ADad 5: The Co-morbidity in Anxiety Disorders Among Adolescents in a Rural Community Population in India

• Published in: Indian journal of pediatrics 2013-11, Vol.80 (Suppl 2), p.155-159
• Main Authors: Russell, Paul Swamidhas Sudhakar, Nair, M. K. C., Mammen, Priya, Chembagam, Neethu, Vineetha, K. S., Shankar, Satya Raj, Nazeema, Suma, George, Babu
• Format: Article
• Language: English
• Subjects: Adolescent; Anxiety Disorders - diagnosis; Anxiety Disorders - epidemiology; Child; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Female; Gynecology; Health Surveys; Humans; India - epidemiology; Interviews as Topic; Male; Medicine; Medicine & Public Health; Pediatrics; Prevalence; Prospective Studies; Psychiatric Status Rating Scales; Rural Health - statistics & numerical data; Severity of Illness Index; Special Supplement on Adolescent Care Counseling; Young Adult
• ISSN: 0019-5456; 0973-7693
• DOI: 10.1007/s12098-013-1207-4

Objective Anxiety Disorders (AD) have been known to have high prevalence of intra-AD and extra-AD co-morbidities. This study documents the prevalence and profile of intra and extra-AD co-morbidities, the effect of the presence and number of co-morbidities on the severity of anxiety symptoms and the influence of age as well as gender on the co-morbidity. Methods In a prospective community survey of 500 adolescents, independent raters administered the Screen for Child Anxiety Related Emotional Disorders (SCARED) and Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version (K-SADS-PL) to collect the required data. Descriptive statistics, independent t tests, one-way ANOVA and Chi-square tests were done to evaluate the prevalence and profile of co-morbidity presentation, compare the effect of co-morbidity on severity of anxiety symptoms as well as analyse the influence of age groups and gender on intra-AD co-morbidities. Results Among those with AD, 14.2 % had a DSM-IV-TR intra-AD co-morbidity and 70 % had SCARED based intra-AD co-morbidity. Adolescents with Separation Anxiety Disorder and Generalised Anxiety Disorder had the highest SCARED and DSM-IV-TR prevalence of intra-AD co-morbidity respectively. Also, 23.7 % had overlapping extra-AD co-morbidity. Presence and number of intra-AD co-morbidity was significantly associated with severity of total anxiety score and subscale scores (all with P  = 0.001). Age and gender of adolescents were not related to the co-morbidity. Conclusions Intra and extra-AD co-morbidities are quite prevalent among adolescents with Anxiety Disorders in India. As such, co-morbidities increase the severity of anxiety symptoms, they should be identified and appropriate management should be established.