Academic pediatrics · 2026
National Trends in Clinically Recognized Anxiety Among US Children and Adolescents.
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Diggs Devin T, Olfson Mark
Аннотация
OBJECTIVE: To examine recent trends and correlates of clinically recognized anxiety among US children and adolescents by severity and sociodemographic group.
METHOD: Repeated cross-sectional analysis of the 2016 to 2023 National Survey of Children's Health, a nationally representative survey of non-institutionalized youth. Outcomes included annual rates and adjusted prevalence ratios (aPRs) of caregiver-reported, clinician-diagnosed anxiety, stratified by demographic groups and severity. Multivariate logistic regression identified correlates of anxiety and severity.
RESULTS: In a nationally representative sample of children aged 6 to 17 years (N=223,178; 51.1% male; 26.4% Hispanic, 4.7% non-Hispanic Asian, 13.7% non-Hispanic Black, 49.3% non-Hispanic White), 10.0% had anxiety (4.5% moderate, 1.0% severe). From 2016 to 2023, anxiety increased from 8.2% to 12.8% (aPR 1.63; 95%CI, 1.53-1.75), with stable distributions of severity. Increases were greater among girls (aPR 1.85; 95%CI, 1.69-2.03, P<.001) and adolescents 12 to 17 years (aPR 1.76; 95%CI, 1.63-1.91, P<.001) than boys and children 6 to 11 years. Anxiety rose across most racial and ethnic groups with no significant interaction between sex and race and ethnicity over time. Overall, 70.1% of children with anxiety had at least 1 co-occurring mental health condition, most commonly ADHD (38.8%), depression (35.1%), and behavioral problems (32.0%), and co-occurrence was associated with higher severity.
CONCLUSION: Clinically recognized anxiety increased significantly among US youth from 2016 to 2023, especially among girls and adolescents. High rates of co-occurring mental health conditions and greater anxiety severity emphasize the need to expand access to mental health services to meet growing service demands of clinically complex presentations.
METHOD: Repeated cross-sectional analysis of the 2016 to 2023 National Survey of Children's Health, a nationally representative survey of non-institutionalized youth. Outcomes included annual rates and adjusted prevalence ratios (aPRs) of caregiver-reported, clinician-diagnosed anxiety, stratified by demographic groups and severity. Multivariate logistic regression identified correlates of anxiety and severity.
RESULTS: In a nationally representative sample of children aged 6 to 17 years (N=223,178; 51.1% male; 26.4% Hispanic, 4.7% non-Hispanic Asian, 13.7% non-Hispanic Black, 49.3% non-Hispanic White), 10.0% had anxiety (4.5% moderate, 1.0% severe). From 2016 to 2023, anxiety increased from 8.2% to 12.8% (aPR 1.63; 95%CI, 1.53-1.75), with stable distributions of severity. Increases were greater among girls (aPR 1.85; 95%CI, 1.69-2.03, P<.001) and adolescents 12 to 17 years (aPR 1.76; 95%CI, 1.63-1.91, P<.001) than boys and children 6 to 11 years. Anxiety rose across most racial and ethnic groups with no significant interaction between sex and race and ethnicity over time. Overall, 70.1% of children with anxiety had at least 1 co-occurring mental health condition, most commonly ADHD (38.8%), depression (35.1%), and behavioral problems (32.0%), and co-occurrence was associated with higher severity.
CONCLUSION: Clinically recognized anxiety increased significantly among US youth from 2016 to 2023, especially among girls and adolescents. High rates of co-occurring mental health conditions and greater anxiety severity emphasize the need to expand access to mental health services to meet growing service demands of clinically complex presentations.