Ramsawh Holly J, Chavira Denise A
*Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD; †Department of Psychiatry, University of California San Diego, CA.
J Dev Behav Pediatr. 2016 May;37(4):269-76. doi: 10.1097/DBP.0000000000000296.
Anxiety disorders are associated with measurable deficits in quality of life (QOL) in adult samples. However, this association has largely been unexplored in pediatric samples. In this study, we examined relationships between child anxiety-including number of anxiety disorders (comorbidity), symptom severity, and subtypes of anxiety-and QOL in a pediatric primary care sample.
Anxiety comorbidity was common in the current sample (n = 73), with 3-quarters being diagnosed with more than one anxiety disorder. QOL in the current sample did not vary significantly by age, gender, or race/ethnicity. Both greater comorbidity and higher total anxiety symptom severity were inversely associated with QOL across multiple domains, although anxiety comorbidity did not reach significance in multivariate models adjusted for gender, income, and externalizing symptoms. On the anxiety severity subscales, both physical symptoms and social anxiety had independent associations with QOL.
Anxiety-related outcomes, as measured by anxiety comorbidity, symptom severity, and type of anxiety, are associated with significantly worse QOL in a pediatric sample. Providers should be aware that QOL is impacted by both severity and type of anxiety-related conditions, particularly social anxiety and somatic-related anxiety.
焦虑症与成年样本中可测量的生活质量(QOL)缺陷相关。然而,这种关联在儿科样本中很大程度上尚未得到探索。在本研究中,我们在儿科初级保健样本中研究了儿童焦虑(包括焦虑症的数量(共病)、症状严重程度和焦虑亚型)与生活质量之间的关系。
在当前样本(n = 73)中,焦虑共病很常见,四分之三的人被诊断患有不止一种焦虑症。当前样本中的生活质量在年龄、性别或种族/民族方面没有显著差异。共病程度越高和总焦虑症状严重程度越高均与多个领域的生活质量呈负相关,尽管在根据性别、收入和外化症状进行调整的多变量模型中,焦虑共病未达到显著水平。在焦虑严重程度子量表上,身体症状和社交焦虑均与生活质量有独立关联。
通过焦虑共病、症状严重程度和焦虑类型衡量的与焦虑相关的结果,与儿科样本中显著更差的生活质量相关。医疗服务提供者应意识到,生活质量受到焦虑相关状况的严重程度和类型的影响,特别是社交焦虑和躯体相关焦虑。