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This study analyses the possible risk factors for the on-set of behavioural disorders and psychiatric disturbances in a group of 30 early-treated congenital hypothyroidism (CH) subjects (12 children and 18 adolescents) compared with a control group of 116 age-matched normal subjects (58 children and 58 adolescents). The study also allowed us to evaluate the possible age at onset of behavioural disorders. Both the sample's and the controls' behaviours were assessed using a specific diagnostic instrument: Achenbach's and Edelbrock's Child Behaviour Checklist (CBCL). A clinical structured interview, the Diagnostic Interview for Children and Adolescents--Revised (DICA-R) was also administered to 18 adolescents with early-treated CH, in order to determine the presence of psychopathological disturbances. In accordance with literature data, the children and adolescents with early-treated CH showed more behavioural problems than age-matched, normal controls. In the children, a statistically significant difference versus the controls emerged only in their higher delinquent behaviour score, while the adolescents gave, on the CBCL, significantly higher scores compared with controls in the withdrawal, anxiety/depression, thought problems, attention problems and aggressive behaviour scales. In the DICA-R, 44% of adolescents with early-treated CH showed symptoms of anxiety disorder, in particular, separation anxiety disorder with phobic components; 16% showed mood disorder and depression and 11% showed behavioural disorders with attention deficit.
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PMID:Behavioural disorders in adolescents with early-treated congenital hypothyroidism. 1470 98

We conducted a longitudinal study of young children with clinical, subclinical, or nonclinical levels of separation anxiety to evaluate the diagnostic stability and concomitant parent and family variables of separation anxiety disorder (SAD). Youngsters were assessed at age 3 years (n = 60) and 3.5 years later (n = 44). Data were collected from children, parents, teachers, and clinicians. Results revealed that most diagnoses of SAD were not stable during this developmental period, as many children drifted toward subclinical or nonclinical status. In addition, children with clinical SAD, compared to those with subclinical SAD or no symptoms of SAD, had a disproportionately higher number of comorbid diagnoses and experienced significantly greater somatic concerns, anxiety, and general internalizing behavior. In addition, their parents experienced greater depression, obsessive-compulsive behavior, phobic anxiety, and general distress. The results preliminarily support prior findings that most children experience a dissipation of SAD symptoms in young childhood but that some children continue to experience stable, significant distress. The results are consistent with prior research on older children that SAD remits for many but not all youth and suggest that parent and family variables may have much to do with cases of poor remission in this population.
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PMID:Separation anxiety disorder in young children: a longitudinal and family analysis. 1471 Apr 68

Studies have reported that childhood asthma is associated with internalizing disorders, but most of these studies have used global measures of depressive and anxiety symptoms. The Diagnostic Interview Schedule for Children was administered to a group of 1891 youth ages 4 to 17 and their caregivers in Puerto Rico to determine DSM-IV symptoms and diagnoses. Asthma diagnosis and having had an asthma attack were assessed by parental report. A diagnosis of asthma was associated with having any depressive disorder and one symptom of separation anxiety. An asthma attack was associated with any depressive disorder and any anxiety disorder and, more specifically, with separation anxiety disorder, major depressive disorder, and symptoms of depression, separation anxiety, and generalized anxiety. Possible explanations for the findings are discussed.
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PMID:Comorbidity of asthma and anxiety and depression in Puerto Rican children. 1501 21

The non-OCD (obsessive-compulsive disorder) anxiety disorders in the pediatric population- separation anxiety disorder, generalized anxiety disorder, and social phobia and others- are arguably the most common psychiatric disorders in this age group. Anxiety disorders, in addition to being common, also significantly impair the affected child at home, school, and with peers. A small developing evidence base suggests the selective serotonin reuptake inhibitors (SSRIs) are the pharmacological treatment of choice for pediatric non-OCD anxiety disorders. In clinical trials, SSRIs are often very effective in reducing symptoms and improving functioning and generally well tolerated. The U.S. Food and Drug Administration's (FDA) review of the safety of antidepressants in the pediatric population suggest a small, but significant, increased relative risk for suicidality adverse events on antidepressant versus placebo. Despite the apparent increased risk, the larger magnitude of benefit of the SSRIs for pediatric non-OCD anxiety disorders compared to depression suggests the benefit/risk ratio for anxiety disorders is more favorable than that for depression. This paper will review available studies on the treatment of non-OCD childhood anxiety disorders with antidepressants, including the SSRIs, and discuss pertinent safety issues.
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PMID:Selective serotonin reuptake inhibitor use in the treatment of the pediatric non-obsessive-compulsive disorder anxiety disorders. 1655 37

Despite sleep problems being part of the diagnostic criteria for mood disorders, research on sleep difficulties related to early-onset bipolar spectrum disorders (EBSDs) is sparse. The authors examined the parent and child agreement, frequency, and severity of EBSD-related manic, depressive, and comorbid sleep problems. A sample of one hundred thirty-three 8- to 11-year-olds with EBSDs was assessed with parental and self-report measures of EBSD-related sleep problems. Dimensional and categorical measures indicated low agreement and high discrepancy between parent and child reports of EBSD sleep problems. Subsequent combination of parent-child data revealed the majority (96.2%) of children had moderate-to-severe sleep problems related to manic, depressive, or comorbid symptoms, either currently or during their worst mood period. More depression-related sleep problems than mania-related sleep problems were reported, especially initial insomnia. Over half the sample had sleep problems associated with current comorbidity, particularly separation anxiety disorder. These findings, their implications, and study limitations are discussed.
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PMID:Parent and child reports of sleep problems associated with early-onset bipolar spectrum disorders. 1737 Nov 16

