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Neuropsychological aspects of anxiety disorders in children and adolescents: a comparative study between the pre and postpharmacological treatment

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Author(s):
Camila Luisi Rodrigues
Total Authors: 1
Document type: Master's Dissertation
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD)
Defense date:
Examining board members:
Fernando Ramos Asbahr; Sheila Cavalcante Caetano
Advisor: Fernando Ramos Asbahr
Abstract

The high level of anxiety may interfere with the performance of various cognitive functions. Thus, people with anxiety disorders are more vulnerable to the presence of cognitive deficits. Through neuropsychological testings, it is possible to measure performance and, therefore, to describe potential changes in cognitive functions. Studies have pointed to deficits in attentional processes, memory and executive functions. Since there are insufficient data in the literature on the cognitive functioning of young people with anxiety disorders, the aim of this study is to evaluate cognitive functioning in children and adolescents with anxiety disorders, before and after pharmacological treatment. The sample consisted of subjects (7-17 years) diagnosed with generalized anxiety disorder, separation anxiety disorder and / or social phobia. Thirty subjects with at least one anxiety disorder, assessed before the beginning of pharmacological treatment, and 34 healthy controls. Eighteen subjects with anxiety disorders were reassessed after they have been randomly assigned (by table of random numbers) into three groups [clomipramine (n = 5), fluoxetine (n = 5) and placebo (n = 8)] and submitted to treatment for a period of six months. Likewise, ten subjects in the control group were evaluated after the same interval of time. The instruments used in the neuropsychological tests were \"Wechsler Abbreviated Sacal of Intelligence,\" \"Trail Making Test,\" \"Card Stroop Test, Matching Familiar Figures Test-20\", tests of verbal fluency for letters (FAS) and category (animals), \"Wisconsin Card Sorting Test\", \"Tower of Hanoi\", \"Wide Range Assessment of Memory and Learning-2\", \"Rey Complex Figure\". For the assessment of anxiety symptoms, the \"Multidimensional Anxiety Scale for Children\" was utilized. From the data observed, statistical comparisons were performed at two different times: before and after treatment of subjects with diagnoses of anxiety disorders. Results from the pre-treatment evaluation suggest that subjects from the anxiety disorder group when compared to the control group showed significantly lower performance in activities that measure attention, visual memory, verbal memory and executive function. In relation to anxiety symptoms, as measured by the \"Multidimensional Anxiety Scale for Children\", the group with anxiety disorders had significantly higher scores than those observed among controls. Results from the post-treatment evaluation suggest that, no matter which interventions have been used (either medications or placebo), performance on attentional, memory and executives processes of the group of children with anxiety disorder improved. We, therefore, conclude that anxious symptomatology in children and adolescents with anxiety disorder interferes with the performance of cognitive functions (AU)