ADad 6: the predictive factors for Anxiety Disorders among adolescents in a rural community population in India

Prevalence and determinants of anxiety disorders among adolescents in a rural community from northern India

INTRODUCTION

There is scarce data available on community based prevalence of Anxiety Disorders (ADs) amongst adolescents in north Indian settings.

OBJECTIVE

To determine the prevalence of anxiety disorders, and associated factors amongst adolescents in a rural community of Ballabgarh block, district Faridabad, Haryana.

METHODS

Participants (10-19 years) were enrolled through simple random sequence from a sampling frame of adolescents residing in 28 villages of Ballabgarh block using household survey technique. They were screened using Screen for Childhood Anxiety Related Emotional Disorders (SCARED) tool and then subjected to confirmatory diagnosis using Mini-International Neuropsychiatric Interview for Children/Adolescent (MINI KID). All adolescents with ADs were assessed for co-psychiatric morbidities using MINI-KID and functional impairment using Children Global Assessment Scale (CGAS). Prevalence and 95% Confidence intervals are reported. Additionally, socio-demographic factors were elicited using a semi-structured interview schedule and associations were determined using multivariable logistic regression analysis.

RESULTS

A total of 678 adolescents participated in this study with mean age (SD) as 14.2 (2.5) years. The age adjusted prevalence of anxiety disorders was found to be 16.6% (95% CI: 16.0-17.2). The most prevalent anxiety disorder among participants was social anxiety disorders followed by specific phobias. Female sex and low socio-economic status were associated with anxiety disorders. Two third of adolescents with ADs had no functional impairment and almost one third were found to have one or more co-existing psychiatric co-morbidity.

CONCLUSION

We found a high prevalence of ADs in rural north Indian community settings warranting adequate health system response at primary care level.

Anxiety Disorders among Adolescents in a Rural Area of Northern India using Screen for Child Anxiety-Related Emotional Disorders Tool: A Community-based Study

Background

Anxiety disorders are the most frequent mental disorders encountered in childhood and adolescent years. The number of epidemiological studies done in this area within India is limited.

Objectives

We determined the prevalence of anxiety disorders among adolescents in a rural community of Ballabgarh block, district Faridabad, Haryana. Secondarily, we also assessed sociodemographic and other factors associated with anxiety disorders among adolescents.

Materials and Methods

This community-based cross-sectional study was conducted among 729 adolescents (10-19 years). Screen for Child Anxiety-Related Emotional Disorders tool was used for assessing prevalence and type of anxiety disorders. Sociodemographic and personal factors were included in the logistic regression multivariable model to establish associations. Adjusted odds ratios (AOR) along with 95% confidence intervals (CI) are computed.

Results

The prevalence of anxiety disorders among adolescents was (22.7%; 95% CI: 19.7-26.0). Girls (27.6%) had higher prevalence than boys (18.3%) (P < 0.01). Social anxiety disorder (14.3%; 95% CI: 11.7-16.9) was the most common form of anxiety disorder. Female sex (AOR 1.8; 95% CI 1.2-2.6; P < 0.01), lower-middle socioeconomic status (AOR 1.96; 95% CI 1.2-3.1; P < 0.01), and presence of stressful event within the past 1-year (AOR 2.48; 95% CI: 1.12-5.06; P = 0.01) were found to be associated with the presence of anxiety disorders.

Conclusions

Anxiety disorders are common among adolescents in rural settings of India. Tackling them will require appropriate health systems response. Adequate interventions should be incorporated at primary care level to address the mental health concerns of adolescents.

Prolonged rooming-in in infancy is associated with generalized anxiety disorder in the adolescent period

OBJECTIVE

This study aims to investigate whether anxiety disorders in adolescents have a link with the separation time of bed/bedroom sharing with parents. It also aims to raise awareness in society about the issue of minimizing anxiety disorders in childhood.

METHODS

A case-control study was conducted in Şevket Yılmaz Training and Research Hospital between June 2013 and May 2014. The participants included 51 adolescents who were diagnosed as generalized anxiety disorder (GAD) with no-comorbidity and 71 healthy adolescents as the control group, who were chosen randomly. Diagnosis of GAD was based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed) by child and adolescent psychiatry doctors. The Turkish version of the State-Trait Anxiety Inventory (STAI) was used for the control group. A special survey about demographics and bed-sharing statements was constructed for the purpose of the study. The groups were analyzed in terms of duration of co-sleeping (bed-sharing) and rooming-in (keeping the mother and the baby in same room) with parents during infancy and the development of anxiety disorders in later period.

RESULTS

Mean duration of rooming-in was significantly longer in the case group than in the control group (p=0.009). Similarly, mean duration of co-sleeping in the case group was longer than that of the control group. However, this difference was not statistically significant (p=0.529).

CONCLUSION

Sleeping in the same room with children for a long time may result in anxiety disorders in later period due to possible difficulties in bonding and/or less self-confidence.

CDC Kerala--The Untold Story

This article is our life time experience in conceptualizing and systematically developing Child Development Centre (CDC) Kerala in the last 25 years, from a research project to a national training centre in child and adolescent development and premarital counseling. CDC Kerala's major contribution was in creating a 'conceptual framework' of a valid link between childhood disability, low birth weight, adolescent girls' nutrition and fetal onset adult lifestyle diseases. It all started with a randomized controlled trial (RCT) proving beyond doubt that early stimulation is effective in improving the neurodevelopmental status of high risk babies at one and two years and the same cohort was followed-up in detail at 5, 13, 16, 19 and 24 completed years. The process of establishing CDC Kerala is being presented under (i) clinical child development, (ii) adolescent care counseling, (iii) young adults and premarital counseling and (iv) institution building.