Adolescent anxiety may predict future psychiatric diagnoses and suicidal ideation

Adolescents with anxiety are at risk for future psychiatric diagnoses and suicidal ideation, according to a study published in BMC Psychiatry.  Anxiety disorders, which include disorders like social anxiety disorder and panic disorder, are the most widespread mental health disorders in the western world. These disorders often make their appearances in childhood or young adulthood and frequently co-occur with other mental health issues like substance abuse, depression and suicidal ideation.

Previous research has found a significant relationship between anxiety disorders in youth and various psychiatric outcomes in adulthood, yet most studies have failed to consider the confounding influence of neurodevelopmental disorders.

Disorders like autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and developmental coordination disorder (DCD) tend to co-occur with anxiety and lead to the same adverse outcomes such as substance abuse and suicidal tendencies. This new study aimed to separate these effects to gain a clearer understanding of how anxiety predicts future psychiatric outcomes independent of these diagnoses.

Researchers analyzed data from two longitudinal twin studies. One was The Child and Adolescent Twin Study in Sweden, which involved 14,106 fifteen-year-old Swedish twins born between 1994 and 2002. The other was a replication sample from the Netherlands Twin Register, which included 9,211 Dutch twins who were born between 1985 and 1999. Both studies screened participants for indicators of neurodevelopmental disorders and had families complete questionnaires to assess various mental health problems using self-reports and/or parental reports.

The Swedish study used the Swedish National Patient Register to check for the presence of psychiatric disorders in participants. Researchers found that for both parental and self-reports, participants who scored in the ‘borderline’ and ‘abnormal’ anxiety categories were more likely to be assigned a psychiatric outcome during the follow-up period, compared to those in the ‘normal’ category. Psychiatric outcomes included issues like substance use, depression and suicidal ideation.

The Netherlands sample replicated these results, showing increased psychiatric outcomes in those scoring higher in anxiety, particularly for anxiety and depression. Findings from both studies remained significant when adjusting for ADHD, ASD, and DCD, suggesting that anxiety does proceed psychiatric outcomes independent of neurodevelopmental diagnoses.

The findings suggest potential treatment options for those at risk. As the authors state, “It is possible that treatments directed towards the core symptoms of anxiety in adolescence may attenuate the risk and affect the trajectories leading into a wide array of psychiatric outcomes (i.e. anxiety disorders, depressive disorders, alcohol and drug misuse disorders, possibly also bipolar/psychotic disorders) and suicidal ideation.”

The article, “Anxiety at age 15 predicts psychiatric diagnoses and suicidal ideation in late adolescence and young adulthood: results from two longitudinal studies”, was authored by Sabrina Doering, Paul Lichtenstein, Christopher Gillberg, NTR, Christel M. Middeldorp, Meike Bartels, Ralf Kuja-Halkola and Sebastian Lundström.

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