The objective of this study was to evaluate the longitudinal course of psychiatric disorders in children of parents with and without panic disorder and major depression as they transition through the period of risk from early to late childhood. Over a 5-year follow-up, we compared the course of psychiatric disorders in offspring of parents with panic disorder, major depression, or neither disorder. Subjects consisted of 233 offspring (from 151 families) with baseline and follow-up assessments. Subjects were comprehensively assessed with structured diagnostic interviews. Anxiety disorders at baseline were used to predict anxiety disorders and major depression at follow-up using stepwise logistic regression. Separation anxiety disorder significantly increased the risk for the subsequent development of specific phobia, agoraphobia, panic disorder, and major depression, even after parental panic and depression were covaried. Agoraphobia significantly increased the risk for subsequent generalized anxiety disorder. These findings suggest that separation anxiety disorder is a major antecedent disorder for the development of panic disorder and a wide range of other psychopathological outcomes, and that it increases the risk for subsequent psychopathology even among children already at high familial risk for anxiety or mood disorder.
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PMID:Developmental trajectories of anxiety disorders in offspring at high risk for panic disorder and major depression. 1776 53

Anxiety disorders are highly prevalent and have negative consequences on individual and societal level. This study examined the usefulness of screening for anxiety disorders in primary school children. More specifically, the value of the screening method to discriminate between and to predict anxiety disorders was studied. Children and their parents were selected if the children had self-reported scores on the screening questionnaire Screen for Child Anxiety Related Emotional Disorders-71 (SCARED-71) within the top-15% (High-anxious) or from two points below to two points above the median (Median-anxious). Of the selected children, 183 high-anxious children and their parents, and 80 median-anxious children and their parents took part in a diagnostic interview, the Anxiety Disorder Interview Schedule (ADIS). Of the high-anxious children, 60% had an anxiety disorder versus 23% of the median-anxious children, whereas groups did not differ on rates of dysthymia/depression and attention deficit hyperactivity disorder. The diagnoses separation anxiety disorder, social phobia and specific phobia were specifically predicted by the corresponding subscales of the screening questionnaire, while the diagnosis generalised anxiety disorder was not predicted by any of the subscales. The screening method has proven its utility for discriminating between children with and without anxiety disorders when applying the top-15% cut-off. Moreover, separation anxiety disorder, social phobia, and specific phobia, all known to be prevalent and debilitating childhood anxiety disorders, can be predicted by the corresponding subscale of the screening instrument.
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PMID:Screening for anxiety disorders in children. 1941 15

The Revised Child Anxiety and Depression Scale-Parent Version (RCADS-P) is a 47-item parent-report questionnaire of youth anxiety and depression, with scales corresponding to the DSM-IV categories of Separation Anxiety Disorder, Social Phobia, Generalized Anxiety Disorder (GAD), Panic Disorder, Obsessive-Compulsive Disorder, and Major Depressive Disorder (MDD). The RCADS-P is currently the only parent-report questionnaire that concurrently assesses youth symptomatology of individual anxiety disorders as well as depression in accordance with DSM-IV nosology. The present study examined the psychometric properties of the RCADS-P in a large (N = 490), clinic-referred sample of youths. The RCADS-P demonstrated favorable psychometric properties, including high internal consistency, convergent/divergent validity, as well as strong discriminant validity-evidencing an ability to discriminate between anxiety and depressive disorders, as well as between the targeted anxiety disorders. Support for the DSM-related six-factor RCADS-P structure was also evidenced. This structure demonstrated superior fit to a recently suggested alternative to the DSM-IV classification of anxiety and affective disorders-namely, the MDD/GAD "distress" factor.
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PMID:A psychometric analysis of the revised child anxiety and depression scale--parent version in a clinical sample. 1983 May 45

Research indicates that depression and anxiety are highly comorbid in youth. Little is known, however, about the clinical and family characteristics of youth with principal anxiety disorders and comorbid depressive diagnoses. The present study examined the demographic, clinical, and family characteristics of 200 anxiety-disordered children and adolescents (aged 7-17) with and without comorbid depressive disorders (major depressive disorder or dysthymic disorder), seeking treatment at a university-based anxiety clinic. All participants met DSM-IV diagnostic criteria for a principal anxiety disorder (generalized anxiety disorder, separation anxiety disorder, or social phobia). Of these, twelve percent (n = 24) also met criteria for a comorbid depressive disorder. Results suggest that anxiety-disordered youth with comorbid depressive disorders (AD-DD) were older at intake, had more severe anxious and depressive symptomatology, and were more impaired than anxiety-disordered youth without comorbid depressive disorders (AD-NDD). AD-DD youth also reported significantly more family dysfunction than AD-NDD youth. Future research should examine how this diagnostic and family profile may impact treatment for AD-DD youth.
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PMID:Comorbid depressive disorders in anxiety-disordered youth: demographic, clinical, and family characteristics. 2006 89

Although separation anxiety disorder appears to be common among children exposed to disasters, there are no data focusing on the impact of trauma on adult separation anxiety disorder. The present exploratory study examined the relationship of adult separation anxiety disorder with other psychological reactions (posttraumatic stress disorder [PTSD], complicated grief, depression) and dimensions of trauma among 126 war-affected Bosnian refugees resettled in Australia. Adult separation anxiety disorder was associated with PTSD, but not with complicated grief or depression. Although adult separation anxiety disorder was weakly linked with traumatic losses, this association was nonspecific. Further research is needed to clarify the pathogenic pathways leading to the comorbid PTSD-adult separation anxiety disorder pattern and its clinical implications.
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PMID:Adult separation anxiety disorder among war-affected Bosnian refugees: comorbidity with PTSD and associations with dimensions of trauma. 2013 80


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