Anxiety Disorders in Youth: Separation Anxiety, Social Anxiety, and Generalized Anxiety Disorder

Anxiety disorders are high prevalence, prepubertal onset conditions that can become persistently impairing without adequate treatment. They are among the most common disorders in children, commonly co-occur with other anxiety disorders, and increase the risk of developing secondary disorders (e.g., major depressive disorder). In children and adolescents, a range of developmental, genetic, cognitive, neurobiological, social, and environmental factors contribute to their onset and course. Multimethod, multi-informant assessment is recommended for making an accurate diagnosis and measuring symptoms. Combined treatment with cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) produces the greatest improvement, particularly when exposure-based treatment and family involvement are optimized. Children who receive timely diagnosis and treatment of anxiety disorders and achieve symptom remission have better long-term outcomes than those who do not. Hence it is recommended that children are screened for pediatric anxiety disorders, and combined treatment is prioritized with attention to the quality implementation of CBT and medication treatment.