Epidemiology and Impact of Health Care Provider-Diagnosed Anxiety and Depression Among US Children.
Rebecca H Bitsko, Joseph R Holbrook, Reem M Ghandour and 4 others
PMID 29688990WHAT IT FOUND
Diagnosed anxiety in US children rose significantly from 2007 to 2012, but depression did not.
Many children with these diagnoses still lack a medical home or care coordination. This suggests a need to screen for anxiety in children with other conditions and improve care navigation.
Key findings
01Current anxiety diagnoses increased 19% from 2007 to 2011-2012, while current depression diagnoses did not change significantly.
02Children with anxiety or depression were less likely to have a medical home or effective care coordination compared to children with other chronic health conditions.
03Approximately 25% of children with anxiety or depression did not receive mental health treatment or counseling in the past year.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Diagnoses were based on parent report of what a provider told them, which relies on access to care, accurate communication, and parental recall. The survey is cross-sectional, so it cannot determine causality or whether the increase in diagnoses reflects true prevalence or better identification. Survey methodology changed over time (e.g., separating anxiety and depression questions after 2003), which may bias trend comparisons. Response rates declined over time, and cell-only households were only included in the final wave, potentially affecting representativeness. The study did not capture specific types of anxiety disorders or the severity of impairment in daily life beyond broad indicators.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume the rise in diagnosed anxiety reflects an actual increase in anxiety symptoms. The authors note this may be due to improved identification or increased service use, not a change in the underlying condition. Also, do not interpret the lack of change in depression diagnoses as a sign that depression is stable; the survey method for depression may have different sensitivities.