The impact of medical comorbidity on mental health and functional health outcomes among children with anxiety disorders

J Dev Behav Pediatr. 2008 Oct;29(5):394-402. doi: 10.1097/DBP.0b013e3181836a5b.


Objective: Medical comorbidity is common among children with anxiety disorders; however, little is known about the impact of such comorbidity on mental and functional health outcomes. Even less is known about these problems in high-risk samples of youth.

Method: Participants in this study were youth with at least one anxiety disorder with a physical illness (N = 77) or without a physical illness (N = 73), as well as youth with at least one physical illness (but no anxiety disorder) (N = 438). These youth were recruited as part of the Patterns of Care study in which the original set of participants (N = 1715) were randomly sampled from one of five public sectors of care (e.g., juvenile justice, child welfare, mental health, alcohol and substance use services, school services for children with serious emotional disturbance) in San Diego County. Psychiatric diagnoses were assessed with a structured interview and three standardized measures were used to assess child health, emotional, and behavior functioning.

Results: At least half of children with anxiety disorders had a comorbid physical illness. Allergies and asthma were the most common comorbid physical illnesses. Children with anxiety disorders who had a comorbid physical illness exhibited greater levels of emotional problems, more somatic complaints, and more functional impairment than anxious children without a physical illness as well as than children with physical illness alone. Parents of children in the comorbid group also reported greater caregiver strain than the other two groups.

Conclusions: Children with anxiety disorders have high rates of chronic illnesses such as asthma and allergies. These children experience considerable impairment and likely have unique needs that may complicate usual care.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / psychology
  • Asthma / epidemiology*
  • California / epidemiology
  • Child
  • Chronic Disease
  • Comorbidity
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Health Status
  • Humans
  • Hypersensitivity / epidemiology*
  • Interviews as Topic
  • Male
  • Mental Health / statistics & numerical data*
  • Severity of Illness Index
  • Somatoform Disorders / epidemiology*
  • Surveys and Questionnaires