Thursday, October 25, 2018

Children With Anxiety Disorders Face Higher Risk for Self-Harm, ER Visits, Hospitalization

Children with newly diagnosed anxiety disorders were significantly more likely to experience serious medical events requiring treatment in the emergency room (ER) or inpatient hospitalization than children who did not have these disorders, according to a study published in Depression and Anxiety.

“Within two years following a new anxiety disorder diagnosis, a significant proportion of children have a mental health–related hospitalization, inpatient treated self-harm event, or ER visit, which translates to a sizable number of children, given the prevalence of anxiety disorders,” wrote author Greta A. Bushnell, Ph.D., a postdoctoral fellow in the Department of Epidemiology at Columbia University Mailman School of Public Health, and colleagues. Some 54 million children worldwide are estimated to have an anxiety disorder, according to the Global Burden of Disease Pediatrics Collaboration.

For the study, Bushnell and colleagues identified nearly 200,000 commercially insured children (aged 3 to 17) who were newly diagnosed with anxiety disorder in an office setting and had not received treatment for anxiety. The authors then examined the incidence of mental health–related hospitalization, inpatient treatment for suicide and self-inflicted injury, suicidal ideation, and ER visits in these children over a two-year period. They also examined the incidence of these events in children without an anxiety diagnosis (matched by age, sex, geographical region).

Within two years of diagnosis with anxiety, the children were three times more likely to have had a mental health related–hospitalization than children without an anxiety diagnosis (3.2% vs. 0.9%). Nearly one-third of the children with an anxiety diagnosis were treated in the ER (31.9%) versus about one-fifth of the children without an anxiety diagnosis (21.8%). Children with anxiety were also more than three times more likely to have suicidal ideation (1.7% vs. 0.4%) or receive inpatient treatment for self-harm (0.13% vs. 0.03%).

The rate of serious events were even higher than expected by researchers, Bushnell told Psychiatric News. “For example, more than 3% of youth aged 14 to 17 years had a mental health–related hospitalization in the year following a new anxiety diagnosis. An important next step would be to examine how we can improve follow-up care and treatment to reduce these events,” she said.

“The findings can help inform discussions providers have with patients and caregivers when a child is newly diagnosed with anxiety, including discussions on monitoring anxiety symptoms and when to seek additional care to prevent serious events,” Bushnell added. “Our results draw attention to the importance of follow-up care, particularly in older children with psychiatric comorbidities.”

For related information, see the Psychiatric News article “Peer Program Helps High Schoolers Handle Depression, Anxiety.”

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