Mental Health Children Can be Screened for Anxiety Disorders Through School Health Care

A new study has revealed that children cannot only be screened for anxiety disorders but their symptoms can also be reduced through proper school health care programmes.

Turku/Finland – A new study from the Research Centre for Child Psychiatry at the University of Turku in Finland screened school-age children for anxiety and examined the efficacy of the Master Your Worries programme developed for treating anxiety among children. The study found that the programme reduced children's symptoms of generalized anxiety, social anxiety, and separation anxiety. The study also found that lighter, fully digital study material can reduce anxiety symptoms in children.

The study, led by Professor Andre Sourander, is the first randomised controlled trial in the world to examine the efficacy of an internet-based cognitive behavioural therapy (iCBT) intervention using a population-based screening method in school-age children. The study has been published as an editorial in the prestigious Journal of the American Academy of Child & Adolescent Psychiatry.

The study used a two-stage model to screen children for anxiety at the annual health check-up at school. Over 11,000 children aged 10–13 were screened with a five-item version of the Screen for Child Anxiety Related Emotional Disorders (Scared) questionnaire, and children who screened positive in the second phase completed the full 41-item questionnaire.

“We found that 80 percent of all children screened at stage two received an anxiety disorder diagnosis. This is a significant result as it shows that children's anxiety disorder can be screened at a population level. Early identification of anxiety disorders is particularly challenging as some anxiety is normal, and early manifestations of the disorder often go unnoticed by those around the child,” says Andre Sourander.

The study also found that less than five percent of participants had received medication for anxiety and less than 13 percent of participants had contacted specialised health care in the last six months.

“This highlights the prevalence of untreated anxiety in school-age children," says Sourander.

Master Your Worries programme developed at the University of Turku reduced anxiety symptoms in children

A total of 465 children from all the screened participants took part in the randomised controlled trial. Some of the children were offered the Master Your Worries intervention based on cognitive behavioural therapy and the control group was offered digital psychoeducation, i.e. independent study materials. The study found that after completing the Master Your Worries programme, children's symptoms of generalised anxiety, social anxiety, and separation anxiety decreased.

“A noteworthy result is that the greatest benefit of the intervention was obtained by children who met the diagnostic criteria for anxiety disorder. A targeted intervention is therefore most effective for children who suffer from severe anxiety," says Andre Sourander.

Master Your Worries is an intervention programme developed by the Research Centre for Child Psychiatry at the University of Turku for the

treatment of anxiety in school-age children. The programme lasts 10 weeks and includes weekly digital material and exercises as well as weekly telephone calls. Previous studies have shown that a very high proportion of children who participate in the programme complete it, and the vast majority of families say they are satisfied with the care they have received.

The new study also found that children in the control group who received only psychoeducation, as well as their parents, reported significant improvements in their child's anxiety-related symptoms, daily functioning, and quality of life at the six-month follow-up. Parents also reported a significant improvement in their own well-being.

“Identifying children's anxiety symptoms as part of school health care and providing low-threshold psychoeducation can bring great benefits to children with anxiety and their families. The findings are important in planning low-threshold early interventions and in service planning for children with anxiety,” says Sourander.

Untreated anxiety in childhood predicts other problems in adulthood

Common forms of anxiety include individual fears, excessive nervousness, worrying about past or future events, and fear of social situations. Anxiety is often accompanied by a range of physical sensations, such as pain, shortness of breath, or dizziness.

An estimated 6–18 percent of school-age children and adolescents suffer from an anxiety disorder. Previous studies by the Research Centre for Child Psychiatry at the University of Turku have found that anxiety has increased in recent years, particularly among adolescents.

“Anxiety has increased globally among adolescents over the past decade. Early identification and treatment of anxiety is one of the biggest challenges mental health services face today. Untreated anxiety in childhood predicts depression, substance abuse, suicidal thoughts, and other psychiatric problems in adulthood. This is why it is important to identify and provide evidence-based treatment for childhood anxiety," concludes Sourander.

The study "Internet-Based Cognitive-Behavioral Therapy Intervention Master Your Worries With Telephone Coaching for Anxious Finnish Children Aged 10-13 Years: A Population-Based Randomized Controlled Trial” has been published in the Journal of the American Academy of Child and Adolescent Psychiatry.

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