Children with attention-deficit/hyperactivity disorder and at least two anxiety disorders have poorer functioning and quality of life than peers with ADHD and no anxiety, a study showed.
"Systematically assessing and treating anxiety in children with ADHD has the potential to improve functioning for these children," wrote Dr. Emma Sciberras of Murdoch Children’s Research Institute in Parkville, Australia, and her colleagues (Pediatrics 2014;133:801-8)
The researchers analyzed parent-reported quality of life, behavior and peer problems, daily functioning, and school attendance, as well as teacher-reported behavior and peer problems, in 392 children with ADHD, aged 5-13 years, from 21 pediatric practices across Victoria, Australia. Eighty-five percent of the children were taking medication for ADHD. Nearly two in five had at least two anxiety disorders (143 children, 39%), while 95 children (26%) had one anxiety disorder, and 132 (36%) had no anxiety disorders.
The most common anxiety disorder was social phobia in 177 children (48%), followed by generalized anxiety in 125 children (34%), and separation anxiety in 119 children (32%). In addition, 8% had obsessive-compulsive disorder, 6% had posttraumatic stress disorder, and 2% had panic disorder.
Although children with one anxiety disorder did not function any more poorly than the children without anxiety, children with two or more anxiety disorders did experience poorer quality of life, more behavioral difficulties, and more daily functioning difficulty than those without anxiety after investigators adjusted for ADHD medication use and symptom severity; the existence of a mood disorder, externalizing disorder, or autism spectrum disorder; parent age and education; and the child’s age, sex, and neighborhood socioeconomic disadvantage.
Compared with those without anxiety, children with at least two anxiety disorders showed poorer quality of life measures with an effect size of –0.8. Children with two or more anxiety disorders also showed more behavioral difficulties (effect size, 0.4) and more problems with daily functioning (effect size, 0.3).
The research was supported by a Project Grant from the Australian National Health and Medical Research Council and partly by the Centre for Community Child Health at the Royal Children’s Hospital and the Murdoch Children’s Research Institute. The authors reported no relevant financial disclosures.