Clinical manifestations of children and adolescents with anxiety disorders with and without specific learning disorders.

Background: Anxiety disorders (ADs) are common among children and adolescents and frequently co-occur with specific learning disorder (SLD). Approximately 20% of children with SLD meet criteria for ADs, while those with anxiety are six times more likely to have a premorbid SLD. The strong relationship between premorbid SLD and ADs underscores the importance of examining developmental trajectories and manifestations of neuropsychiatric conditions like ADs, particularly when SLD is present. In this context, this study investigates the clinical profiles of children and adolescents with a first diagnosis of an AD and a history of SLD compared to those with a first diagnosis of an AD without a history of SLD. The analysis focuses on various clinical characteristics, including developmental history, demographic aspects, age of anxiety onset, global functioning, types of ADs, self-report anxiety and depressive symptoms, and adaptive behavior. Additionally, the study aims to explore the relationship between anxiety symptoms and depressive symptoms, adaptive behavior, and age.

Methods: We conducted a cross-sectional, retrospective study with 78 participants from the Child and Adolescent Neuropsychiatry Unit, divided into two groups: those with ADs alone (Group AD, n = 42) and those with both ADs and premorbid SLD (Group AD + SLD, n = 36). We collected data on developmental history, demographic information, age of anxiety onset, global functioning, anxiety and depressive symptoms, and adaptive behavior.

Results: Our findings revealed that Group AD experienced more stressful life events and had higher cognitive levels, whereas Group AD + SLD showed a greater impairment in global functioning. Notably, Group AD exhibited lower social adaptive behavior and higher self-reported anxiety and depressive symptoms than Group AD + SLD, possibly indicating a greater awareness of their emotional distress.

Conclusions: These findings highlight the impact of premorbid neurodevelopmental disorders into clinical manifestations of psychopathological symptoms. In particular, results underline the importance of developing tailored clinical interventions for children with co-occurring ADs and learning difficulties, focusing more on their emotional awareness to better address the unique challenges posed by the comorbidity.