Trends in Office-Based Anxiety Treatment Among US Children, Youth, and Young Adults: 2006-2018

BACKGROUND AND OBJECTIVES: Anxiety disorder diagnoses in office-based settings increased for children through the mid-2010s, but recent changes in diagnosis and treatment are not well understood. The objectives of the current study were to evaluate recent trends in anxiety disorder diagnosis and treatment among children, adolescents, and young adults. METHODS: This study used serial cross-sectional data fromthe National AmbulatoryMedical Care Survey (2006-2018), a nationally representative annual survey of US office-based visits. Changes in anxiety disorder diagnosis and 4 treatment categories (therapy alone, therapy andmedications, medications alone, or neither) are described across 3 periods (2006-2009, 2010-2013, 2014-2018). Multinomial logistic regression compared differences in treatment categories, adjusting for age group, sex, and race/ethnicity, contrasting the last andmiddle periodswith the first. RESULTS: The overall proportion of office visits with an anxiety disorder diagnosis significantly increased from 1.4% (95% confidence interval [CI] 1.2-1.7; n 5 9 246 921 visits) in 2006 to 2009 to 4.2% (95% CI 3.4-5.2; n 5 23 120 958 visits) in 2014 to 2018. The proportion of visits with any therapy decreased from 48.8% (95% CI 40.1-57.6) to 32.6% (95% CI 24.5-41.8), but there was no significant change in the overall use of medications. The likelihood of receiving medication alone during office visits was significantly higher in the last, relative to the first period (relative risk ratio 5 2.42, 95% CI 1.24-4.72). CONCLUSIONS: The proportion of outpatient visits that included a diagnosis of anxiety increased over time, accompanied by a decrease in the proportion of visits with therapy.

Automated summary

This study evaluated the trends in anxiety disorder diagnosis and treatment among children, adolescents, and young adults. The findings showed an increasing proportion of visits with anxiety disorder diagnosis and a decreasing proportion of visits with therapy. Moreover, there was a significant increase in visits with medication treatment alone.