title: Screening for adolescent anxiety disorders in a pediatric emergency department.
abstract: OBJECTIVE
  Adolescence is a time of increasing risk for some anxiety disorders. Scant data exist on adolescent anxiety in emergency department (ED) settings. We sought to characterize select clinical characteristics and health care use associated with anxiety disorders in a pediatric ED.
  
  
  METHODS
  We screened a convenience sample of 100 adolescent-parent dyads presenting to the ED for the presence of child anxiety disorders using the 5-item Screen for Child Anxiety Related Emotional Disorders, parent (SCARED-P) and child (SCARED-C) versions. Additional demographic and clinical data were also collected.
  
  
  RESULTS
  The SCARED-P and SCARED-C screens identified probable anxiety disorder(s) in 26% to 33% of adolescent participants, respectively. Correlates of positive SCARED-C screens were female sex, asthma, presenting complaint involving headache or migraine, and school absenteeism due to physical problems. Correlates of positive SCARED-P screens were lower parental educational level, presenting complaint involving headache or migraine, and more medical specialty and total medical visits. Few anxious adolescents had received mental health services in the past 6 months. In multivariate models, female sex was independently associated with SCARED-C total score, and presenting complaint involving headache or migraine was independently associated with SCARED-P total score.
  
  
  CONCLUSIONS
  The current pilot data suggest that anxiety disorders are more prevalent among adolescent ED patients than among the general population but largely untreated. Several demographic and clinical variables may help to identify occult anxiety disorders. Greater awareness of anxiety disorders in this population may assist in redirecting a pattern of low use of mental health services but higher overall health care use.
authors.affiliation: Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093-0855, USA. hramsawh@ucsd.edu
authors.forename: Holly J
authors.initials: HJ
authors.lastname: Ramsawh
authors.forename: Denise A
authors.initials: DA
authors.lastname: Chavira
authors.forename: John T
authors.initials: JT
authors.lastname: Kanegaye
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.forename: P Jamil
authors.initials: PJ
authors.lastname: Madati
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology; D002140:California / Q000453:epidemiology; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D008297:Male; D011594:Psychometrics / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires