Patterns and predictors of comorbidity of DSM-IV anxiety disorders in a clinical sample of children and adolescents

doi:10.1016/j.janxdis.2013.01.010

Journal of Anxiety Disorders

Volume 27, Issue 3, April 2013, Pages 306-311

https://doi.org/10.1016/j.janxdis.2013.01.010 Get rights and content

Abstract

This study examined the comorbidity of anxiety disorders and its predictors in a large, clinically referred sample of children and adolescents. Participants were 608 youth aged 4–18 years presenting at a large anxiety clinic for assessment and treatment of anxiety or mood related problems. The diagnoses were determined using the Anxiety Disorder Interview Schedule, Child/Parent versions. Sixty three percent of the participants had an additional diagnosis of an anxiety or depressive disorder. Comorbidity patterns differed based on the principal diagnostic category. Older children and females with anxiety were more likely to have a comorbid anxiety disorder. The presence of a medical condition increased the odds of having a comorbid anxiety disorder as well. This is the largest clinical sample of children and adolescents in which comorbidity of emotional disorders has been examined. Understanding the common patterns of comorbidity has important implications for future classification and treatment planning of childhood anxiety disorders.

Highlights

► We examined comorbidity of anxiety disorders in children and adolescents. ► 63% of the sample has a comorbid anxiety or mood disorder. ► Age and sex predicted the presence of comorbidity.

Section snippets

Participants

Participants were 608 children and adolescents presenting for assessment and treatment for anxiety and related concerns at a large university-based outpatient clinic. The participants were consecutive referrals from the community, for specialized anxiety treatment. The mean age of participants was 12.03 (SD = 3.25), their age ranging from 4 to 18 years. 278 (45.7%) of the participants were males, and 330 (54.3%) were females. Eighty per cent of the participants were Caucasian. Income level was

Results

Table 1 presents the prevalence of all anxiety and depressive disorder diagnoses for patients with current DSM-IV principal diagnoses of generalized anxiety disorder (GAD), separation anxiety disorder (SAD), specific phobia (SPEC), social phobia (SOC), panic disorder with and without agoraphobia (PD/PDA), agoraphobia without history of panic disorder (AG), obsessive-compulsive disorder (OCD), anxiety disorder not otherwise specified (Anx NOS), post-traumatic stress disorder (PTSD), dysthymia

Discussion

The purpose of this study was to examine the comorbidity rates of anxiety disorders in the largest clinically referred sample of children and adolescents conducted to date, and to determine whether the presence of a comorbid disorder was associated with sex, age, medical condition, and maternal anxiety. The results of the study showed that 63% of the sample had a comorbid anxiety or mood disorder, which is similar to previous studies’ findings of comorbidity rates in children (e.g., Kendall et

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Patterns and predictors of comorbidity of DSM-IV anxiety disorders in a clinical sample of children and adolescents

Abstract

Highlights

Section snippets

Participants

Results

Discussion

Behaviour Research and Therapy

Journal of Anxiety Disorders

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of Anxiety Disorders

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of Anxiety Disorders

Behaviour Research and Therapy

Journal of the American Academy of Child and Adolescent Psychiatry

Biological Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Behaviour Research and Therapy

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of Anxiety Disorders

Diagnostic and statistical manual of mental disorders

Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales (DASS) in clinical groups and a community sample

Psychological Assessment

Anxiety and its disorders: the nature and treatment of anxiety and panic

Suicidal ideation and suicide attempts: comorbidity with depression, anxiety disorders and substance abuse disorder

European Archives of Psychiatry and Clinical Neuroscience

Treatment outcomes for primary care patients with major depression and lifetime anxiety disorders

American Journal of Psychiatry

Dimensional versus categorical classification of mental disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and beyond: comment on the special section

Journal of Abnormal Psychology

Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample

Journal of Abnormal Psychology

Age at onset of selected mental disorders in five community populations

Archives of General Psychiatry

Comorbidity in child psychopathology: concepts, issues and research strategies

Journal of Child Psychology and Psychiatry

Child anxiety disorders in public systems of care: comorbidity and service utilization

Journal of Behavioral Health Services and Research

Temperament, personality, and the mood and anxiety disorders.

Journal of Abnormal Psychology

Temperament as a unifying basis for personality and psychopathology

Journal of Abnormal Psychology