Childhood anxiety disorders: Lessons from the literature

Studies of childhood anxiety disorders have increased in recent years, but the clinical implications of the work are sometimes difficult to discern. T his paper reviews salient findings (related to the assessment and managemen t of anxious children) published in the last 5 years. The high comorbidity among disorders, the occurrence of different disorders in the same child ov er time, recent changes in diagnostic categories, the availability of new a nxiety measures, and poor correspondence between parent and child reports o f symptoms all underscore the need for thorough assessment. Increasing evid ence supports cognitive-behavioural treatments for anxiety disorders, alone or in combination with pharmacotherapy. Other important aspects of managem ent suggested by developmental studies of anxious children include psychoed ucation about constitutional factors in the development of anxiety, interve ntions to address parental anxiety, parenting advice regarding behaviour ma nagement and reduction of family conflict, and treatment of child impairmen t to decrease the risk of depression. Questions requiring further research are identified.