Peds anxiety

Question 1

prevalence of anx DO in peds

Answer 1

6-20%

girls more thanboys

Question 2

Treatment of anx DO in peds meds vs therapy?

Answer 2

If mild: therapy
If severe, urgent, comorbid, or partial response to therapy combination
CAMS study (child and adolescent multimodal study) for sep anx, social phobia and GAD
showed combination> CBT=sertraline> placebo acutely and manitenance

Question 3

Meds for anx DO in peds

Answer 3

SSRIs
positive trials for fluoxetine, sertraline, paxil

effexor =ve, TCA conflicting, benzos -ve

Question 4

therapies for anx DO in children

Answer 4

CBT (education, somatic sx mx, cognitive restructuring, exposure, relapse prevention)
coping cat for sep anx, social phobia and GAD
meeky mouse for selective mutism (graded exposure)
Group therapy is also good (not for ADHD and severe cases or trauma)

Parent envolvement to coach, earn and teach relaxation, deal with own anxiety, d ohomework, give positive re-inforcement
educational support

less evidence but extensive clinical familiarity with psychodynamic thrapy