Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, South India,
Indian J Pediatr. 2013 Nov;80 Suppl 2:S149-54. doi: 10.1007/s12098-013-1234-1. Epub 2013 Sep 24.
Anxiety Disorders (AD) in children and adolescents present with unique clinical features and exhibit phenotypic diversity. The symptom presentation varies with regard to age of onset, developmental factors and gender. This study documents the clinical presentation of AD among adolescents in India, and explores the symptom clusters among the different age groups as well as gender.
Five hundred adolescents aged between 11 and 19 y from Pattanakad ICDS block, of Allapuzha district in Kerala were recruited and assessed using the self-rated Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire to identify symptom clusters of anxiety and this was followed by confirmation of the diagnosis using DSM-IV TR within a week. Anxiety symptom clusters and severity (obtained from continuous SCARED scores) were compared between early, middle and late adolescence subgroups as well as between sexes.
The most predominant anxiety symptoms across the subtypes were the anxious mood, which was noted in 12.60% followed by cognitive symptoms in 9.94% of the cases and finally physical symptoms in 9.22% of the study sample. The symptom clusters varied among the subtypes with anxious mood being commoner in Panic Disorder (PD), cognitive symptoms in Generalised Anxiety Disorder (GAD) and physical symptoms were prominent among Separation Anxiety (SeAD) and Social Anxiety Disorders (SoAD). The severity of anxiety disorder in general and its various subtypes were mostly of mild intensity although significant proportion had a severe form of the disease(s). The severity of the AD among girls was statistically significantly higher than boys (P = 0.02). There was no significant difference on symptom frequency or anxiety severity with regard to age.
Understanding of age appropriate presentation of anxiety symptoms may help in streamlining the treatment guidelines and yield a better estimate of the disease process.
儿童和青少年的焦虑障碍 (AD) 具有独特的临床特征，并表现出表型多样性。症状表现因发病年龄、发育因素和性别而异。本研究记录了印度青少年 AD 的临床表现，并探讨了不同年龄组和性别的症状群。
在喀拉拉邦阿拉普扎县帕塔纳卡德 ICDS 街区招募了 500 名年龄在 11 至 19 岁之间的青少年，使用自我评估的儿童焦虑相关情绪障碍筛查量表 (SCARED) 评估他们的焦虑症状群，然后在一周内使用 DSM-IV TR 确认诊断。比较了早、中、晚期青春期亚组以及性别之间的焦虑症状群和严重程度（从连续 SCARED 评分中获得）。
在所有亚型中，最常见的焦虑症状是焦虑情绪，在 12.60%的病例中出现，其次是认知症状，占 9.94%，最后是躯体症状，占 9.22%。症状群在亚型之间存在差异，惊恐障碍 (PD) 中更常见焦虑情绪，广泛性焦虑障碍 (GAD) 中更常见认知症状，而分离焦虑症 (SeAD) 和社交焦虑障碍 (SoAD) 中更常见躯体症状。一般焦虑障碍及其各种亚型的严重程度大多为轻度，但相当一部分患者患有严重的疾病。女孩的焦虑障碍严重程度明显高于男孩 (P = 0.02)。症状频率或焦虑严重程度与年龄无关。
了解适合年龄的焦虑症状表现可能有助于简化治疗指南，并对疾病过程有更好的估计。
