Despite their widespread prevalence, childhood anxiety disorders remain vastly underdiagnosed, undertreated and understudied, according to a monograph resulting from an expert conference co-sponsored by the Anxiety Disorders Association of America (ADAA) and the National Institute of Mental Health (NIMH). The report, Conference on Treating Anxiety Disorders in Youth: Current Problems and Future Solutions, is the first to confirm the dearth of research about anxiety disorders in children and teens.

About 13 percent of children ages 9 to 17 suffer from an anxiety disorder. Moreover, many youth suffer from more than one, and depression and substance abuse often co-occur with these disorders. However, only 15 clinical trials to date have been conducted on childhood anxiety disorders.

"Although research over the last 20 years has shed welcome light on anxiety disorders in adults, ... we're really still in the dark about how these disorders manifest themselves and can best be treated in youngsters," says Jerilyn Ross, M.A., L.I.C.S.W., President and Chief Executive Officer of the ADAA. Clearly, we do not yet have the solid scientific evidence we need to make recommendations to clinicians, educators, and parents on how to prevent and treat these illnesses," Ross says. (Anxiety Disorders of America; The full text of the monograph is available on ADAA's Web site at www.adaa.org)

Because ADHD is more common among boys than girls, some have questioned the validity of diagnosing ADHD in girls. Recently published research has provided more evidence that attention deficit/hyperactivity-disorder (ADHD) is a valid diagnosis in girls.

Researchers who were blind to diagnosis administered structured psychiatric interviews to 140 girls with ADHD and their 417 first-degree relatives and to 122 girls without ADHD and their 369 first-degree relatives.

Relatives of the ADHD girls had a significantly higher prevalence of ADHD (DSM-III or DSM-IV definition) than relatives of the comparison girls. This was similar to the authors' previous findings for families of boys with ADHD. Like the boys' families, the relatives of the girl probands also had significantly higher prevalences of antisocial, mood, anxiety and substance use disorders, although the prevalence of familial antisocial disorders was lower than had been observed in the boys' families. There was no association between the DSM-IV subtypes of the probands and relatives.

The researchers conclude that the familial transmission of ADHD and comorbid disorders generalizes to families of girls with ADHD. Neither proband gender nor subtype influences the familial transmission of ADHD.

Faraone SV, Biederman J, Mick E, Williamson S, et al.: Family Study of Girls With Attention Deficit Hyperactivity Disorder. American Journal of Psychiatry, 2000. 157:1077-1083. Reprint requests to: Steven Faraone,Ph.D.. Pediatric Psychopharmacology Unit (ACC 725), Massachusetts General Hospital, Fruit St., Boston, MA 02114.

Mild to moderate asthma has modest effects on daily life of young children affected with the disease, but does not appear to create increased psychological problems, say researchers.

Investigators with Childhood Asthma Management Program (CAMP) examined disease severity and psychological questionnaire responses from 1,041 children ages 5 to 12 with mild to moderate asthma who were in enrolled in CAMP, and their parents. Psychological questionnaires administered at baseline to parents and participants assessed anxiety, depression, behavioral competence, social support and family functioning.

The researchers found that psychological difficulty was not increased in this group. "Psychological adaptation in the children was associated with the psychological adaptation of the family but not with disease-related variables," say the researchers. Scores from the Impact on Family Scale, a measure of family quality of life related to the child's illness, were associated more strongly with the overall psychological characteristics of the family and child and very little with disease characteristics or severity.

"Relatively mild or even moderate illness is unlikely to result in psychological disturbance, but emotional and behavioral problems may emerge when the illness occurs in a distressed family," say the researchers.

Bender BG, Annett RD, Ikle D, et al.: Relationship between disease and psychological adaptation in children in the Childhood Asthma Management Program and their families, Archives of Pediatrics and Adolescent Medicine, 2000. 154(7); 706-713. Reprint requests to: Bruce G. Bender, Ph.D., National Jewish Medical and Research Center, Denver, CO 80206.