title: Empirically derived subtypes of lifetime anxiety disorders: developmental and clinical correlates in U.S. adolescents.
abstract: OBJECTIVE
  The current study examined the sex- and age-specific structure and comorbidity of lifetime anxiety disorders among U.S. adolescents.
  
  
  METHODS
  The sample consisted of 2,539 adolescents (1,505 females and 1,034 males) from the National Comorbidity Survey-Adolescent Supplement who met criteria for Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev. [DSM-IV-TR]) lifetime anxiety disorders (American Psychiatric Association, 2000). Adolescents ranged in age from 13 to 18 years (M = 15.2 years, SE = 0.08 years) and were 39% non-White. Multiple-group latent class analysis was conducted by adolescent sex and age to identify subgroups of adolescents with similar anxiety disorder profiles. Developmental and clinical correlates of empirically derived classes were also examined to assess the nomological validity of identified subgroups.
  
  
  RESULTS
  A 7-class solution provided the best fit to the data, with classes defined primarily by one rather than multiple anxiety disorders. Results also indicated that classes displayed similar diagnostic profiles across age, but varied by sex. Classes characterized by multiple anxiety disorders were consistently associated with a greater degree of persistence, clinical severity, impairment, and comorbidity with other DSM-IV-TR psychiatric disorders.
  
  
  CONCLUSIONS
  The presentation of lifetime anxiety disorders among adolescents and the observation of unique correlates of specific classes provide initial evidence for the utility of individual DSM-IV-TR anxiety disorder categories. Although findings of the present study should be considered preliminary, results emphasize the potential value of early intervention and gender-specific conceptualization and treatment of anxiety disorders.
authors.affiliation: Genetic Epidemiology Research Branch, National Institute of Mental Health, 35 Convent Drive, Bethesda, MD 20892, USA. marcy.burstein@nih.gov
authors.forename: Marcy
authors.initials: M
authors.lastname: Burstein
authors.forename: Katholiki
authors.initials: K
authors.lastname: Georgiades
authors.forename: Femke
authors.initials: F
authors.lastname: Lamers
authors.forename: Sonja A
authors.initials: SA
authors.lastname: Swanson
authors.forename: Lihong
authors.initials: L
authors.lastname: Cui
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: He
authors.forename: Shelli
authors.initials: S
authors.lastname: Avenevoli
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Merikangas
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001008:Anxiety Disorders / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
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