ADad 5: the co-morbidity in Anxiety Disorders among adolescents in a rural community population in India.
OBJECTIVE
Anxiety Disorders (AD) have been known to have high prevalence of intra-AD and extra-AD co-morbidities. This study documents the prevalence and profile of intra and extra-AD co-morbidities, the effect of the presence and number of co-morbidities on the severity of anxiety symptoms and the influence of age as well as gender on the co-morbidity.


METHODS
In a prospective community survey of 500 adolescents, independent raters administered the Screen for Child Anxiety Related Emotional Disorders (SCARED) and Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version (K-SADS-PL) to collect the required data. Descriptive statistics, independent t tests, one-way ANOVA and Chi-square tests were done to evaluate the prevalence and profile of co-morbidity presentation, compare the effect of co-morbidity on severity of anxiety symptoms as well as analyse the influence of age groups and gender on intra-AD co-morbidities.


RESULTS
Among those with AD, 14.2% had a DSM-IV-TR intra-AD co-morbidity and 70% had SCARED based intra-AD co-morbidity. Adolescents with Separation Anxiety Disorder and Generalised Anxiety Disorder had the highest SCARED and DSM-IV-TR prevalence of intra-AD co-morbidity respectively. Also, 23.7% had overlapping extra-AD co-morbidity. Presence and number of intra-AD co-morbidity was significantly associated with severity of total anxiety score and subscale scores (all with P = 0.001). Age and gender of adolescents were not related to the co-morbidity.


CONCLUSIONS
Intra and extra-AD co-morbidities are quite prevalent among adolescents with Anxiety Disorders in India. As such, co-morbidities increase the severity of anxiety symptoms, they should be identified and appropriate management should be established.
Child and Adolescent Psychiatry Unit, Christian Medical College, Vellore, 632 002, Tamil Nadu, South India, russell@cmcvellore.ac.in.
Paul Swamidhas Sudhakar
PS
Russell
M K C
MK
Nair
Priya
P
Mammen
Neethu
N
Chembagam
K S
KS
Vineetha
Satya Raj
SR
Shankar
Suma
S
Nazeema
Babu
B
George
D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006306:Health Surveys; D006801:Humans; D007194:India / Q000453:epidemiology; D007407:Interviews as Topic; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012423:Rural Health / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D055815:Young Adult