Clinical and autonomic functions: a study of childhood anxiety disorders

BACKGROUND AND OBJECTIVES: Childhood and adolescent anxiety is generally associated with a varied somatic symptom pattern thought to reflect autonomic system activity. Few studies have examined the autonomic characteristics of generalized anxiety disorder (GAD). This omission is at odds with contemporary models of autonomic cardiovascular control. The current study aimed to find differences in autonomic functions between children with a diagnosis of childhood anxiety disorder and a control group using a case-control design. DESIGN AND SETTING: A cross sectional experimental study conducted in the years 2004-2005 in the psycho-physiology lab of a tertiary care multi-speciality teaching hospital. METHODS: Assessments were carried out using a semistructured interview, K-SADS (Schedule for Affective Disorders and Schizophrenia for Children and Adolescents); STAIC (State and Trait Anxiety Inventory for Children); CDRS (Childhood Depression Rating Scales); SCARED (Self-Report for Childhood Anxiety–Related Disorders). Autonomic reactivity was tested using the standard battery of tests. RESULTS: There were differences between 34 children and adolescents (age range, 8-18 years) with a diagnosis of childhood anxiety disorder and a control group of 30 age- and sex-matched subjects from a nearby school in autonomic activity and reactivity between individuals with anxiety disorder and non-anxious control subjects. Our finding is suggestive of autonomic rigidity or diminished physiologic flexibility in children with anxiety disorder CONCLUSIONS: The study is probably the first of its kind to look into the issue in detail using a detailed battery of the autonomic function tests, and the results are of help in better understanding the condition. The result of the present experiment supports differences in autonomic activity and reactivity between individuals with anxiety disorder and non-anxious control subjects.