Journal of child psychology and psychiatry, and allied disciplines · 2025
A detailed investigation of anxiety disorders in children of clinically anxious parents: a population-based study.
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Elfström Sigrid, Wicks Susanne, Dalman Christina, Åhlén Johan
Аннотация
BACKGROUND: We assessed the risk of anxiety disorders in children of clinically anxious parents, focusing on the influence of parent and child sex, parental care level, depressive comorbidity, and anxiety subtype, while controlling for socioeconomic factors and other parental psychiatric conditions.
METHODS: We conducted a population-based study utilizing comprehensive healthcare data. A cohort of children (N = 516,134), born in 1998-2015 and residing in Stockholm, Sweden, was followed until they were diagnosed with anxiety, moved, or turned 18. The primary and secondary exposures were parental specified and unspecified anxiety diagnoses, respectively. The outcome was child specified anxiety diagnosis. Associations were estimated using hazard ratios (HRs) with 95% confidence intervals (CIs).
RESULTS: Among exposed children, 4.3% were diagnosed with specified anxiety disorders, compared to 3.0% of unexposed (HR: 1.44, 95% CI: 1.38, 1.51). Adjustment for socioeconomic factors and other parental psychiatric disorders attenuated the risk (HR: 1.27, 95% CI: 1.21, 1.34). The risk was higher when parental anxiety was recorded in specialized psychiatric care (HR: 1.69, 95% CI: 1.60, 1.79) than in primary care (HR: 1.24, 95% CI: 1.17, 1.32). Maternal anxiety was linked to a higher risk (HR: 1.49, 95% CI: 1.41, 1.56) than paternal (HR: 1.31, 95% CI: 1.21, 1.42). Children were most likely to develop the same anxiety disorder as their parents, in cases of social anxiety, specific phobia, and panic disorder. Parental unspecified anxiety diagnoses were not associated with an increase in risk (HR: 1.02, 95% CI: 0.98, 1.07).
CONCLUSIONS: Parental specified anxiety modestly increased the risk of child anxiety disorders. While the overall risk was lower than previously reported, it varied across diagnosis types and care levels.
METHODS: We conducted a population-based study utilizing comprehensive healthcare data. A cohort of children (N = 516,134), born in 1998-2015 and residing in Stockholm, Sweden, was followed until they were diagnosed with anxiety, moved, or turned 18. The primary and secondary exposures were parental specified and unspecified anxiety diagnoses, respectively. The outcome was child specified anxiety diagnosis. Associations were estimated using hazard ratios (HRs) with 95% confidence intervals (CIs).
RESULTS: Among exposed children, 4.3% were diagnosed with specified anxiety disorders, compared to 3.0% of unexposed (HR: 1.44, 95% CI: 1.38, 1.51). Adjustment for socioeconomic factors and other parental psychiatric disorders attenuated the risk (HR: 1.27, 95% CI: 1.21, 1.34). The risk was higher when parental anxiety was recorded in specialized psychiatric care (HR: 1.69, 95% CI: 1.60, 1.79) than in primary care (HR: 1.24, 95% CI: 1.17, 1.32). Maternal anxiety was linked to a higher risk (HR: 1.49, 95% CI: 1.41, 1.56) than paternal (HR: 1.31, 95% CI: 1.21, 1.42). Children were most likely to develop the same anxiety disorder as their parents, in cases of social anxiety, specific phobia, and panic disorder. Parental unspecified anxiety diagnoses were not associated with an increase in risk (HR: 1.02, 95% CI: 0.98, 1.07).
CONCLUSIONS: Parental specified anxiety modestly increased the risk of child anxiety disorders. While the overall risk was lower than previously reported, it varied across diagnosis types and care levels.