A Profile of Anxiety Disorders in Australian Children and Youth – Findings from the Australian Child and Adolescent Survey of Mental Health and Wellbeing

WHAT DID THEY DO?

Now, a group of researchers from Griffith University and the University of Western Australia have published findings from an important study on three specific anxiety disorders in Australian children and youth, in the Australian and New Zealand Journal of Psychiatry. [1]

In 2013/2014, Australia conducted the second Australian Child and Adolescent Survey of Mental Health and Wellbeing.

More than 6000 Australian families were selected randomly and interviewed as part of the Young Minds Matter survey, which looked at the emotional and behavioural development of children and young people aged between 4 and 17 years. [2]

This included assessment of anxiety disorders with separate evaluation of social anxiety disorder (SOC), separation anxiety disorder (SEP) and generalised anxiety disorder (GAD).

Using data from this survey, the authors of this study aimed to examine the 12-month prevalence, patterns of comorbidity, demographic and socio-environmental correlates, type and severity of functional impairment, and professional service use associated with these three disorders among Australian youth.

Informants were parents or carers, reporting on 6310 children and youth aged 4- to 17-years (55% of eligible households).

The presence of each of the three anxiety disorders was determined based on the Diagnostic Interview Schedule for Children–Version IV.

Socio-environmental data include 1) Family structure; 2) Household income; 3) Level of parent/carer education; 4) Labour force status; 5) Primary carer mental health; 6) Negative family events; 7) Experience of repeated bullying, and 8) Family functioning.

Parents and carers responded to questions about service use received at school (or another educational institution) or from a health practitioner in the past 12 months about their child’s presenting emotional or behavioural problems.

The severity of the impact of mental disorders on functioning was assessed using a measure specifically developed for the study. [3]

It calculated a composite score from 17 items assessing the impact of each disorder on (a) functioning at school or in the workplace; (b) quality of relationships and participation with friends; (c) disruption to family activities and (d) the individual in terms of distress, achievements and sleep patterns.

Carers were also asked to report on the number of days that the young person had been absent from school over the school year to date.

For those with an anxiety disorder, carers also reported on the number of days absent from school in the past 12 months as a consequence of the anxiety problems.

WHAT DID THEY FIND?

• In the previous 12 months, 6.6% of youth had experienced at least one of SOC, SEP or GAD, with rates of 2.3% for SOC, 4.3% for SEP and 2.3% for GAD
• Rates did not differ by gender but were significantly higher for SOC and GAD and lower for SEP in 12- to 17-year-olds than 4- to 11-year-olds
• Comorbidity between these disorders was high, although lower for SEP
• Having SOC, SEP or GAD was associated with not living with both biological parents, having a parent with a mental health problem, elevated negative family events, low carer employment and peer victimization. The association with family risk factors was greater for SEP than for SOC and GAD
• Although the majority of anxious youth had received professional help, this was less likely in the younger cohort

WHAT DOES IT MEAN?

This study was conducted using a large, representative, Australian community sample. It confirmed the relatively high prevalence of SOC, SEP and GAD during childhood and adolescence for both males and females.

Furthermore, it highlighted the significant impairment in functioning across multiple domains and the high rate of use of school and health sector services.

All disorders showed a high level of comorbidity, and although there was a high degree of commonality between the three anxiety disorders in terms of the socio-environmental factors with which they were associated (such as peer victimization and living with a parent with a mental health problem), there were also differences.

In particular, family factors such as family dysfunction, negative family life events and low carer employment were more strongly associated with SEP than for SOC or GAD.

This has implications for both mental health and social service provision and planning in children and youth with this particular condition.

It is clear that these disorders are a major issue in terms of personal distress to children and families and the cost of providing services.

The findings of this study reinforce the need for continued and enhanced provision of services for the treatment of anxious youth and for further development and evaluation of prevention and early intervention initiatives targeted at modifying family and individual risk factors for child and adolescent anxiety disorders.

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