Prevalence and correlates of anxiety disorders among school children aged 13-15 years in Colombo District, Sri Lanka

Background: Anxiety disorders (AD) being the most prevalent psychological problem among children and adolescents remain largely unrecognized due to their nature. If untreated, AD could lead to many adverse outcomes. The aim of this study was to assess the prevalence and correlates of anxiety disorders among children aged 13-15 years attending government Sinhala medium schools in Colombo district, Sri LankaMethods: A school based cross-sectional study was conducted among 1524 children in Sinhala-medium government schools aged 13-15 years old selected by stratified cluster sampling. The presence of “any anxiety disorder” and its correlates were assessed using a pre-tested self-administered questionnaire that included validated Screen for Child Anxiety Related Disorders (SCARED). Multivariable analysis with binary logistic regression was carried out using backward elimination method to determine the association between anxiety disorders and selected correlates identified at bivariate analysis at p<0.05 level.Results: The adjusted prevalence of anxiety disorders was 12.3% (95% CI: 9.8% to 14.9%) Factors significantly associated with having any anxiety disorders at the multivariable analysis  included  being female (OR=3.0, 95% CI:2.0-4.4,p<0.001), residing away from the family (OR= 4.6, 95%:1.2-17.8, p=0.027), low to moderate self-esteem (OR=1.6, 95% CI: 1.1-2.5, p=0.022), having Stress (OR=2.3, 95%, CI: 1.5-3.6, p= <0.001), having Depression (OR= 2.5, 95% CI: 1.4-4.5, p<0.001), attending tuition classes for 5-7 days per week (OR=2.9, 95% CI: 1.9-4.3, p<0.001), non-engagement in sports activities (OR=1.6, 95%CI: 1.1-2.6, p=0.028), having a sibling/s less than one year of age ( OR=2.9, 95% CI: 1.2-6.6, p=0.015), father’s low level of education (OR=2.0, 95% CI: 1.1-3.8 p=0.044) and mother engaged in foreign employment (OR=5.3 , 95% CI: 2.0-13.9,p= 0.001), having an insecure attachment style (OR=2.7, 95% CI: 1.8-4.0, p<0.001).Conclusions: The prevalence of AD is high in this community and is associated with multiple personal, family, and educational factors. Screening for ADs need to be considered at routine mental health services.