Anxiety disorders children

Merikangas KR, Dierker LC, Szatmari P (1998a) Psychopathology among offspring of parents with substance abuse and/or anxiety disorders a high-risk study. J Child Psychol Psychiatry 39 711-720... 

Numerous studies found that childhood sexual, physical, and emotional abuse also predisposes victims of such abuse to the development of depression in adulthood (e.g., McCauley et ah, 1997). The risk for depression increases with early onset and severity of the abuse as well as with the experience of multiple types of abuse. In addition, child abuse is related to an array of anxiety disorders, including generalized anxiety disorder and PTSD (e.g., Kendler et ah, 2000). Other disorders related to childhood abuse include substance abuse, eating disorders, dissociation, and so-... 

Adverse early environmental stress has also been investigated in human populations. Observations of the effects of early childhood experience of environmental adversity have led investigators to propose a stress vulnerability mediated by changes in stress-responsive CRF systems implicated in both mood and anxiety disorders (Heim and Nemeroff, 1999). Granger et al. (1996) measured children s adrenocortical reactions to a conflict-oriented mother-child interaction task and found that children s pretask cortisol scores were negatively associated with anxiety symptoms. 

Sallee, F.R., Richman, H., Sallee, F.R., Richman, H., Sethuraman, G. Dougherty, D., Sine, L., and Attman-Hamandzic, S. (1998) Clon-idine challenge in childhood anxiety disorder. J Am Acad Child Adolesc Psychiatry 37 655—662. 

Bernstein, G.A., Borchardt, C.M., and Perwien, A.R. (1996) Anxiety disorders in children and adolescents a review of the past 10 years./ Am Acad Child Adolesc Psychiatry 1996 35 1110-1119. 

Birmaher B., Waterman GS, Ryan N, Cully M, Balach L, Ingram J, Brodsky M. Fluoxetine for childhood anxiety disorders. / Am Acad Child Adolesc Psychiatry 33 993-999. 

Klein, R.G., Koplewicz, H.S., and Kanner, A. (1992) Imipramine treatment of children with separation anxiety disorder. J Am Acad Child Adolesc Psychiatry 31 21—28. 

Screen for Child Anxiety-Related Emotional Disorders (SCARED)... 

Birmaher, B., Brent, D.A., Chiappetta, L., Bridge, Monga, S., and Baugher, M. (1999) Psychometric properties of the Screen for Child Anxiety-Related Emotional Disorders (SCARED) a replication study. 1 Am Acad Child Adolesc Psychiatry 38 1230-1236. 

Bernstein, G.A., and Shaw, K. (1997) Practice parameters for the assessment and treatment of children and adolescents with anxiety disorders. American Academy of Child and Adolescent Psychiatry. / Am Acad Child Adolesc Psychiatry 36(10 Suppl) 69S-84S. 

A. Is anxiety excessive for this child Multidimensional Anxiety Scale for Children (MASC) Screen for Child Anxiety-Related Emotional Disorders (SCARED)... 

B. Does this child have an anxiety disorder Anxiety Disorders Interview Schedule for Children (ADIS-C/P) Kiddie Schizophrenia and Affective Disorders Schedule (K-SADS)... 

Despite these limitations, CBT treatments have proven to be efficacious for a majority of child and adolescent subjects with anxiety disorders. Indeed,... 

Barrett, P.M. (1998) Evaluation of cognitive-behavioral group treatments for childhood anxiety disorders. / Clin Child Psychol 27 459-468. 

Mendlowitz, S.L., Manassis, K., Bradley, S., Scapillato, D., Miezitis, S., and Shaw, B. (1999) Cognitive-behavioral group treatments in childhood anxiety disorders the role of parental involvement. / Am Acad Child Adolesc Psychiatry 38 1223-1229. 

Rapee, R.M., Barret, P.M., Dadds, M.R., and Evans, L. (1994) Reliability of the DSM-III-R childhood anxiety disorders using structured interview interrater and parent-child agreement. / Am Acad Child Adolesc Psychiatry 33 984-992. 

Silverman, W.K., and Nelles, W.B. (1988) The Anxiety Disorders Interview Schedule for Children. / Am Acad Child Adolesc Psychiatry 27 772-778. 

Simeon, J.G., Knott, V.J., Dubois, C., Wiggins, D., Geraets, I., Thatte, S., and Miller, W. (1994) Buspirone therapy of mixed anxiety disorders in childhood and adolescence a pilot study. J Child Adolesc Psychopharmacol 4 159-170. 

Allen, A.J., Leonard, H., and Swedo, S. (1995) Current knowledge of medications for the treatment of childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry 34 976-986. 

Fairbanks, J., Pine, D.S., Tancer, N.K., Dummit, E.S., Kentgen, L.M., Martin, J., Asche, B.K., and Klein, R.G. (1997) Open fluoxetine treatment of mixed anxiety disorders in children and adolescents. J Child Adolesc Psychopharmacol 17 17—29. 

In general, following guidelines established for the treatment of other child psychiatric disorders would seem to be the most prudent initial approach to the question of discontinuation, with the caveats listed above. In the author s experience, continuing treatment for at least 6 months to a year following successful treatment of a psychiatric syndrome (assuming that the symptoms or syndrome was not situational, such as anxiety prior to a procedure or a resolved delirium) would seem to be a reasonable starting point. 

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