Enhanced Anxiety Screening in Primary Care for Children with ADHD

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Introduction Attention-deficit hyperactivity disorder (ADHD) and anxiety have been found in a multitude of previous studies to have a high likelihood of co-occurrence in children and adolescence. These studies have identified co-occurrence of anxiety and ADHD is diagnosed in around 50% of pediatric cases. Finding the correct treatment options for children with this dual diagnosis is important for the child’s quality of life and can impact both their academic and social functioning. Ensuring prompt and early diagnosis and treatment is key to helping each child with a dual diagnosis to have the best quality of life possible.

Methods The aim of this project was to assess if routine screening for anxiety in the primary care setting helps with improved diagnosis of comorbid anxiety in children with ADHD. For this project design data was collected in a pediatric private practice in the state of Virginia on children ages 11-17 utilizing chart reviews and then administering the Generalized Anxiety Disorder -7 screen for Adolescents (GAD-7A) to assess for diagnostic criteria of anxiety in patients who already had an ADHD diagnosis. To find out effectiveness of the assessments a pre chart review of children diagnosed with ADHD was conducted prior to the start of routine anxiety screening of children with ADHD who come in for medication checks, well checks, and sick visits. Six weeks after the start of administration of the GAD-7A a post chart review was conducted to reassess if administering the inventories had helped identify more patients meeting criteria and needing treatment for anxiety.

Results Post project chart review revealed that 63% of participants (n=35) had been diagnosed with anxiety and offered treatment measures compared to 29% that had previously been documented as having a diagnosis for anxiety. McNamar’s test revealed a significant (p=0.000532) increase in anxiety diagnosis for children with known ADHD.

Conclusion Anxiety and ADHD are commonly occurring comorbid diagnosis’ in children and identification and treatment of these disorders can improve a child’s social and emotional growth. This project has provided insight into the importance of regularly screening for anxiety in children already diagnosed with ADHD in the primary care setting and supports routine anxiety screening in primary care as an effective way to help identify and offer treatment for anxiety to children with an ADHD diagnosis.

DNP project