ADad 4: the symptomatology and clinical presentation of Anxiety Disorders among adolescents in a rural community population in India.
OBJECTIVE
Anxiety Disorders (AD) in children and adolescents present with unique clinical features and exhibit phenotypic diversity. The symptom presentation varies with regard to age of onset, developmental factors and gender. This study documents the clinical presentation of AD among adolescents in India, and explores the symptom clusters among the different age groups as well as gender.


METHODS
Five hundred adolescents aged between 11 and 19 y from Pattanakad ICDS block, of Allapuzha district in Kerala were recruited and assessed using the self-rated Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire to identify symptom clusters of anxiety and this was followed by confirmation of the diagnosis using DSM-IV TR within a week. Anxiety symptom clusters and severity (obtained from continuous SCARED scores) were compared between early, middle and late adolescence subgroups as well as between sexes.


RESULTS
The most predominant anxiety symptoms across the subtypes were the anxious mood, which was noted in 12.60% followed by cognitive symptoms in 9.94% of the cases and finally physical symptoms in 9.22% of the study sample. The symptom clusters varied among the subtypes with anxious mood being commoner in Panic Disorder (PD), cognitive symptoms in Generalised Anxiety Disorder (GAD) and physical symptoms were prominent among Separation Anxiety (SeAD) and Social Anxiety Disorders (SoAD). The severity of anxiety disorder in general and its various subtypes were mostly of mild intensity although significant proportion had a severe form of the disease(s). The severity of the AD among girls was statistically significantly higher than boys (P = 0.02). There was no significant difference on symptom frequency or anxiety severity with regard to age.


CONCLUSIONS
Understanding of age appropriate presentation of anxiety symptoms may help in streamlining the treatment guidelines and yield a better estimate of the disease process.
Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, South India, cdcmkc@gmail.com.
M K C
MK
Nair
Paul Swamidhas Sudhakar
PS
Russell
Raman
R
Krishnan
Sushila
S
Russell
Vinod Shanmukham
VS
Subramaniam
Suma
S
Nazeema
Neethu
N
Chembagam
Babu
B
George
D000293:Adolescent; D000367:Age Factors; D001008:Anxiety Disorders / Q000175:diagnosis*; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006306:Health Surveys; D006801:Humans; D007194:India; D008297:Male; D011569:Psychiatric Status Rating Scales; D012423:Rural Health; D057566:Self Report; D012720:Severity of Illness Index; D012737:Sex Factors; D055815:Young Adult