Bittner Antje, Egger Helen L, Erkanli Alaattin, Jane Costello E, Foley Debra L, Angold Adrian
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
J Child Psychol Psychiatry. 2007 Dec;48(12):1174-83. doi: 10.1111/j.1469-7610.2007.01812.x.
Few longitudinal studies of child and adolescent psychopathology have examined the links between specific childhood anxiety disorders and adolescent psychiatric disorder. In this paper we test the predictive specificity of separation anxiety disorder (SAD), overanxious disorder (OAD), generalized anxiety disorder (GAD), and social phobia.
Data come from the Great Smoky Mountains Study (GSMS). A representative population sample of children--ages 9, 11, and 13 years at intake--was followed to age 19. Diagnoses of both childhood (before age 13 years) and adolescent psychiatric disorders (age 13 to 19 years) were available from 906 participants.
Childhood SAD predicted adolescent SAD, whereas OAD was associated with later OAD, panic attacks, depression and conduct disorder (CD). GAD was related only to CD. Social phobia in childhood was associated with adolescent OAD, social phobia, and attention-deficit/hyperactivity disorder (ADHD).
Anxiety disorders in childhood are predictors of a range of psychiatric disorders in adolescence. It appears that children meriting a well-defined diagnosis are missed by the current rules for the diagnosis of GAD. Future studies should examine whether OAD deserves reconsideration as a nosological entity.
很少有关于儿童和青少年精神病理学的纵向研究探讨特定儿童焦虑症与青少年精神障碍之间的联系。在本文中，我们检验分离焦虑症（SAD）、过度焦虑症（OAD）、广泛性焦虑症（GAD）和社交恐惧症的预测特异性。
数据来自大烟山研究（GSMS）。对一组具有代表性的儿童样本（入组时年龄为9岁、11岁和13岁）进行追踪，直至19岁。906名参与者提供了儿童期（13岁之前）和青少年期精神障碍（13至19岁）的诊断信息。
儿童期SAD可预测青少年期SAD，而OAD与后期的OAD、惊恐发作、抑郁和品行障碍（CD）相关。GAD仅与CD有关。儿童期社交恐惧症与青少年期OAD、社交恐惧症和注意力缺陷多动障碍（ADHD）相关。
儿童期焦虑症是青少年期一系列精神障碍的预测因素。目前GAD的诊断标准似乎遗漏了一些值得明确诊断的儿童。未来的研究应探讨OAD作为一个疾病分类实体是否值得重新考虑。
