研究综述：儿科焦虑障碍——在过去的 10 年里我们学到了什么？
Research Review: Pediatric anxiety disorders - what have we learnt in the last 10 years?
机构信息
Department of Psychiatry, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
出版信息
J Child Psychol Psychiatry. 2021 Feb;62(2):114-139. doi: 10.1111/jcpp.13262. Epub 2020 Jun 5.
BACKGROUND
Anxiety disorders first emerge during the critical developmental periods of childhood and adolescence. This review synthesizes recent findings on the prevalence, risk factors, and course of the anxiety disorders; and their neurobiology and treatment.
METHODS
For this review, searches were conducted using PubMed, PsycINFO, and clinicaltrials.gov. Findings related to the epidemiology, neurobiology, risk factors, and treatment of pediatric anxiety disorders were then summarized.
FINDINGS
Anxiety disorders are high prevalence, and early-onset conditions associated with multiple risk factors including early inhibited temperament, environment stress, and structural and functional abnormalities in the prefrontal-amygdala circuitry as well as the default mode and salience networks. The anxiety disorders are effectively treated with cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).
CONCLUSIONS
Anxiety disorders are high prevalence, early-onset conditions associated with a distinct neurobiological fingerprint, and are consistently responsive to treatment. Questions remain regarding who is at risk of developing anxiety disorders as well as the way in which neurobiology predicts treatment response.
背景
焦虑障碍最早出现在儿童和青少年的关键发育期。本综述综合了近期关于焦虑障碍的患病率、风险因素和病程的研究结果；以及它们的神经生物学和治疗方法。
方法
本综述使用了 PubMed、PsycINFO 和 clinicaltrials.gov 进行检索。然后总结了与儿科焦虑障碍的流行病学、神经生物学、风险因素和治疗相关的发现。
结果
焦虑障碍是高患病率的疾病，发病年龄早，与多种风险因素相关，包括早期抑制气质、环境压力、前额叶-杏仁核回路以及默认模式和突显网络的结构和功能异常。焦虑障碍可以通过认知行为疗法（CBT）、选择性 5-羟色胺再摄取抑制剂（SSRIs）和 5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRIs）有效治疗。
结论
焦虑障碍是高患病率、发病年龄早的疾病，与独特的神经生物学特征有关，并且对治疗有一致的反应。目前仍存在一些问题，例如哪些人有患焦虑障碍的风险，以及神经生物学如何预测治疗反应。
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