Parents With Anxiety Disorders Are Likely to Have Children With Such Disorders

Paula Moyer, MA

June 03, 2006

June 3, 2006 (Toronto) -- Children who have a parent with an anxiety disorder are highly likely to develop an anxiety disorder themselves, according to investigators who presented their findings here at the 159th annual meeting of the American Psychiatric Association. In particular, children who already have separation anxiety have a high risk of developing several anxiety disorder subtypes.

"We recruited a high-risk sample and followed them prospectively for 5 years," said principal investigator Joseph Biederman, MD. "When we see separation anxiety, we need to pay attention and be aware of opportunities to intervene and prevent the development of anxiety disorders." Dr. Biederman is a professor of psychiatry at Harvard Medical School in Boston, Massachusetts, where he is chief of the Clinical Research Program in Pediatric Psychiatry and Adult ADHD.

Dr. Biederman and coinvestigators wanted to know whether children at high risk for panic disorder are on developmental trajectories that would lead to the development of pediatric panic disorder. Because earlier studies had shown that separation anxiety disorder would be a potent predictor of subsequent panic disorder in children at risk, they wanted to see if it were a predictor in these offspring.

Therefore, the investigators analyzed data from their large, 5-year, longitudinal follow-up study of children who had been classified as being at high and low risk for panic disorder. Children who had had separation anxiety as infants were defined as being at high risk. The investigators compared the course of psychiatric disorders in offspring of parents with panic disorder. A total of 95 parents with panic disorder were included and 186 offspring.

Among the offspring, 120 of the high-risk offspring of parents with panic disorder (65%) had at least 1 anxiety disorder, and 86 (46%) had 2 or more anxiety disorders. The 74 children with separation anxiety had a higher risk for several disorders: The odds ratios (ORs) were 4.8 for panic disorder ( P = .006), 2.7 for agoraphobia ( P = .02), 2.7 for general anxiety disorder (GAD; P = .01), and 2.8 for major depressive disorder ( P = .006). The 48 offspring with agoraphobia had an OR of 5.9 compared with the overall group ( P = .008). The 47 offspring of parents with GAD had an OR of 2.4 for developing panic disorder ( P = .003).

"The findings of this study provide compelling evidence for divergent risks conferred by specific anxiety disorders in childhood," the investigators reported. "The findings further suggest that the risk for panic disorder is heterogeneous, and that separation anxiety disorder may help identify a group of children at very high risk for a wide range of adverse psychopathological outcomes."

An expert in child and adolescent anxiety disorders agreed that the findings will help psychiatrists manage at-risk patients more effectively, and be more aware of which patients may be more vulnerable to developing anxiety disorders.

"The results of this study are consistent with previous findings," David Fassler, MD, told Medscape. "Anxiety disorders clearly run in families, and children of parents with anxiety disorders have an increased genetic predisposition to develop the same or related disorders. This study helps identify a subset of children who may be at particular risk." Dr. Fassler is a clinical professor of psychiatry at the University of Vermont College of Medicine in Burlington.

He stressed that the investigators' findings "have the potential to enhance early recognition of anxiety disorders." Further, knowing about the confluence of these risks "may also lead to new strategies designed to reduce the risk of anxiety disorders in children with a known family history."
The study was funded by a grant from the National Institute of Mental Health.

APA 159th Annual Meeting: Abstract NR630. Presented May 24, 2006.

Reviewed by Elizabeth Saenger, PhD

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