Anxiety in a neglected population: prevalence of anxiety disorders in pre-adolescent children

It is widely believed that anxiety is a common disorder of childhood and adolescence, but epidemiological studies have varied substantially in the prevalence rates that they report. In addition, less attention has been paid to the prevalence of anxiety in pre-adolescent children. For these reasons, a review of epidemiological studies reporting on the prevalence of anxiety disorders in this younger population is described. A comprehensive literature search, encompassing electronic searches of databases and hand searches of journals, returned 11 studies that reported on the prevalence of DSM-III-R or DSM-IV anxiety, specifically in children aged below 12 years of age, which had employed certain minimum standards of epidemiological practice, and had some degree of generalisability to wider populations. The rates of diagnosis of 'any anxiety disorder' varied widely between the studies. The minimum figure reported was 2.6%, and the maximum was 41.2%. Separation Anxiety Disorder appeared to be the most common individual anxiety diagnosis in this age group. Anxiety disorders appear to be more common than depressive disorders, and probably also more common than disorders of behaviour. Anxiety disorders are, at the very least, fairly common in pre-adolescent children. This is concerning when the limited current treatment options for this age group are considered. Reasons for the varied prevalence rates reported by the studies, focussing on the differences in methods employed, are suggested. Implications for treatment are discussed.