9%), followed by behavioral disorders (9.6%).

CONCLUSION

According to the results, 28.2% of the children and adolescents in Tehran province had psychiatric disorders, that is with increasing rate, compared with similar studies. Therefore, as a public health policy, the necessary tools for identifying, preventing and treating psychiatric disorders in children and adolescents should be considered in Tehran.