Objective: To present an approach to intervention in childhood anxiety disorders.
Sources of information: This paper is based on selected findings from a MEDLINE search for recent literature on childhood anxiety disorders and on my experience as a child psychiatrist and researcher in a specialized anxiety disorders clinic.
Main message: Children with symptoms of high sympathetic arousal; persistent worries or intrusive thoughts; and extreme clinging, avoidance, or repetitive behaviours that interfere with daily functioning should be investigated for anxiety disorders. Counseling parents, relaxation techniques, and incentives for "brave" behaviour can often return children with mild disorders to age-appropriate functioning. Children who are severely impaired or fail to respond to these simple interventions might require medication or referral for cognitive-behavioural therapy.
Conclusion: Family physicians can play an important role in recognizing and intervening early in childhood anxiety disorders.