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Anxiety disorders in children: Assessment and diagnosis

Authors
Shannon Bennett, PhD
John T Walkup, MD
Section Editor
David Brent, MD
Deputy Editor
Richard Hermann, MD

INTRODUCTION

Worries and fears are a natural and adaptive part of childhood development. Anxiety and fear meet the criteria for a clinical anxiety disorder when the concerns are persistent and excessive, causing notable distress or impairment in day-to-day life.

Anxiety disorders are the most common childhood-onset psychiatric disorders. Anxiety disorders in children (up to 12 years old) and adolescents (13 to 18 years old) are associated with educational underachievement and co-occurring psychiatric conditions, as well as functional impairments that can extend into adulthood.

This topic describes the assessment and diagnosis of anxiety disorders in children and adolescents. The epidemiology, pathogenesis, clinical manifestations, and course of anxiety disorders in children and adolescents are discussed separately. Pharmacotherapy and psychotherapy for anxiety disorders in children and adolescents are discussed separately. (See "Anxiety disorders in children and adolescents: Epidemiology, pathogenesis, clinical manifestations, and course" and "Pharmacotherapy for anxiety disorders in children and adolescents" and "Psychotherapy for anxiety disorders in children and adolescents".)

ASSESSMENT

Psychiatric assessment for anxiety disorders in children and adolescents is performed through a face-to-face diagnostic interview with the child and parents. Detailed information should be obtained on the child’s symptoms, their frequency, duration, severity, and degree of distress or interference. It is important to ask about the child’s specific thoughts and triggers underlying a particular anxious or avoidant behavior.

The diagnostic interview should include comprehensive questions pertaining to developmental history, medical history, and family psychiatric history. A detailed social history includes questions about the family relationships, social relationships, school functioning, preferred recreational activities, substance abuse and sexual history if age appropriate. The child’s strengths should be assessed. (See 'Differential diagnosis' below.)

             

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Literature review current through: Nov 2016. | This topic last updated: Mon Mar 16 00:00:00 GMT 2015.
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