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Study: More youths with anxiety getting medication without therapy

June 7, 2023

More youths and young adults are being diagnosed with anxiety in outpatient offices, while a smaller proportion are receiving therapy, according to a new study.

“The reduction in therapy during office visits and the greater reliance on medications for anxiety disorders may reflect growing resource constraints in office settings in the context of a child and youth mental health crisis that has been building over time,” authors wrote in “Trends in Office-Based Anxiety Treatment among U.S. Children, Youth, and Young Adults: 2006-2018,” (Chavez LJ, et al. Pediatrics. June 7, 2023).

Researchers analyzed nationally representative data on ambulatory care office visits from 2006-’18, which they divided into three time periods. Patients ranged in age from 4-24 years.

Data showed about 4.2% of office visits in the most recent period had an anxiety disorder diagnosis, up from 1.4% in the earliest period. Diagnosis rates rose from 2.5% to 7.1% among young adults and from 1.4% to 4.6% for adolescents. Children’s rates increased just slightly from 0.6% to 1.5%.

About 62% of patients in the most recent period received medications, about the same as previous years, with the most common being selective serotonin reuptake inhibitors. However, the rate of those receiving therapy dropped from 48.8% to 32.6%. The proportion receiving any treatment (therapy or medication) decreased from 79.7% to 70.7%.

Authors said clinicians may have had to forego therapy as a treatment as they tried to keep up with the growing number of diagnoses. Prescribing incentives and preferences also may have played a role in medication use.

“Findings from the current study identify a gap in the quality of care for patients with anxiety disorders, which could worsen with increasing prevalence of anxiety,” they wrote. “If the volume of children and adolescents with anxiety disorders continues to increase, the health system … would be further taxed.”

The study data do not include the COVID pandemic. Numerous studies have found youth mental health struggles were exacerbated during this time. In 2021, the AAP and its partners declared a national emergency in children’s mental health, and the surgeon general released an advisory on youth mental health challenges.



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