title: Comparison of behavioral profiles for anxiety-related comorbidities including ADHD and selective mutism in children.
abstract: BACKGROUND
  Elucidating differences in social-behavioral profiles of children with comorbid presentations, utilizing caregiver as well as teacher reports, will refine our understanding of how contextual symptoms vary across anxiety-related disorders.
  
  
  METHODS
  In our pediatric anxiety clinic, the most frequent diagnoses and comorbidities were mixed anxiety (MA; ≥ 1 anxiety disorder; N = 155), anxiety with comorbid attention-deficit hyperactivity disorder (MA/ADHD, N = 47) and selective mutism (SM, N = 48). Behavioral measures (CPRS, CTRS) were analyzed using multiple one-way multivariate analyses of covariance tests. Differences between the three diagnostic groups were examined using completed parent and teacher reports (N = 135, 46, and 48 for MA, MA/ADHD, and SM groups, respectively).
  
  
  RESULTS
  Comparisons across the MA, MA/ADHD, and SM groups indicate a significant multivariate main effect of group for caregiver and teacher responses (P < 0.01). Caregivers reported that children with SM are similar in profile to those with MA, and both groups were significantly different from the MA/ADHD group. Teachers reported that children with SM had more problems with social behaviors than with the MA or MA/ADHD groups. Further comparison indicates a significant main effect of group (P < 0.001), such that children with SM have the greatest differences in behavior observed by teachers versus caregivers.
  
  
  CONCLUSIONS
  Clinical profiles between MA/ADHD, MA, and SM groups varied, illustrating the importance of multi-rater assessment scales to capture subtle distinctions and to inform treatment planning given that comorbidities occur frequently in children who present with anxiety.
authors.affiliation: Institute for Juvenile Research and the Department of Psychiatry, University of Illinois at Chicago (UIC), IL, USA.
authors.forename: Tal
authors.initials: T
authors.lastname: Levin-Decanini
authors.forename: Sucheta D
authors.initials: SD
authors.lastname: Connolly
authors.forename: David
authors.initials: D
authors.lastname: Simpson
authors.forename: Liza
authors.initials: L
authors.lastname: Suarez
authors.forename: Suma
authors.initials: S
authors.lastname: Jacob
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009155:Mutism / Q000453:epidemiology / Q000523:psychology*; D012919:Social Behavior
keywords: Attention deficit disorder with hyperactivity; anxiety disorders; school children; selective mutism