School Phobia: The Overlap of Affective and Anxiety Disorders

In a group of 26 early adolescent, chronic school refusers, 69% met DSM-III criteria for affective disorder (depression), 62% met criteria for anxiety disorder, and 50% had both depressive and anxiety disorders. Patients with both disorders were more severely symptomatic as indicated by higher scores on rating scales for anxiety and depression. While children and adolescents with depressive disorders frequently reported anxiety symptoms, in general those with anxiety disorders did not commonly describe depression. However, those patients with severe anxiety symptoms reported specific depressive symptomatology, indicating that severe anxiety disorders in children and adolescents may be clinically indistinguishable from depression.