Office of the Clinical Director, National Institutes of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.
Depress Anxiety. 2011 Jan;28(1):40-9. doi: 10.1002/da.20727. Epub 2010 Aug 18.
Anxiety disorders are thought to be one of the most common psychiatric diagnoses in children/adolescents. Chronic medical illness is a significant risk factor for the development of an anxiety disorder, and the prevalence rate of anxiety disorders among youths with chronic medical illnesses is higher compared to their healthy counterparts. Anxiety disorders may develop secondary to predisposing biological mechanisms related to a child's specific medical illness, as a response to being ill or in the hospital, a threatening environment, as a result of other genetic and psychological factors, or as a combination of all these factors. Additionally, exposure to physical pain early in one's life and/or frequent painful medical procedures are correlated with fear and anxiety during subsequent procedures and treatments, and may lead to medical nonadherence and other comorbidities. Anxiety disorders can have serious consequences in children/adolescents with chronic and/or life-limiting medical illnesses. Therefore, proper identification and treatment of anxiety disorders is necessary and may improve not only psychiatric symptoms but also physical symptoms. Behavioral and cognitive methods as well as psychotropic medications are used to treat anxiety disorders in pediatric patients. We will review current treatments for anxiety in children/adolescents with medical illnesses and propose future research directions.
焦虑障碍被认为是儿童/青少年中最常见的精神科诊断之一。慢性疾病是焦虑障碍发展的一个重要危险因素，患有慢性疾病的青少年中焦虑障碍的患病率高于健康同龄人。焦虑障碍可能是由于与儿童特定疾病相关的易患生物学机制、生病或住院、威胁性环境、其他遗传和心理因素，或这些因素的组合而继发产生的。此外，生命早期的身体疼痛暴露和/或频繁的疼痛医疗程序与随后的程序和治疗期间的恐惧和焦虑相关，并可能导致医疗不依从和其他合并症。焦虑障碍在患有慢性和/或生命有限的医疗疾病的儿童/青少年中可能会产生严重后果。因此，适当识别和治疗焦虑障碍是必要的，这不仅可以改善精神症状，还可以改善身体症状。行为和认知方法以及精神药物被用于治疗儿科患者的焦虑障碍。我们将回顾目前针对患有医疗疾病的儿童/青少年的焦虑症的治疗方法，并提出未来的研究方向。
