From the Guidelines
When treating a child with anxiety disorder, no specific laboratory or diagnostic tests are routinely required for diagnosis, and the evaluation primarily relies on clinical assessment using standardized tools like the Screen for Child Anxiety Related Disorders (SCARED) or the Multidimensional Anxiety Scale for Children (MASC) 1. The diagnosis of anxiety disorders in children and adolescents is based on a comprehensive clinical evaluation, including a thorough history, mental status examination, and behavioral observations.
- The clinical assessment should include the use of standardized tools, such as the SCARED or MASC, to evaluate the severity of anxiety symptoms.
- Laboratory tests, such as thyroid function tests (TSH, T3, T4), complete blood count (CBC), comprehensive metabolic panel, toxicology screening, and electrocardiogram (ECG), may be ordered to rule out medical conditions that can mimic anxiety symptoms, as suggested by the American Academy of Child and Adolescent Psychiatry 1.
- Additional tests, such as electroencephalogram (EEG), may be considered if seizure disorders are suspected.
- The clinician should focus on a thorough history, mental status examination, and behavioral observations, using the medical tests as supplementary information when specific medical conditions need to be ruled out.
- The evaluation should also consider the differential diagnosis of anxiety disorders, including the exclusion of other psychiatric disorders, such as depression, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and substance-related disorders, as outlined in the DSM-5 criteria 1.
- The use of screening instruments, such as the Pediatric Symptom Checklist or the Difficulties Questionnaire, can help identify anxiety concerns in primary care, school, or other child-serving settings, and facilitate early intervention and treatment.
From the FDA Drug Label
Laboratory Tests There are no specific laboratory tests recommended.
The FDA drug label does not provide specific recommendations for labs and diagnostic tests needed when treating a child with anxiety disorder. No specific tests are mentioned.
- No laboratory tests are recommended in the label.
- The label does not provide guidance on diagnostic tests for treating anxiety disorder in children. 2
From the Research
Diagnostic Tests for Anxiety Disorder in Children
- A clinical interview should be conducted to assess for the three primary ways anxiety presents: behaviors, thoughts, and somatic symptoms 3
- Several semi-structured diagnostic interviews are available, and the Anxiety Disorders Interview Schedule is increasingly used 3
- Rating scales completed by the patient, caregivers, and teachers provide useful information for diagnosis and symptom monitoring 3, 4
- Brief screening measures, such as the Generalized Anxiety Disorder-7, can aid in diagnosis of anxiety disorders 5
Labs and Diagnostic Tests
- No specific labs or diagnostic tests are mentioned in the provided studies as necessary for the diagnosis of anxiety disorder in children
- Diagnosis is primarily based on clinical interviews, semi-structured diagnostic interviews, and rating scales 3, 4, 6
Assessment and Treatment
- Comprehensive assessment of child and adolescent anxiety disorders benefits from a multimethod approach to evaluation and diagnosis, including semistructured interviews, child and informant questionnaires, collateral information, and behavioral observations 4
- Cognitive-behavioral therapy (CBT) and exposure-based therapies have emerged as the most well-established treatment approaches for addressing anxiety disorders among children and adolescents 4, 6
- Selective serotonin reuptake inhibitors (SSRIs) have been established to be safe and efficacious for the treatment of pediatric anxiety and are considered the medications of choice for this population 3, 4, 5