More kids getting anxiety medication without therapy: Research

If children and adolescents get help for an anxiety disorder, it’s usually medications and not counseling according to a study published Wednesday in Pediatrics.

In fact, there was an inverse relationship between need for therapy and what was given over more than a decade. As the number of young people with anxiety disorders has risen steadily since 2006, the number of children undergoing psychotherapy has decreased.

“This really demonstrates that the burden of treating mental health conditions among patients is growing,” said study author Laura Chavez, a senior research scientist in the Center for Child Health Equity and Outcomes Research at Nationwide Children’s Hospital in Columbus, Ohio.

“Even when they’re able to navigate the healthcare system and visit a doctor in an office setting, they may not get the care they need,” she said.

There are several possible reasons, including stigma and lack of access to pediatric therapists, according to the Child Mind Institute.

Chavez and his research team looked at data representing 46.4 million pediatric outpatient visits from 2006 to 2018. They divided those outpatient visits into blocks of time: 2006-2009, 2010-2013, and 2014-2018.

The term “outpatient visits” included pediatrician’s offices, family medicine providers, and a variety of different outpatient care facilities.

Those visits for anxiety disorders tripled, from 1.4% during the first time period studied, to 4.2% during the last time period.

This finding echoes many other studies showing a dramatic increase in the mental health conditions of young people.

Overall, approximately 5.8 million children in the United States were diagnosed with an anxiety disorder in 2019, according to the Centers for Disease Control and Prevention.

Last year, the influential US Preventive Services Task Force recommended that 8-year-olds be screened for anxiety. As the new report ends in 2018, it’s possible that increased screening could result in even more children being prescribed drugs.

Advised

But as the need for care has increased, Chavez’s study indicates that the need is not being met, at least with therapy.

The percentage of doctor visits for anxiety that included medication decreased from 48.8% during the first study period to 32.6% during the last study period.

But the proportion of anxiety medication prescribed during these visits has held steady over time, at around 60%.

This means that the number of children to whom doctors have prescribed only one drug, without therapy, has increased.

That’s a real problem, said Janine Domingues, a psychologist at the Child Mind Institute’s Center for Anxiety Disorders.

“The reason we don’t just recommend medication alone, particularly with children and adolescents,” she said, “is because we know that skills learned through therapy are an important addition.”

Lessons learned through therapy, she said, can help young people find ways to deal with or overcome their anxiety.

“Not only do we want to see children who don’t have anxiety symptoms, we also want to see them functioning, going to school, having friends,” Domingues said.

Symptoms Of Anxiety In Children:

According to the CDC, signs of anxiety disorder in children include:

• Being very afraid away from parents or regular caregivers.
• Being overly concerned about something bad happening in the future.
• Having extreme fears about a specific thing or situation, such as dogs, spiders, or going to school.

These fears can be felt physically, as well as manifest in trouble sleeping, headache, stomach pain, rapid heartbeat, dizziness, and feeling shaky or sweating.

But with the availability of mental health services declining in many areas, Chavez said, the research highlights the need to enlist more support from pediatricians and other doctors caring for children in need.

“We really need to think carefully about how we can empower doctors in the office so they can take better care of their patients,” she said. “We don’t want to see so many missed opportunities for these patients to get the care they need.”

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