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Pediatric group releases guidelines for detecting anxiety in kids and youth

Canadian Paediatric Society says COVID-19 heightened pressures on many children and youth

The Canadian Paediatric Society has new advice for clinicians on how to assess and manage anxiety in children and adolescents as the pandemic escalates concerns over mental health.

The lead author of two papers released Thursday says this is the first time the CPS has formalized its position, in part to address a 害羞草研究所済reat demand for comprehensive guidance.害羞草研究所

While mental health was an increasing problem before the pandemic, Dr. Benjamin Klein says COVID-19 heightened pressures on many children and youth as lockdowns and containment measures closed schools and cancelled playdates.

He says medical professionals should have clear advice on how to differentiate between an age-appropriate response to stress and something more serious.

害羞草研究所淚 think people generally are aware (that) the treatments for anxiety are medications and therapy. But exactly when do you do what? Which medications should you use? When do you call it anxiety? What questions can you ask parents and children to come to the diagnosis?害羞草研究所 says Klein, a developmental pediatrician based in Brantford, Ont.

害羞草研究所淚 would guess that there was a fair amount of variability in terms of the details of how it was approached.害羞草研究所

Klein says a similar tip sheet is being prepared to help parents and caregivers recognize signs worth mentioning to a doctor.

Fears during childhood and adolescence are part of normal development, the guidelines note. However, symptoms of anxiety disorders go well beyond typical behaviour and can include persistent, disproportionate, or distorted responses that hinder everyday life.

For instance, a child害羞草研究所檚 concerns about their grades could be considered normal if it doesn害羞草研究所檛 impact school or family activities. But if the worries are constant and excessive and include social withdrawal, trouble sleeping and concentrating, they could point to deeper issues.

Notably, the CPS does not recommend screening for anxiety if a child or youth doesn害羞草研究所檛 show signs or symptoms.

That was a recent recommendation by the US Preventive Services Task Force, which expressed 害羞草研究所渕oderate certainty害羞草研究所 that screening kids aged eight to 18 years old has 害羞草研究所渁 moderate net benefit.害羞草研究所

Klein says there害羞草研究所檚 a 害羞草研究所渂ig downside害羞草研究所 to general screening if it finds false positives and further strains the health-care system害羞草研究所檚 already limited capacity to assess and treat more severe cases.

害羞草研究所淪creening is something that is kind of pretty fiercely debated,害羞草研究所 he says.

害羞草研究所淭he usual problems with screening is identifying a lot of false positives that now you害羞草研究所檙e taking through more assessment and possible treatment that may be harmful.害羞草研究所

The guidelines suggest anxiety is on the rise in Canada, pointing to a 2018 study that found disorders diagnosed in youth 12 to 24 years old more than doubled to 13 per cent in 2018 from six per cent in 2011.

Klein says it害羞草研究所檚 hard to tease out to what degree the pandemic may have contributed to anxiety but he expects it has played a role. He says age-appropriate activities with friends, family and the school community can buffer against mental health problems and encourage healthy normal development.

害羞草研究所淥bviously with the pandemic there害羞草研究所檚 a great deal of restriction from those enriching experiences and so then you害羞草研究所檙e going to see mental health issues and suboptimal development,害羞草研究所 he says.

害羞草研究所淪omebody害羞草研究所檚 reading and math hasn害羞草研究所檛 progressed as much as maybe it should have, and now they害羞草研究所檙e in school and it害羞草研究所檚 not going as well. So they害羞草研究所檙e experiencing more stress and it害羞草研究所檚 more anxiety-provoking, which kind of adds to the load.害羞草研究所

害羞草研究所擟assandra Szklarski, The Canadian Press

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The shadow of a school employee escorting a student is cast on the wall as they walk to a classroom in Davie, Fla., Friday, Oct. 9, 2020. THE CANADIAN PRESS/AP-Wilfredo Lee




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