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Child Anxiety Disorders in Public Systems of Care: Comorbidity and Service Utilization

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Abstract

Little is known about mental health service use among children with anxiety disorders, and even less is known about these children in public sectors of care. In this study, 1,715 children were randomly sampled from one of five public service systems. Psychiatric diagnoses were assessed with a structured interview, and standardized measures were used to assess mental health service utilization. Data from a subsample (n = 779) of youth with psychiatric disorders were analyzed. Analyses revealed that comorbidity among children with anxiety disorders was substantially higher than general population estimates. Approximately 26% of children with anxiety had a comorbid mood disorder, and 62% had a disruptive behavior disorder. Among children with anxiety disorders, those who had comorbid conditions were more likely to receive inpatient services than those without comorbidity. Comorbidity, caregiver strain, and service sector were associated with inpatient and nonspecialty service use in this group. Findings underscore the substantial comorbidity among children with anxiety disorders in public sectors of care and the potential need to adapt evidence-based interventions to meet the complex and multiple needs of these children.

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Acknowledgements

This research was supported by NIMH grant U01 MH55282 to Dr. Hough and NIMH MH072952 to Dr. Chavira.

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Authors and Affiliations

  1. Department of Psychiatry, University of California San Diego, 8939 Villa La Jolla Drive, Ste 200, La Jolla, CA, 92037, USA

    Denise A. Chavira PhD

  2. Child and Adolescent Services Research Center, San Diego, CA, USA

    Denise A. Chavira PhD, Ann Garland PhD, May Yeh PhD, Kristen McCabe PhD & Richard L. Hough PhD

  3. University of San Diego, San Diego, CA, USA

    Kristen McCabe PhD

  4. San Diego State University, San Diego, CA, USA

    Ann Garland PhD, May Yeh PhD & Richard L. Hough PhD

  5. University of New Mexico, Albuquerque, NM, USA

    Richard L. Hough PhD

  6. Department of Psychiatry, University of California San Diego, La Jolla, CA, USA

    Ann Garland PhD, May Yeh PhD & Richard L. Hough PhD

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  1. Denise A. Chavira PhD
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  2. Ann Garland PhD
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  3. May Yeh PhD
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  4. Kristen McCabe PhD
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  5. Richard L. Hough PhD
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Correspondence to Denise A. Chavira PhD.

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Chavira, D.A., Garland, A., Yeh, M. et al. Child Anxiety Disorders in Public Systems of Care: Comorbidity and Service Utilization. J Behav Health Serv Res 36, 492–504 (2009). https://doi.org/10.1007/s11414-008-9139-x

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  • DOI: https://doi.org/10.1007/s11414-008-9139-x

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