Somatic symptoms in children and adolescents with anxiety disorders
Somatic symptoms in children and adolescents with anxiety disorders
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DOI：
10.1097/01.chi.0000231974.43966.6e
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发表时间：
2006-10-01
影响因子：
13.3
通讯作者：
Davies, Mark
中科院分区：
文献类型：
--
作者：
Ginsburg, Golda S.;Riddle, Mark A.;Davies, Mark
目的：评估焦虑症儿童和青少年的躯体症状（SS）患病率; SS与焦虑严重程度、损伤和儿童整体功能之间的关系;以及氟伏沙明（FLV）与安慰剂（PBO）对减少SS的影响。方法：作为双盲、安慰剂对照试验的一部分，128名患有DSM-IV焦虑症（即，社交、分离和广泛性焦虑）由专家临床医生使用儿科焦虑评定量表对16个SS进行评估。结果如下：基线时最常见的SS为坐立不安（74%）、胃痛（70%）、脸红（51%）、心悸（48%）、肌肉紧张（45%）、出汗（45%）和颤抖/发抖（43%）。年龄较大的儿童（12岁及以上）比年幼的儿童报告更多的SS，男孩和女孩报告类似数量的SS，和SS的儿童比没有广泛性焦虑症。SS与焦虑严重程度、损伤和整体功能显著正相关。在PBO和FLV条件下，SS的前/后减少具有统计学显著性;但是，在减少SS方面，FLV上级优于PBO。结论：SS在患有焦虑症的儿童和青少年中非常普遍，并且与更严重的焦虑和损伤相关。FLV治疗可有效减少而非增加SS。三种焦虑症中每一种的青少年中SS的高发病率表明，在儿童和青少年中最常见的焦虑症的DSM-IV诊断标准中，对SS进行了重新评估。
Objective: To evaluate the prevalence of somatic symptoms (SSs) in children and adolescents with anxiety disorders; the relationship between SSs and anxiety severity, impairment, and child global functioning; and the impact of fluvoxamine (FLV) versus pill placebo (PBO) on reducing SSs. Method: As part of a double-blind, placebo-controlled trial, 128 children (mean age, 10.8 years; range, 6-17) with DSM-IV anxiety disorders (i.e., social, separation, and generalized anxiety) were assessed by expert clinicians on 16 SSs using the Pediatric Anxiety Rating Scale. Results: The most common SSs at baseline were restlessness (74%), stomachaches (70%), blushing (51%), palpitations (48%), muscle tension (45%), sweating (45%), and trembling/shaking (43%). Older children (age 12 and older) reported more SSs than younger children, boys and girls reported similar numbers of SSs, and SSs were higher among children with than without generalized anxiety disorder. SSs were significantly and positively correlated with anxiety severity, impairment, and global functioning. Pre-/postreductions in SSs were statistically significant in both PBO and FLV conditions; however, FLV was superior to PBO in reducing SSs. Conclusions: SSs are highly prevalent among children and adolescents with anxiety disorders and are associated with greater anxiety severity and impairment. Treatment with FLV was effective in reducing rather than increasing SSs. The high rates of SSs in youths with each of the three anxiety disorders suggest a re-evaluation of SSs in the DSM-IV diagnostic criteria for the most common anxiety disorders among children and adolescents.