College of Medicine, Swansea University, Institute of Life Sciences 2, Swansea SA2 8PP, United Kingdom; Farr Institute of Health Informatics Research, College of Medicine, Swansea University, Swansea SA2 8PP, United Kingdom.
College of Medicine, Swansea University, Institute of Life Sciences 2, Swansea SA2 8PP, United Kingdom; Farr Institute of Health Informatics Research, College of Medicine, Swansea University, Swansea SA2 8PP, United Kingdom.
J Affect Disord. 2015 Sep 1;183:134-41. doi: 10.1016/j.jad.2015.05.002. Epub 2015 May 12.
Little is known regarding the recognition of anxiety in children and young people (CYP) in primary care. This study examined trends in the presentation, recognition and recording of anxiety and of anxiolytic and hypnotic prescriptions for CYP in primary care.
A population-based retrospective electronic cohort of individuals aged 6-18 years between 2003 and 2011 within the Secure Anonymised Information Linkage (SAIL) Databank primary care database was created. Incidence rates were calculated using person years at risk (PYAR) as a denominator accounting for deprivation, age and gender.
We identified a cohort of 311,343 registered individuals providing a total of 1,546,489 person years of follow up. The incidence of anxiety symptoms more than tripled over the study period (Incidence Rate Ratio (IRR)=3.55, 95% CI 2.65-4.77) whilst that of diagnosis has remained stable. Anxiolytic/hypnotic prescriptions for the cohort as a whole did not change significantly over time; however there was a significant increase in anxiolytic prescriptions for the 15-18 year age group (IRR 1.62, 95% CI 1.30-2.02).
There was a lack of reliable information regarding other interventions available or received at a primary, secondary or tertiary level such as psychological treatments.
There appears to be a preference over time for the recording of general symptoms over diagnosis for anxiety in CYP. The increase in anxiolytic prescriptions for 15-18 year olds is discrepant with current prescribing guidelines. Specific guidance is required for the assessment and management of CYP presenting with anxiety to primary care, particularly older adolescents.
对于初级保健中儿童和青少年（CYP）焦虑的识别知之甚少。本研究检查了 CYP 在初级保健中焦虑的表现、识别和记录以及抗焦虑和催眠处方的趋势。
创建了一个基于人群的回顾性电子队列，该队列由 2003 年至 2011 年期间 SAIL 数据库中的 6-18 岁个体组成。使用风险人年（PYAR）作为分母计算发病率，该分母考虑了贫困程度、年龄和性别。
我们确定了一个由 311,343 名登记个体组成的队列，提供了总共 1,546,489 人年的随访。在研究期间，焦虑症状的发病率增加了两倍多（发病率比（IRR）=3.55，95%CI 2.65-4.77），而诊断率保持稳定。整个队列的抗焦虑/催眠处方随时间没有明显变化；然而，15-18 岁年龄组的抗焦虑处方显著增加（IRR 1.62，95%CI 1.30-2.02）。
缺乏有关初级、二级或三级治疗中可用或接受的其他干预措施的可靠信息。
随着时间的推移，对于 CYP 的焦虑，记录一般症状而不是诊断似乎更受欢迎。15-18 岁人群抗焦虑处方的增加与当前的处方指南不一致。对于在初级保健中出现焦虑的 CYP，需要特定的评估和管理指南，特别是对于年龄较大的青少年。
