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Pediatric anxiety disorders: Basic concepts for primary care
Christopher M Haymaker1, Stephanie Ellwood1
1Western Michigan Homer Stryker MD School of Medicine, Kalamazoo, MI, USA.
International Journal of Psychiatry in Medicine
|December 4, 2023
Summary
Primary care clinicians can manage childhood anxiety disorders using behavioral interventions like exposure with response prevention (ERP) and cognitive behavioral therapy (CBT). Medication may supplement these, and severe cases warrant psychiatric referral for better outcomes.
Area of Science:
- Pediatric primary care
- Child and adolescent mental health
Background:
- Childhood anxiety disorders are common in primary care settings.
- Anxiety presentation varies with development and has multifactorial origins (temperament, environment, trauma).
- Escape conditioning reinforces anxiety disorders.
Purpose of the Study:
- Provide primary care clinicians with an overview of assessment and treatment principles for pediatric anxiety.
- Highlight evidence-based interventions for child and adolescent anxiety.
Main Methods:
- Review of assessment and treatment principles for anxiety disorders in children and adolescents.
- Focus on behavioral interventions and pharmacotherapy.
Main Results:
- Behavioral therapies, including exposure with response prevention (ERP) and cognitive behavioral therapy (CBT), are primary treatments.
- Medications like SSRIs/SNRIs show efficacy but lack FDA approval for most childhood anxiety conditions.
- Multimodal treatment and psychiatric referral are crucial for severe cases with high functional impairment.
Conclusions:
- Primary care providers play a key role in managing pediatric anxiety.
- Behavioral interventions are the cornerstone of effective treatment.
- Pharmacotherapy and specialized psychiatric care are important adjuncts for complex or severe cases.
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