Department of Psychiatry/Institute for Juvenile Research, University of Illinois Medical Center at Chicago, 1747 West Roosevelt Road, Mail Room 155, Chicago, IL 60608, USA.
Curr Psychiatry Rep. 2011 Apr;13(2):99-110. doi: 10.1007/s11920-010-0173-z.
This article reviews the current screening and assessment tools for anxiety disorders in children and adolescents, as well as evidence-based treatment interventions for these disorders. The following anxiety disorders are discussed: separation anxiety disorder, generalized anxiety disorder, specific phobia, panic disorder, social anxiety disorder (social phobia), and selective mutism. There are several well-studied screening and assessment tools to identify childhood anxiety disorders early and differentiate the various anxiety disorders. Evaluations of baseline somatic symptoms, severity, and impairment ratings of the anxiety disorders, and collecting ratings from several sources is clinically helpful in assessment and treatment follow-up. Cognitive-behavioral therapy (CBT) has been extensively studied and has shown good efficacy in treatment of childhood anxiety disorders. A combination of CBT and medication may be required for moderate to severely impairing anxiety disorders and may improve functioning better than either intervention alone. Selective serotonin reuptake inhibitors are currently the only medications that have consistently shown efficacy in treatment of anxiety disorders in children and adolescents. Despite proven efficacy, the availability of CBT in the community is limited. Current research is focusing on early identification of anxiety disorders in community settings, increasing the availability of evidence-based interventions, and modification of interventions for specific populations.
本文综述了儿童和青少年焦虑障碍的现行筛查和评估工具，以及这些障碍的循证治疗干预措施。讨论了以下焦虑障碍：分离性焦虑障碍、广泛性焦虑障碍、特定恐惧症、惊恐障碍、社交焦虑障碍（社交恐惧症）和选择性缄默症。有几种经过充分研究的筛查和评估工具可用于早期识别儿童期焦虑障碍，并区分各种焦虑障碍。评估基线躯体症状、焦虑障碍的严重程度和损害程度，并从多个来源收集评定结果，这在评估和治疗随访中具有临床意义。认知行为疗法（CBT）已得到广泛研究，在治疗儿童期焦虑障碍方面显示出良好的疗效。对于中度至重度损害的焦虑障碍，可能需要 CBT 与药物治疗相结合，其改善功能的效果可能优于单独干预。选择性 5-羟色胺再摄取抑制剂是目前唯一在治疗儿童和青少年焦虑障碍方面显示出一致疗效的药物。尽管疗效已得到证实，但社区中 CBT 的可获得性有限。目前的研究重点是在社区环境中早期识别焦虑障碍，增加循证干预措施的可获得性，并针对特定人群修改干预措施。
