Depression adolescent generalized anxiety

The selective serotonin reuptake inhibitors (SSRI) have been used in adults for a wide variety of disorders, including major depression, social anxiety (social phobia), generalized anxiety disorder (GAD), eating disorders, premenstrual dysphoric disorder (PMDD), post-traumatic stress disorder (PTSD), panic, obsessive-compulsive disorder (OCD), trichotillomania, and migraine headaches. Some of the specific SSRI agents have an approved indication in adults for some of these disorders, as reviewed later in this chapter. The SSRIs have also been tried in children and in adults for symptomatic treatment of pain syndromes, aggressive or irritable ( short fuse ) behavior, and for self-injurious and repetitive behaviors. This chapter will review general aspects of the SSRIs and discuss their approved indications in children and adolescents. 

Although ADHD generally is considered a childhood disorder, symptoms can persist into adolescence and adulthood. The prevalence of adulthood ADHD is estimated to be 4%, with 60% of adults having manifested symptoms of ADHD from childhood.8,9 Further, problems associated with ADHD (e.g., social, marital, academic, career, anxiety, depression, smoking, and substance-abuse problems) increase with the transition of patients into adulthood. 

Insomnia is the most common complaint in general medical practice settings. Primary insomnia usually begins in young adulthood or middle age, and is rare in childhood or adolescence. More than 50% of the population complains of insomnia in their lifetime. A 1-year prevalence study of insomnia in the United States reports that one-third of the individuals surveyed complained of insomnia, and 17% reported that the symptoms were serious. Conservative estimates of chronic insomnia range from 9% to 12% in adulthood and up to 20% in the elderly. Women complain of insomnia twice as frequently as men. Individuals who are elderly, unemployed, separated or widowed, or those with a lower socioeconomic status reported a significantly higher incidence of insomnia. Forty percent with insomnia also had a concurrent psychiatric disorder (anxiety, depression, or substance abuse). ... 

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