Abstract
Objective: Youth with chronic medical conditions (CMCs) have been reported to be at increased risk for developing anxiety disorders. Importantly, suffering from anxiety may also have an impact on their disease-related outcomes. This study set out to systematically review the literature on anxiety and seven CMCs (asthma, congenital heart disease, diabetes, epilepsy, inflammatory bowel disease, juvenile idiopathic arthritis, and sickle cell disease) among youth. Method: A systematic review was performed according to the PRISMA statement. Searches were conducted across PubMed, PsycNET, Embase, and reference lists of the included studies (1990–2018). Three independent reviewers screened titles and abstracts and conducted full-text assessment. Studies were included if they reported the prevalence of anxiety or the association of anxiety on disease-related outcomes in children and/or adolescents with the focal CMCs. Results: A total of 53 studies met the predetermined inclusion criteria. Across the CMCs, the prevalence of anxiety disorder was increased in youths with CMCs compared to the general population. Evidence for a relationship between anxiety and adverse disease-related outcomes was limited. For asthma, inflammatory bowel disease, and sickle cell disease, there was some evidence indicating that anxiety was associated with adverse outcomes; supported by two longitudinal studies, one in asthma and one in inflammatory bowel disease. For diabetes, results were inconsistent; with some studies indicating that anxiety was associated with worse and others with better treatment adherence. Conclusion: The prevalence of anxiety disorders in youth with CMCs is higher than that in the general population. Anxiety may also be associated with adverse disease-related outcomes for youths, but it is not possible to draw definitive conclusions. Longitudinal studies making use of parent/youth composite anxiety measures and a combination of parent/youth reported and objective measures of disease-related outcomes are needed. Given the burden of disease of anxiety disorders, regardless of the impact on the disease outcomes, screening for and treatment of anxiety is recommended in youths with CMCs.
| Original language | English |
|---|---|
| Pages (from-to) | 595-618 |
| Number of pages | 24 |
| Journal | Journal of the American Academy of Child and Adolescent Psychiatry |
| Volume | 59 |
| Issue number | 5 |
| Early online date | 30 Oct 2019 |
| DOIs | |
| Publication status | Published - May 2020 |
Funding
Dr. Scott is supported by a National Health and Medical Research Council Practitioner Fellowship Grant APPl 105807. Dr. Middeldorp has received funding from the European Union's Horizon 2020 research and innovation programme, Marie Sklodowska Curie Actions—MSCA-ITN-2016—Innovative Training Networks under grant agreement no. 721567. Disclosure: Dr. Cobham is the first author of Fear-Less Triple P, an intervention within Triple P—the Positive Parenting Program, which is developed and owned by The University of Queensland (UQ). Royalties are also distributed to the Faculty of Health and Behavioural Sciences at UQ and contributory authors of published Triple P resources. Triple P International (TPI) Pty Ltd. is a private company licensed by Uniquest Pty Ltd. on behalf of UQ, to publish and disseminate Triple P worldwide. She has no share or ownership of TPI. She may in the future receive royalties and/or consultancy fees from TPI. TPI had no involvement in the study design, collection, analysis, or interpretation of data, or writing of this report. Drs. Thomas, Scott, and Middeldorp and Mss. Hickling and Kimball have reported no biomedical financial interests or potential conflicts of interest.
| Funders | Funder number |
|---|---|
| MSCA-ITN-2016 | 721567 |
| Pty Ltd. | |
| Uniquest Pty Ltd. on behalf of UQ | |
| H2020 Marie Skłodowska-Curie Actions | |
| HORIZON EUROPE Marie Sklodowska-Curie Actions | |
| National Health and Medical Research Council | APPl 105807 |
| University of Queensland | |
| Horizon 2020 |
Keywords
- anxiety
- illness
- medical
- physical
