The Canadian Paediatric Society has new advice for clinicians on how to assess and manage anxiety in children and adolescents as the pandemic escalates concerns over mental health.

The lead author of two papers released Thursday says this is the first time the CPS has formalized its position, in part to address a B次元官网网址済reat demand for comprehensive guidance.B次元官网网址�

While mental health was an increasing problem before the pandemic, Dr. Benjamin Klein says COVID-19 heightened pressures on many children and youth as lockdowns and containment measures closed schools and cancelled playdates.

He says medical professionals should have clear advice on how to differentiate between an age-appropriate response to stress and something more serious.

B次元官网网址淚 think people generally are aware (that) the treatments for anxiety are medications and therapy. But exactly when do you do what? Which medications should you use? When do you call it anxiety? What questions can you ask parents and children to come to the diagnosis?B次元官网网址� says Klein, a developmental pediatrician based in Brantford, Ont.

B次元官网网址淚 would guess that there was a fair amount of variability in terms of the details of how it was approached.B次元官网网址�

Klein says a similar tip sheet is being prepared to help parents and caregivers recognize signs worth mentioning to a doctor.

Fears during childhood and adolescence are part of normal development, the guidelines note. However, symptoms of anxiety disorders go well beyond typical behaviour and can include persistent, disproportionate, or distorted responses that hinder everyday life.

For instance, a childB次元官网网址檚 concerns about their grades could be considered normal if it doesnB次元官网网址檛 impact school or family activities. But if the worries are constant and excessive and include social withdrawal, trouble sleeping and concentrating, they could point to deeper issues.

Notably, the CPS does not recommend screening for anxiety if a child or youth doesnB次元官网网址檛 show signs or symptoms.

That was a recent recommendation by the US Preventive Services Task Force, which expressed B次元官网网址渕oderate certaintyB次元官网网址� that screening kids aged eight to 18 years old has B次元官网网址渁 moderate net benefit.B次元官网网址�

Klein says thereB次元官网网址檚 a B次元官网网址渂ig downsideB次元官网网址� to general screening if it finds false positives and further strains the health-care systemB次元官网网址檚 already limited capacity to assess and treat more severe cases.

B次元官网网址淪creening is something that is kind of pretty fiercely debated,B次元官网网址� he says.

B次元官网网址淭he usual problems with screening is identifying a lot of false positives that now youB次元官网网址檙e taking through more assessment and possible treatment that may be harmful.B次元官网网址�

The guidelines suggest anxiety is on the rise in Canada, pointing to a 2018 study that found disorders diagnosed in youth 12 to 24 years old more than doubled to 13 per cent in 2018 from six per cent in 2011.

Klein says itB次元官网网址檚 hard to tease out to what degree the pandemic may have contributed to anxiety but he expects it has played a role. He says age-appropriate activities with friends, family and the school community can buffer against mental health problems and encourage healthy normal development.

B次元官网网址淥bviously with the pandemic thereB次元官网网址檚 a great deal of restriction from those enriching experiences and so then youB次元官网网址檙e going to see mental health issues and suboptimal development,B次元官网网址� he says.

B次元官网网址淪omebodyB次元官网网址檚 reading and math hasnB次元官网网址檛 progressed as much as maybe it should have, and now theyB次元官网网址檙e in school and itB次元官网网址檚 not going as well. So theyB次元官网网址檙e experiencing more stress and itB次元官网网址檚 more anxiety-provoking, which kind of adds to the load.B次元官网网址�

B次元官网网址擟assandra Szklarski, The Canadian Press