title: Longitudinal patterns of anxiety from childhood to adulthood: the Great Smoky Mountains Study.
abstract: OBJECTIVE
  The aims of this study were 2-fold: to provide a brief introduction to the prospective longitudinal Great Smoky Mountains Study and review recent findings; and to use this sample to conduct an epidemiologic analysis of common childhood anxiety disorders.
  
  
  METHODS
  The population-based Great Smoky Mountains Study assessed 1,420 participants from 11 counties in the southeastern United States up to 11 times between ages 9 and 26 years with the structured Child and Adolescent Psychiatric Assessment and its upward extension, the Young Adult Psychiatric Assessment.
  
  
  RESULTS
  The U-shaped age prevalence curve for any anxiety disorder was the product of high levels of childhood separation anxiety and adult panic, agoraphobia, and generalized anxiety. More than 1 in 5 subjects met criteria for an anxiety disorder by early adulthood. In terms of cumulative comorbidity, there was evidence of overlap between anxiety disorders, but the level of overlap was generally consistent with what is seen among other common childhood disorders. All childhood anxiety disorders were associated with adverse functioning in at least 1 young adult functional domain, with the poorest outcomes for childhood generalized anxiety and DSM-III-R overanxious disorder.
  
  
  CONCLUSIONS
  Clinically significant anxiety is a common mental health problem to have had by adulthood. There was little evidence to support the consolidation of anxiety disorders, and some evidence to justify reintroduction of DSM-III-R overanxious disorder. The transition to young adulthood appears to be a key period for understanding the development of common adult anxiety disorders such as panic and agoraphobia.
authors.affiliation: Duke University Medical Center. Electronic address: William.Copeland@duke.edu.
authors.forename: William E
authors.initials: WE
authors.lastname: Copeland
authors.affiliation: Duke University Medical Center.
authors.forename: Adrian
authors.initials: A
authors.lastname: Angold
authors.affiliation: University of North Carolina at Chapel Hill.
authors.forename: Lilly
authors.initials: L
authors.lastname: Shanahan
authors.affiliation: Duke University Medical Center.
authors.forename: E Jane
authors.initials: EJ
authors.lastname: Costello
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology*; D002648:Child; D006803:Human Development / Q000502:physiology*; D006801:Humans; D055815:Young Adult
keywords: anxiety; comorbidity; development; epidemiology; longitudinal