Objective: This article reviews the clinical and epidemiological aspects of anxiety disorders in youngsters, as well as current medical and psychological treatment strategies. The role of the neurobiological models possibly involved in the etiology of these disorders is also discussed.Sources of data: MEDLINE search of papers published in English from 1981 to 2003. The following key words were used: anxiety disorders, neurobiology, childhood, adolescence.Summary of the findings: Childhood-onset anxiety disorders are among the most frequent psychiatric conditions in children and adolescents. Epidemiological data estimate a prevalence of 10% in this population. The neurobiological models involved in the etiology of anxiety disorders in youngsters are closely related to neuroimaging studies with individuals presenting these pathologies. The role of the amygdala in the pathophysiology of these disorders is underscored. To be effective, treatment must combine several interventions, such as cognitive-behavioral, family, and, frequently, drug treatments.Conclusions: Early identification and prompt treatment of anxiety disorders may prevent negative consequences, such as school absenteeism and frequent and unnecessary visits to pediatric services due to somatic complaints related to anxiety disorders. Moreover, it is possible that psychiatric problems could be avoided or attenuated in adulthood.J Pediatr (Rio J). 2004;80(2 Suppl):S28-S34: Anxiety disorders, childhood, adolescence, neurobiology, psychopharmacology, cognitive-behavioral therapy.
The association between Sydenham's chorea and OCD supports suggestions that similar mechanisms involving the basal ganglia underlie both disorders. Obsessive-compulsive symptoms occurred at the beginning of rheumatic fever, so early psychopathological assessments are essential.
The similar occurrence of OCS in patients with history of RF and diabetes suggests that the development of this symptomatology, triggered by group A beta-haemolytic streptococcus infections, is restricted to the RF acute phase, occurred during infancy, and did not seem to predispose the appearance of OCS in adulthood.
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