Anxiety disorders in children and adolescents

Anksiozni poremećaji pripadaji među najčešće mentalne poremećaje u dječjoj i adolescentnoj dobi. Temeljno obilježje ovih poremećaja je razvojno neprimjerena razina anksioznosti i strahova koji ometaju normalno funkcioniranje djeteta. Važno je dječje strahove promatrati u kontekstu razvojnih procesa. Prevalencija anksioznih poremećaja kod djece kreće se od 10 % do 20 %. Zastupljeni su u oba spola, iako se češće javljaju kod djevojčica i to nakon šeste godine života. Pravodobno otkrivanje i liječenje dječje anksioznosti može smanjiti negativni utjecaj koji ovi poremećaji ostavljaju na daljni razvoj te na školsko, obiteljsko i socijalno funkcioniranje djece i mladih. Često dolaze u komorbiditetu s ostalim psihijatrijskim poremećajima, ali i drugim anksioznim poremećajima. Manifestiraju se čitavim spektrom najrazličitijih promjena emocionalnim, kognitivnim, bihevioralnim i tjelesnim simptomima. Multifaktorskne su etiologije, nastaju djelovanjem različitih biologijskih, genetskih, psihološkh i socijalnih čimbenika. U liječenju anksioznih poremećaja najbolje rezultate daje kombinirani tretman koji se temelji na kognitivno-bihevioralnoj terapiji (KBT) i farmakoterapiji. Kognitivna terapija otkriva i mijenja negativne automatske misli, pogrešna bazična vjerovanja, pretpostavke i iskrivljena mišljenja. Bihevioralne tehnike imaju za cilj promjenu ponašanja. U novije vrijeme uvodi se i terapija temeljena na usredotočenoj svjesnosti (engl. mindfulness based therapy). Od lijekova najčešće se primjenjuju selektivni inhibitori ponovne pohrane serotonina koji su prva linija terapije i dokazano su najučinkovitiji kod anksioznih poremećaja. Prognoze su najbolje ako se tretmanom krene što prije te osim samog djeteta u planiranje i provođenje terapijskog tretmana uključe roditelji odnosno skrbnici djeteta.Anxiety disorders are one of the most common mental disorders when it comes to children and adolescents. The core feature of these disorders is a level of anxiety and fears that is not appropriate for that stage of development of a child which leads to anxiety disorders having a significant impact on disrupting daily activities of a child. It is important to monitor children’s fears within the context of their development. Estimations show that approximately 10 to 20 % of all children develop some kind of anxiety disorders. They are present in children of both sexes, although some anxiety disorders have been shown to be more frequent in girls. Anxiety disorders can be diagnosed after the age of six. Early discovery and proper treatment can significantly help with the possible negative effects these disorders have on social and family life as well as on a child’s performance in school. Anxiety disorders are conditions comorbid with other psychiatric disorders and other anxiety disorders. Anxiety is manifested in the form of bodily, psychological, cognitive and behavioural changes. When it comes to etiology, a variety of factors are present, with the causes of anxiety disorders still not fully known, but both psychiatric and general medical factors are involved. Clinical studies, as well as every-day practice, have shown that utilization of cognitive-behavioural therapy (CBT) combined with prescription medication yields the most effective results. Cognitive therapy bases its approach on identifying and replacing negative thinking patterns and behaviours with positive ones, while behavioural techniques aim to change behavioural patterns in children with anxiety disorders. Nowadays, mindfulness-based cognitive therapy is also used to treat anxiety. Selective serotonin reuptake inhibitors (SSRIs) are the first choice when it comes to medication therapy as they have been repeatedly to be the most effective treatment choice for anxiety disorders. When diagnosed early and using proper treatment, anxiety disorders can be reduced to a minimum as not to cause any damage to the child’s life. It is crucial for the success of the treatment for parents or guardians to be heavily involved in all stages of treatment of the disorder, from planning to practicing techniques proposed by the physician