Anxiety Disorders in Williams Syndrome Contrasted with Intellectual Disability and the General Population: A Systematic Review and Meta-Analysis.
R Royston, P Howlin, J Waite and 1 others
PMID 27696186WHAT IT FOUND
Williams syndrome anxiety was common: 48% had at least one anxiety disorder, mostly phobias of noise and blood/injury.
Rates exceeded intellectual disability and general population estimates. This reports how common anxiety was, not whether treatment works.
Key findings
01In the pooled Williams syndrome studies, 48% of participants had at least one anxiety disorder (95% CI 26.0 to 70.0).
02Compared with heterogeneous intellectual disability, Williams syndrome had higher risk for any anxiety disorder (risk ratio 4.00) and specific phobias (risk ratio 5.57).
03Specific phobias were the most common anxiety disorder (quality-effects 39%), and noise was the most frequently reported top-three phobia (n=6).
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The 1055 participants counted across studies were reduced to 391 unique participants after overlapping cohorts were removed, so the effective sample is small. No study used random or total population sampling, and 37.5% recruited from clinical settings, which may inflate anxiety rates. Williams syndrome and intellectual disability groups were not matched for age, cognitive level, or other characteristics, so group differences may not be comparable. Anxiety measures and diagnostic classifications varied, and 11 studies relied only on caregiver interviews. Confidence intervals were wide, so the 48% estimate is imprecise. Noise fears may reflect hyperacusis and painful sound sensitivity rather than an irrational phobia, so specific phobia rates may be overestimated. Adults were underrepresented, and the comparison intellectual disability review mainly included children and adolescents.
The easy way to misread this
Do not read the 48% estimate as a precise population rate or as evidence that treatment works. It came from 391 unique participants in studies that often recruited from clinical or research sites, and the confidence interval was wide.