ADad 5: the co-morbidity in Anxiety Disorders among adolescents in a rural community population in India

Anxiety Disorders (AD) have been known to have high prevalence of intra-AD and extra-AD co-morbidities. This study documents the prevalence and profile of intra and extra-AD co-morbidities, the effect of the presence and number of co-morbidities on the severity of anxiety symptoms and the influence of age as well as gender on the co-morbidity.

In a prospective community survey of 500 adolescents, independent raters administered the Screen for Child Anxiety Related Emotional Disorders (SCARED) and Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version (K-SADS-PL) to collect the required data. Descriptive statistics, independent t tests, one-way ANOVA and Chi-square tests were done to evaluate the prevalence and profile of co-morbidity presentation, compare the effect of co-morbidity on severity of anxiety symptoms as well as analyse the influence of age groups and gender on intra-AD co-morbidities.

Among those with AD, 14.2% had a DSM-IV-TR intra-AD co-morbidity and 70% had SCARED based intra-AD co-morbidity. Adolescents with Separation Anxiety Disorder and Generalised Anxiety Disorder had the highest SCARED and DSM-IV-TR prevalence of intra-AD co-morbidity respectively. Also, 23.7% had overlapping extra-AD co-morbidity. Presence and number of intra-AD co-morbidity was significantly associated with severity of total anxiety score and subscale scores (all with P = 0.001). Age and gender of adolescents were not related to the co-morbidity.

Intra and extra-AD co-morbidities are quite prevalent among adolescents with Anxiety Disorders in India. As such, co-morbidities increase the severity of anxiety symptoms, they should be identified and appropriate management should be established.