Hemaila Tariq, MD1, Aemen Bazaz, MBBS2, Fauzia Cheema, MBBS3, Danish Saifullah, MBBS4, Arham Javaid, MBBS5, Husnain Cheema, MD6, Humna Ellahi ,MD7, Muhammad Umar Azam, MD8

1 Aga Khan University, Karachi, Pakistan, 2 Rawalpindi Medical University, Rawalpindi, Pakistan, 3 Psychiatry Department, Mayo Hospital, Lahore, Pakistan, 4 Rawalpindi Medical University, Rawalpindi, Pakistan, 5 Allama Iqbal Medical College, Lahore, Pakistan, 6 Punjab Institute of Mental Health, Lahore, Pakistan, 7 Lahore General Hospital, Lahore , Pakistan, 8 Brookdale Hospital, New York, USA

Background:

Anxiety disorders tend to co-occur with depression and literature suggests that the comorbidity between the two is more prevalent among children and adolescents1. Comorbidity rates in youth are estimated to be 20-50%2. Comorbid anxiety and depression is associated with symptom severity, poor prognosis, poor response to treatment, and increased risk of suicide among youth. The purpose of this study is to assess the prevalence and management of comorbid anxiety and depression in children/adolescents.

Material(s) and Method(s):

We searched databases Pubmed and Google Scholar. We reviewed 33 articles and included 5 in this review. Systematic review involving 115 articles published between 1987 and 20151. Analysis of data from the 2016 National Survey of Children’s Health to estimate prevalence of depression, anxiety and behavioral issues among children2. Randomized controlled trial conducted to assess efficacy of the transdiagnostic program, EMOTION among children between 8-12 years3. Randomized controlled trial assessing the impact of 12 sessions of CBT on symptoms4. Assessment of the psychometric properties of the Revised Child and Adolescent Scales5.

Result(s):

Comorbidity between anxiety and depression was supported by literature1. In spite of the high symptom severity, there is less understanding about the exact pathophysiology and neurobiology of comorbid anxiety and depression. This is complicated by a lack of a dimensional, evidence-based assessment, which causes inadequate diagnosis and management. Among children aged 3-17, 7.1% had current anxiety while 3.2% had current depression2. The intervention had twice the reduction in symptoms compared to the control3. The effectiveness of CBT was demonstrated4. The Revised Child and Adolescent Scale is a reliable screening tool5.

Conclusion(s):

The literature suggests that comorbid anxiety and depression is common amongst children and adolescents. Further research to understand their pathophysiology and develop diagnosis strategies is necessary for effective treatment.