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Key takeaways:
- The likelihood of a child with anxiety receiving medication but not therapy during office visits significantly increased over time.
- Symptoms are being recognized and diagnosed in clinical settings.
A study found an increase in children diagnosed with anxiety during office visits in a recent 12-year period but a decrease in the proportion of office visits that included therapy, according to results published in Pediatrics.
At the same time, there was no change in the proportion of patients receiving medication.
“This meant that more patients were receiving medication that wasn’t combined with therapy,” Laura J. Chavez, PhD, MPH, a data scientist at Nationwide Children’s Hospital and assistant professor of pediatrics at The Ohio State University College of Medicine, told Healio. “We know that patients have the best outcomes when therapy is combined with medications.”
According to Chavez, anxiety disorder symptoms are increasing among children in the United States, which is in the midst of a mental health crisis.
“Anxiety disorders are among the most common mental health conditions of childhood,” Chavez said. “We were interested in understanding whether the prevalence of anxiety disorder diagnosis has changed and whether the treatment of these conditions has changed among children, adolescents and young adults.”
Chavez and colleagues used data from the National Ambulatory Medical Care Survey to examine anxiety disorder diagnosis. They focused on four treatment categories: therapy alone, therapy and medications, medications alone, or neither. These were then cataloged across periods ranging from 2006 to 2009, 2010 to 2013 and 2014 to 2018.
The researchers found that the proportion of pediatric office visits that included a diagnosis of anxiety disorder increased from 1.4% during 2006 to 2009 to 4.2% during 2014 to 2018. At the same time, the proportion of visits with any therapy decreased from 48.8% to 32.6%.
Although there was no change in the proportion of visits receiving medication, the absolute number of children and youth receiving medications did increase, meaning that more patients were receiving either no treatment or only medication during the 2014 to 2018 period.
“I think this really shows that the burden for treating mental health conditions among young patients is growing,” Chavez said. “But even when patients are able to successfully navigate the health care system and attend a visit with a physician in an office setting, they may not be able to get the treatment that they need. Office-based physicians need more support so that patients don’t leave without getting the help that they need.”
Although the researchers observed changes in treatment and practice, they do not know the causes for the changes, Chavez cautioned.
“It will be important to continue to evaluate these trends moving forward to see if the trends we observed continued, or even worsened, since 2020,” Chavez said. “It could be driven by many factors, including patient preferences or provider training for treatment of mental health conditions, or lack thereof. An area for future study could be to unpack what is driving these changes in treatment practice.”
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