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Sonali D. Nanayakkara, MD

Sonali D. Nanayakkara, MD

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The American Academy of
Child and Adolescent Psychiatry recommends
routine screening for anxiety in
childhood, querying various sources (child,
parent, teacher) about anxiety symptoms,
assessing for comorbid disorders,
and evaluating severity and functional
impairment. Transient and developmentally
appropriate worries and fears need to
be distinguished from anxiety disorders.
Somatic symptoms, such as headache or
stomachache, often accompany anxiety.
A child’s anxiety may manifest as crying,
irritability, or other behaviors that may
be misunderstood by adults as disobedience.
Self-report measures can help
screen for anxiety symptoms and monitor
treatment response. Psychotherapy is
the initial treatment of children with
anxiety. Pharmacotherapy with selective
serotonin reuptake inhibitors may be
necessary for those with moderate to
severe anxiety. In these children, the
addition of cognitive-behavioral therapy
may improve functioning better than
either intervention alone.

Anxiety disorders are one of the most common psychiatric disorders in children and adolescents, but they often go undetected or untreated. Identification and effective treatment of childhood anxiety disorders can decrease the negative impact of these disorders on academic and social functioning in youth and their persistence into adulthood.

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