Epidemiology and Impact of Health Care Provider-Diagnosed Anxiety and Depression Among US Children

Abstract

Objective: This study documents the prevalence and impact of anxiety and depression in US children based on the parent report of health care provider diagnosis.

Methods: National Survey of Children's Health data from 2003, 2007, and 2011-2012 were analyzed to estimate the prevalence of anxiety or depression among children aged 6 to 17 years. Estimates were based on the parent report of being told by a health care provider that their child had the specified condition. Sociodemographic characteristics, co-occurrence of other conditions, health care use, school measures, and parenting aggravation were estimated using 2011-2012 data.

Results: Based on the parent report, lifetime diagnosis of anxiety or depression among children aged 6 to 17 years increased from 5.4% in 2003 to 8.4% in 2011-2012. Current anxiety or depression increased from 4.7% in 2007 to 5.3% in 2011-2012; current anxiety increased significantly, whereas current depression did not change. Anxiety and depression were associated with increased risk of co-occurring conditions, health care use, school problems, and having parents with high parenting aggravation. Children with anxiety or depression with effective care coordination or a medical home were less likely to have unmet health care needs or parents with high parenting aggravation.

Conclusion: By parent report, more than 1 in 20 US children had current anxiety or depression in 2011-2012. Both were associated with significant comorbidity and impact on children and families. These findings may inform efforts to improve the health and well-being of children with internalizing disorders. Future research is needed to determine why child anxiety diagnoses seem to have increased from 2007 to 2012.

Figure 1

Selected indicators of impact among US children aged 6 to 17 years with parent-reported anxiety or depression with and without effective care coordination or a medical home, 2011–2012. Adjusted prevalence ratios and 95% confidence intervals comparing children with effective care coordination or a medical home to those without either were calculated, adjusting for the following factors categorized as they are shown in Table 1, except as noted: age, sex, race/ethnicity (white non-Hispanic vs others), highest household education, household income (percent of federal poverty level), insurance status (yes/no), and whether the child had severe depression or severe anxiety. *p < 0.001. Data source: CDC/NCHS, National Survey of Children's Health, 2011–2012. CDC, Centers for Disease Control and Prevention; NCHS, National Center for Health Statistics.