title: Preschool anxiety disorders in pediatric primary care: prevalence and comorbidity.
abstract: OBJECTIVE
  We sought to establish prevalence rates and detail patterns of comorbidity for generalized anxiety disorder, separation anxiety disorder, and social phobia in preschool-aged children.
  
  
  METHODS
  The Duke Preschool Anxiety Study, a screen-stratified, cross-sectional study, drew from pediatric primary care and oversampled for children at risk for anxiety. A total of 917 parents of preschool children (aged 2-5 years) completed the Preschool Age Psychiatric Assessment.
  
  
  RESULTS
  Generalized anxiety disorder, separation anxiety disorder, and social phobia are common in preschool-aged children attending pediatric primary care. Three-fourths of preschoolers with an anxiety disorder only had a single anxiety disorder. Generalized anxiety disorder displayed the greatest degree of comorbidity: with separation anxiety disorder (odds ratio [OR] = 4.1, 95% CI = 2.0-8.5), social phobia (OR = 6.4, 95% CI = 3.1-13.4), disruptive behavior disorders (OR = 5.1, 95% CI = 1.6-15.8), and depression (OR = 3.7, 95% CI = 1.1-12.4).
  
  
  CONCLUSIONS
  The weakness of association between generalized anxiety disorder and depression stands in contrast to substantial associations between these 2 disorders reported in older individuals. Attenuated associations in preschool-aged children could translate into clinical opportunities for targeted early interventions, aimed at modifying the developmental trajectory of anxiety disorders.
authors.affiliation: Center for Developmental Epidemiology, Duke University Medical Center. Electronic address: lauren.franz@dm.duke.edu.
authors.forename: Lauren
authors.initials: L
authors.lastname: Franz
authors.forename: Adrian
authors.initials: A
authors.lastname: Angold
authors.forename: William
authors.initials: W
authors.lastname: Copeland
authors.forename: E Jane
authors.initials: EJ
authors.lastname: Costello
authors.forename: Nissa
authors.initials: N
authors.lastname: Towe-Goodman
authors.forename: Helen
authors.initials: H
authors.lastname: Egger
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology*; D001010:Anxiety, Separation / Q000453:epidemiology*; D002662:Child Health Services / Q000706:statistics & numerical data; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000453:epidemiology*; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*
keywords: comorbidity; pediatric primary care; preschool anxiety disorders; prevalence