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Incidence, recurrence and comorbidity of anxiety disorders in four major developmental stages
Open accessAbstract
Background Anxiety disorders are common in childhood, adolescence, and adulthood, and frequently comorbid with other mental disorders.Objective The main aim of the present study was to examine the incidence, recurrence and comorbidity rates of anxiety disorders across four developmental periods, namely, during childhood (5 - 12.9 years), adolescence (13 - 17.9 years), emerging adulthood (18 - 23.9 years), and adulthood (24 - 30 years).Method Eight hundred and sixteen participants from a large community sample were interviewed twice during adolescence, at age 24, and at age 30. They completed self-report measures of psychosocial functioning and semi-structured diagnostic interviews during adolescence and adulthood.Results The result showed first incidence of anxiety disorders to be significantly higher in childhood and adulthood than in adolescence and emerging adulthood. Female gender was associated with first incidence, but not with recurrence. Significant comorbidity was found between anxiety disorders and major depressive disorder (MDD) across the four developmental periods. The comorbidity between anxiety and substance use disorders (SUD) was significant in childhood, emerging adulthood and adulthood, but not in adolescence. The presence of anxiety disorders during childhood and adolescence significantly increased the probability of having an anxiety disorder during emerging adulthood.Limitations The participants are ethically and geographically homogenous.Conclusion Incidence and recurrence rates of anxiety disorders differed across four diverse developmental periods. The magnitude of comorbidity between anxiety disorders and MDD was comparable across periods.
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“Anxiety disorders emerging during childhood and early adolescence will o en persist into young adulthood (Copeland 2014;Essau 2018).”
From Exercise for the treatment of anxiety in children and adolescents (2022) · cites this paper as Essau 2018
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“They o en occur alongside other conditions such as depression, substance misuse and suicidal behaviour (Essau 2018;Hill 2011), and place young people at increased risk of experiencing comorbidities later in life (Plana-Ripoll 2019).”
From Exercise for the treatment of anxiety in children and adolescents (2022) · cites this paper as Essau 2018
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“The presence of ADs during those periods has been linked to an increased likelihood of experiencing anxiety during emerging adulthood [12]”
From Acceptance and commitment therapy as a transdiagnostic approach to adolescents with different anxiety disorders: study protocol. (2025) · cites this paper as [12]
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Prevalence of mental disorders and psychosocial impairments in adolescents and young adults
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Canals, J., Voltas, N., Hernández‐Martínez, C., Cosí, S., & Arija, V. (2018) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-018-1207-z · Cited by 127
Cao, J., Truong, A. L., Banu, S., Shah, A. A., Sabharwal, A., & Moukaddam, N. (2019) · doi:10.2196/preprints.14045 · Cited by 81
Post-secondary Student Mental Health During COVID-19: A Meta-Analysis
Zhu, J., Racine, N. M., Xie, E. B., Park, J., Watt, J., Eirich, R., Dobson, K. S., & Madigan, S. L. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.777251 · Cited by 88
In search of disorders: internalizing symptom networks in a large clinical sample
McElroy, E., & Patalay, P. (2019) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13044 · Cited by 65
Brown, J. S. L., Blackshaw, E., Stahl, D., Fennelly, L., McKeague, L., Sclare, I., & Michelson, D. (2019) · Journal of Adolescence · doi:10.1016/j.adolescence.2018.11.009 · Cited by 52
Metadata
- Authors
- Essau, C. A., Lewinsohn, P. M., Lim, J. X., Ho, M.-H. R., & Rohde, P.
- Affiliations
- University of Roehampton (GB)
- Oregon Research Institute (US)
- Nanyang Technological University (SG)
- Corresponding author
- Essau, Cecilia A.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2018-03
- Volume
- 228
- Pages
- 248-253
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC5807150
- OpenAlex
- W2773451785
- Cited by
- 178
- References
- 44
- Citations by year
- 2026: 12 · 2025: 18 · 2024: 25 · 2023: 19 · 2022: 40 · 2021: 24 · 2020: 18 · 2019: 17 · 2018: 3
- FWCI
- 13.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (acceptedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- DR-NTU (Nanyang Technological University) (submittedVersion)
- Funders
- National Institute of Mental Health (R01MH040501, R01MH050522)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- anxiety disorders, incidence, recurrence, comorbidities, developmental stages, childhood, adolescence, emerging adulthood, adulthood, major depressive disorder, substance use disorders, gender differences, community sample
- MeSH terms
- Adolescent, Adult, Anxiety, Anxiety Disorders, Child, Child, Preschool, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Recurrence, Comorbidity, Incidence, Substance-Related Disorders, Young Adult
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