Anxiety disorders in an attention-deficit/hyperactivity disorder clinical sample

Abstract

For many years, childhood anxiety was considered a benign and transitory disorder with a good o u tcome. More recent studies, however, show this b elief was wro n g 1 . Anxiety disorders are now considered chronic and pervasive and their prevalence increases throughout adolescence 2 . These children show a generalized anxious feeling with excessive w o rries about their parents, school tests, future events and visits to a doctor or past behavior. They a re also distressed about their competence, behavior and performance in different settings such as school, sports and social relationships and experience physical distress with flushing, rapid heart b e a t , headache, insomnia, agitation, muscles cramps a n d u r i n a ry urg e n c y. Young children might also show separation anxiety, which is a very particular feeling of distress, along with worries about separating f ro m parents or other close ones. These symptoms are usually expressed by refusing to go to school and inability to perf o rm social functions. Some anxious children develop specific fears with avoidance behaviors and social impairment. Obsessive-compulsive disorder can also be diagnosed in children.Anxiety disorders are one of the most studied fields of comorbid conditions with attention deficit hyperactivity disorder (ADHD). Several studies documented a high prevalence of comorbidity in child ren and adolescents suffering from ADHD (Ta b l e 1). There are two Brazilian studies re p o rting pre v alence rates similar to those described in intern a t i onal literature. Also, when using strict diagnostic criteria, there is no diff e rence in the prevalence rates ABSTRACT -Objective: To evaluate the prevalence of anxiety disorders in a clinical referred sample of child ren and adolescents with attention deficit/hyperactivity disorder (ADHD). M e t h o d : 78 children and adolescents with ADHD according to DSM-IV criteria were investigated with a semi-structured interview (P-CHIPS), complemented by clinical interviews with the children or adolescents and their parents. Their IQ was calculated with neuropsychological testing. Results: A high prevalence of anxiety disorders (23.05%) was found in the sample. Generalized anxiety disorder was the most prevalent disorder (12,8%), followed by social phobia (3,84%) and separation anxiety disorder (3,8%). Two children showed more than one anxiety disord e r. C o n c l u s i o n : C h i l d ren and adolescents with ADHD seem to be more prone to have comorbid anxiety disorders, at least in clinical samples referred to specialized units.KEY WORDS: ADHD, attention deficit hyperactivity disorder, anxiety, comorbidity.Transtorno de ansiedade em amostra de pacientes com déficit de atenção e hiperatividade RESUMO -O b j e t i v o: Avaliar a presença de transtornos de ansiedade numa amostra clínica referida de crianças e adolescentes com transtorno do déficit de atenção e hiperatividade (TDAH). M é t o d o:78 crianças c o m TDAH de acordo com os critérios da DSM-IV foram avaliadas através de entrevista semi-estruturada...

Comorbid anxiety in children with attention-deficits hyperactive disorder

“…Similarly, Lahey et al [23] found 33.5% of their sample had anxiety disorders; however, our results considered a high frequency value in comparison with other studies which reported an average comorbidity rate of anxiety disorder of 25% that was found in epidemiological and clinical samples [11,24,25]. Similar results by Souza et al [12] found a high prevalence of anxiety disorders (23%) among his clinically referred sample; generalized anxiety disorder was the most prevalent disorder (12.8%), followed by social phobia (3.84%) and separation anxiety disorder (3.8%). Two children showed more than one anxiety disorder.…”

“…Some children can have more than one type of anxiety disorder. However, children with comorbid anxiety disorders and ADHD have more severe symptoms and overall impairment than children with either condition alone [12,13]. It is very important to distinguish between true anxiety disorders and those children who are experiencing anxiety in response to ADHD, if the anxiety is situational; the individual may be anxious because the ADHD is making it difficult to succeed academically, vocationally, or socially.…”

Developmental comorbidity in attention-deficit/hyperactivity disorder

“…Co-occurrence of ADHD and anxiety was linked to higher rates of attentional problems, school phobia, mood disorders and lower levels of social competence compared to children who had either ''ADHD only'' or ''anxiety only''. Amongst a group of 78 children and adolescents with ADHD generalized anxiety disorder was the most prevalent anxiety disorder (12.8%), followed by social phobia (3.84%) and separation anxiety disorder (3.8%) (Souza et al 2005). Comorbidity of ADHD and dysthymic disorder in primary school-age was further associated with separation anxiety disorder and social phobia in a group of drug-naïve ADHD patients (Vance et al 2003).…”

Adolescência e saúde mental: revisão de artigos brasileiros publicados em periódicos nacionais

“…Especificamente sobre os Transtornos da Ansiedade destacam-se artigos de revisão sobre a descrição e identificação dos sintomas, características associadas aos quadros ansiosos 29 e sobre aspectos clínicos, epidemiológicos e de intervenção 30 . Outros estudos abordavam os quadros associados à ansiedade, como o transtorno da falta de atenção e hiperatividade (TDAH) discutido quanto à identificação do quadro 31 , à associação com drogas 32 , ao tratamento farmacológico 33 , à suscetibilidade genética 34 e à alta prevalên-cia dos transtornos de ansiedade nos quadros de TDAH 35 . Fundamentalmente, destacou-se a importância da identificação e do diagnóstico adequado do quadro, visto os aspectos negativos e prejuízos na aprendizagem e convívio social de adolescentes.…”