Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Pediatric Generalized Anxiety Disorder Workup

  • Author: Dennis A Nutter, Jr, MD; Chief Editor: Caroly Pataki, MD  more...
 
Updated: Nov 14, 2014
 

Approach Considerations

Consider urine drug screening (especially with adolescents), thyroid-stimulating hormone level assessment, and less common laboratory tests based on history and physical findings.

Excessive laboratory exclusion of somatic complaints is to be avoided; however, careful interview and physical examination assessment of stress-related symptoms should be repeated if the psychological diagnostic picture is unclear.

Many substances of abuse and even prescribed medications can contribute to anxiety manifestations (eg, stimulants for attention deficit-hyperactivity disorder, beta-2 agonists and corticosteroids for reactive airway disease). Furthermore, both use and/or withdrawal from substances of abuse may contribute to anxiety signs and symptoms.

 
 
Contributor Information and Disclosures
Author

Dennis A Nutter, Jr, MD President and Director, North Georgia Neuropsychiatry, PC

Dennis A Nutter, Jr, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Psychiatric Association

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Acknowledgements

Chet Johnson, MD Professor and Chair of Pediatrics, Associate Director, Developmental Pediatrician, Center for Child Health and Development, Shiefelbusch Institute for Life Span Studies, University of Kansas School of Medicine; LEND Director, University of Kansas Medical Center

Chet Johnson is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Lene Holm Larsen, PhD Instructor, Department of Child and Adolescent Psychiatry, Children's Memorial Hospital of Chicago

Disclosure: Nothing to disclose.

Carrie Sylvester, MD, MPH Senior Child and Adolescent Psychiatrist, Sound Mental Health

Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

References
  1. Barrios BA, Hartmann DB. Fears and anxieties. Marsh EJ, Terdal LG, eds. Behavioral Assessment of Childhood Disorders. 2nd ed. New York, NY: Guilford; 1988. 196-264.

  2. Kendall PC. Childhood Disorders. London, England: Psychology Press; 2000.

  3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.

  4. Last CG, Perrin S, Hersen M, Kazdin AE. A prospective study of childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry. 1996 Nov. 35(11):1502-10. [Medline].

  5. March JS, Parker JD, Sullivan K, Stallings P, Conners CK. The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. J Am Acad Child Adolesc Psychiatry. 1997 Apr. 36(4):554-65. [Medline].

  6. Kendall PC, Chu BC, Pimental SS. Treating anxiety disorders in youth. Kendall PC, ed. Child & Adolescent Therapy: Cognitive-Behavioral Procedures. 2nd ed. New York, NY: Guilford; 2000. 235-87.

  7. Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill JT, et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med. 2008 Dec 25. 359(26):2753-66. [Medline]. [Full Text].

  8. Barrett PM, Dadds MR, Rapee RM. Family treatment of childhood anxiety: a controlled trial. J Consult Clin Psychol. 1996 Apr. 64(2):333-42. [Medline].

  9. Last CG, Hansen C, Franco N. Cognitive-behavioral treatment of school phobia. J Am Acad Child Adolesc Psychiatry. 1998 Apr. 37(4):404-11. [Medline].

  10. Silverman WK, Kurtines WM, Ginsburg GS, Weems CF, Lumpkin PW, Carmichael DH. Treating anxiety disorders in children with group cognitive-behaviorial therapy: a randomized clinical trial. J Consult Clin Psychol. 1999 Dec. 67(6):995-1003. [Medline].

  11. Ginsburg GS. The Child Anxiety Prevention Study: intervention model and primary outcomes. J Consult Clin Psychol. 2009 Jun. 77(3):580-7. [Medline].

  12. McGrath PJ, Lingley-Pottie P, Thurston C, et al. Telephone-based mental health interventions for child disruptive behavior or anxiety disorders: randomized trials and overall analysis. J Am Acad Child Adolesc Psychiatry. 2011 Nov. 50(11):1162-72. [Medline].

  13. Cymbalta (duloxetine) [package insert]. Indianapolis, IN 46285: Lilly USA, LLC. October 29, 2014. Available at [Full Text].

  14. Simon GE, Savarino J, Operskalski B, Wang PS. Suicide risk during antidepressant treatment. Am J Psychiatry. 2006 Jan. 163(1):41-7. [Medline].

  15. Bridge JA, Iyengar S, Salary CB, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA. 2007 Apr 18. 297(15):1683-96. [Medline].

  16. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Elk Grove, Ill: APA; 1987.

  17. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th Edition, Text Revision. 4th ed. Washington, DC: APA Press; 2000.

  18. Keeton CP, Kolos AC, Walkup JT. Pediatric generalized anxiety disorder: epidemiology, diagnosis, and management. Paediatr Drugs. 2009. 11(3):171-83. [Medline].

  19. Manassis K. Keys to Parenting Your Anxious Child. Hauppage, NY: Barron's Educational Series; 1996.

  20. Spence S. Helping Your Anxious Child: A Step-By-Step Guide for Parents. Oakland, Calif: New Harbinger Publications; 2000.

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.