The Epidemiological Investigation Of Anxiety Disorders In Urban And Rural Primary And Middle School In Changsha

Objective: To explore the characteristics and prevalence of anxiety disorders in rural and urban primary school and middle school in Changsha and the risk factors of anxiety disorders, and provide basis for interventive measures.Methods: Using a two-phase design, 2561 cases of students age 5-17 years old were assessed for DSM-IV diagnoses using the Kiddy Schedule for affective diseases and schizophrenia (K-SADS-PL). FACESII-CV(Family Adaptability and Cohension Scale, Second Edition-Chinese version), SCARED (The Screen for Child Anxiety Related Emotional Disorders) , CSCS (Children's self-concept Scale Children's self-concept Scale, EMBU (Egma Minnen av Bardndosna Uppforstran) were completed by children with anxiety disorders and controls. And their parents completed general data questionnaire, CBCL (Child Behavior Checklist), PLOC (The Parenting Locus of Control Scale). Conbined Raven'Test (CRT) and achievement test were used in children with suspicious diagnoses as learning disorder, mental retardation or pervasive developmental disorder. Foxpro 6.0 was used in setting up database. Single variable analyses and multiple-variables analyses were analysed by SPSS 11.5 version for Windows.Results: 1. The prevalence rate of anxiety disorders was 3.51%(male 3.72%,female 3.37%;rural 3.96%, urban 3.18%).Adolescents had higher prevalence rate than children(X~2=4.037, P=0.045) .There were significant differences among all groups with different age(X~2=21.484, P=0.011), but no differences between two gender groups(X~2=0.215, P=0.643) and the urban and rural areas(X~2= 1.082, P=0.298). The comorbidities in children with anxiety disorders such as other disorders, including oppositional defiant disorder, attention deficit hyperactive disorder, learning disorder, depression, dysthymic disorder.2. Scores of externalizing and internalizing behavior in anxiety disorders group were higher than those in control group in CBCL(P<0.001), and the total scores of social abilities were lower than those in control group(P<0.001). Scores of sub-scores and total scores of SCARED in anxiety disorders group were higher than those in control group(P<0.001). Scores of sub-scores as behavior, intelligence, school achievement, anxiety, good friendship and total scores of CSCS in anxiety disorders group were lower than those in control group(P<0.01, P<0.001).3. The score of factor "affect warmth" for the mother and father scales of EMBU in anxiety disorders group were significantly lower than those of control group(P<0.05, P<0.001). The scores on factors such as "punishment", "refusal", "excessive interference" of parents and "excessive protection" of father scales of EMBU in anxiety disorders group were found significantly higher than those of the control group(P=0.05-0.000). In FACESII-CV, the scores of "family cohension" and "family adaptability" factors in anxiety disorders group were lower than those of control group(P<0.01). In PLOC,the scores of "the education achievement", "controller of parents", "controller of children" facors in anxiety disorders group were higher than those of control group(P<0.01, P<0.001).The scores of every factor and sub scales in Children Maltreatment Questionnaire in anxiety disorders group were higher than those in control group(P<0.01, P<0.001).4. There are remarkable differences in mother personality, parenting modes,maternal mood during pregnancy between anxiety disorders group and control group (P<0.05, P<0.01).5. The results of Logistic regression analysis of risk factors in children with anxiety disorders were that the disabled character in their mother,maltreatment,the parenting modes as mother refusal, controller of parents , controller of children were the risk factors in children with anxiety disorders. Anxiety disorders were related with the genetic and family environment factors.Conclusions:1. The prevalence of anxiety disorders is high, and it is significantly higher in adolescents than children. The comorbidity of ODD ADHD LD and Depression is common in children with anxiety disorders.2. Children with anxiety disorders have more externalizing and internalizing behaviors, lower self-concept level and family dysfunction.3. Risk factors include the disabled character in their mother, maltreatment, the parenting modes as mother refusal, controller of parents , controller of children.