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Anxiety disorders in children and adolescents. Research, assessment and intervention
  1. Elena Garralda

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    Edited by Wendy K Silverman and Philip A D Treffers (Pp 418, £39.95). Published by Cambridge University Press, Cambridge, 2001. ISBN 0 521 78966 4.

    Child psychiatric epidemiology has consistently identified anxiety disorders as one of the common forms of childhood psychopathology. However anxiety disorders have been less researched that the so called “disruptive-externalising” conditions. This may be due to the fact that they are less visible and that they feature less prominently among psychiatric clinic referrals. This book, based on a symposium held in Leiden, The Netherlands, in 1997 aims to provide an integrative summary of recent literature on anxiety disorders of children and adolescents. Behavioural cognitively oriented theories and clinical research are featured most strongly, but a biomedical perspective is also represented.

    There is full discussion of well researched possible temperamental precursors as seen in young children with “behavioural inhibition” but the nature of family influences and relationships is also explored. The book provides a good update on post-traumatic stress disorder, a condition which is currently attracting considerable clinical and research attention. The well informed neuropsychiatry chapter concludes that anxiety disorders of children and adolescents are likely to involve both disorder specific and overlapping dysregulation in brain stem, limbic, and orbitostriatal cortical circuits. In some patients, obsessive-compulsive disorders may reflect an autoimmune illness related to rheumatic fever.

    The chapters on psychological and pharmacological interventions should help inform clinical practice. Randomised control trials of cognitive behavioural treatments have demonstrated their superiority over waiting list control status. However, it is unclear to what extent they are also superior to psychoeducational support to children and parents. There is scientific evidence for the use of SSRIs and clomipramine in the treatment of obsessive-compulsive disorders.

    The book is a useful update in a relatively uncrowded research area of childhood psychopathology.