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Review
. 2021 Feb;62(2):114-139.
doi: 10.1111/jcpp.13262. Epub 2020 Jun 5.

Research Review: Pediatric anxiety disorders - what have we learnt in the last 10 years?

Jeffrey R Strawn #  1 , Lu Lu #  1   2 , Tara S Peris  3 , Amir Levine  4 , John T Walkup  5
Affiliations
Review

Research Review: Pediatric anxiety disorders - what have we learnt in the last 10 years?

Jeffrey R Strawn et al. J Child Psychol Psychiatry. 2021 Feb.

Abstract

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.

Keywords: Generalized anxiety disorder; SRI); fMRI; pharmacogenomics; selective serotonin reuptake inhibitor (SSRI; separation anxiety disorder.

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Figures

FIGURE 1:
FIGURE 1:. Neurofunctional (top) and neurofunctional (bottom) abnormalities in pediatric patients with generalized, separation and social anxiety disorders.
VLPFC, ventrolateral prefrontal cortex; STG, superior temporal gyrus; ACC, anterior cingulate cortex; mPFC, medial prefrontal cortex; dACC, dorsal anterior cingulate cortex
See this image and copyright information in PMC

References

    1. Abbass AA, Rabung S, Leichsenring F, Refseth JS, & Midgley N (2013). Psychodynamic psychotherapy for children and adolescents: A meta-analysis of short-term psychodynamic models. Journal of the American Academy of Child and Adolescent Psychiatry 10.1016/j.jaac.2013.05.014 - DOI - PubMed
    1. Asselmann E, Wittchen H-U, Lieb R, & Beesdo-Baum K (2018). Sociodemographic, clinical, and functional long-term outcomes in adolescents and young adults with mental disorders. Acta Psychiatrica Scandinavica, 137(1), 6–17. 10.1111/acps.12792 - DOI - PubMed
    1. Asselmann E, Wittchen H-U, Lieb R, Höfler M, & Beesdo-Baum K (2014). Associations of fearful spells and panic attacks with incident anxiety, depressive, and substance use disorders: A 10-year prospective-longitudinal community study of adolescents and young adults. Journal of Psychiatric Research, 55, 8–14. 10.1016/j.jpsychires.2014.04.001 - DOI - PubMed
    1. Beesdo-Baum K, & Knappe S (2012). Developmental Epidemiology of Anxiety Disorders. Child and Adolescent Psychiatric Clinics of North America. 10.1016/j.chc.2012.05.001 - DOI - PubMed
    1. Beesdo K, Bittner A, Pine DS, Stein MB, Höfler M, Lieb R, & Wittchen H-U (2007). Incidence of social anxiety disorder and the consistent risk for secondary depression in the first three decades of life. Archives of General Psychiatry, 64(8), 903–12. 10.1001/archpsyc.64.8.903 - DOI - PubMed

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