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Epidemiology and Impact of Health Care Provider–Diagnosed Anxiety and Depression Among US Children

Bitsko, Rebecca, H., PhD*; Holbrook, Joseph, R., PhD*; Ghandour, Reem, M., DrPH, MPA; Blumberg, Stephen, J., PhD; Visser, Susanna, N., DrPH§; Perou, Ruth, PhD; Walkup, John, T., MD

Journal of Developmental & Behavioral Pediatrics: June 2018 - Volume 39 - Issue 5 - p 395–403
doi: 10.1097/DBP.0000000000000571
Original Articles

Objective: This study documents the prevalence and impact of anxiety and depression in US children based on the parent report of health care provider diagnosis.

Methods: National Survey of Children's Health data from 2003, 2007, and 2011–2012 were analyzed to estimate the prevalence of anxiety or depression among children aged 6 to 17 years. Estimates were based on the parent report of being told by a health care provider that their child had the specified condition. Sociodemographic characteristics, co-occurrence of other conditions, health care use, school measures, and parenting aggravation were estimated using 2011–2012 data.

Results: Based on the parent report, lifetime diagnosis of anxiety or depression among children aged 6 to 17 years increased from 5.4% in 2003 to 8.4% in 2011–2012. Current anxiety or depression increased from 4.7% in 2007 to 5.3% in 2011–2012; current anxiety increased significantly, whereas current depression did not change. Anxiety and depression were associated with increased risk of co-occurring conditions, health care use, school problems, and having parents with high parenting aggravation. Children with anxiety or depression with effective care coordination or a medical home were less likely to have unmet health care needs or parents with high parenting aggravation.

Conclusion: By parent report, more than 1 in 20 US children had current anxiety or depression in 2011–2012. Both were associated with significant comorbidity and impact on children and families. These findings may inform efforts to improve the health and well-being of children with internalizing disorders. Future research is needed to determine why child anxiety diagnoses seem to have increased from 2007 to 2012.

*Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA;

Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD;

Division of Health Interview Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD;

§Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO;

Office of the Director, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA;

Department of Psychiatry, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.

Address for reprints: Rebecca H. Bitsko, PhD, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway, MS E-88, Atlanta, GA 30341; e-mail: rbitsko@cdc.gov.

Disclosure: J. Walkup has received free drug/placebo from the following pharmaceutical companies for National Institute of Mental Health–funded studies: Eli Lilly (2003), Pfizer (2007), and Abbott (2005). J. Walkup is a paid speaker of the Tourette Association of America—Centers for Disease Control and Prevention outreach educational programs, the American Academy of Child and Adolescent Psychiatry, and the American Psychiatric Association. J. Walkup also receives grant funding from the Hartwell Foundation and the Tourette Association of America. J. Walkup receives royalties for books on Tourette syndrome from Guilford Press and Oxford Press and for educational materials from Wolters Kluwer. He is also an unpaid advisor to the Anxiety Disorders Association of America, the Trichotillomania Learning Center, and the American Foundation of Suicide Prevention. The remaining authors declare no conflicts of interest. There was no funding for these analyses or writing of the manuscript.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Health Resources and Services Administration.

Received November , 2017

Accepted February , 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.