Anxiety Disorders

Anxiety Disorders May Force Students to Drop Out

The Medical Post, Oct. 10, 1995

VICTORIA - Kids don't always drop out of school to get a job or because they're bored. Many simply can't cope with speaking in front of a class.

Almost half of adult patients suffering an anxiety disorder dropped out of school before completing their education, according to a new study from McMaster University.

Specialists are calling for more intervention to identify and treat children with anxiety disorders before they drop out of school. Teens suffering from these disorders who do quit school often end up in menial, dead-end jobs that are far below their intellectual potential, said Dr. Michael Van Ameringen, assistant professor of psychiatry, McMaster University, Hamilton, Ont.

"It's an issue of underachievement and missed opportunities. These people have potential, but because of their anxiety disorder, which we know starts in their teens, they're not continuing on in school."

Researchers asked 201 patients in the university's two anxiety disorders clinics about the impact of their disorder on school functioning. Of these, 49% reported leaving school prematurely, with only 25.9% completing Grade 12.

There's little research on the school dropout rate among the general population with which to compare these figures, but Statistics Canada reports that 18% of 20-year-olds have not completed high school.

Many of the reasons cited by patients for leaving school prematurely related to anxiety. More than 22% said they felt too nervous in school; 16.9% had problems speaking in front of a class; and 10.9% were intimidated by teachers or peers.

Lifetime diagnosis

Just under 21% said they left school to get a job and 20.4% left because they were bored, Dr. Van Ameringen said during a poster presentation.

The study found patients who left school early were significantly more likely to have a lifetime diagnosis of social phobia. Of the 98 patients who quit school, 61.2% had such a diagnosis compared to 44.7% of the 103 patients who did not leave school prematurely.

Dr. Van Ameringen said it's up to doctors, educators and the public to identify anxiety disorders among children and adolescents to improve their chances of completing school and going on to college or university, and then perhaps to meaningful employment.

"These are treatable conditions yet they're going very unrecognized. I think generally the school people and the public and the medical community aren't aware that these things are starting at this age and that it's what's disabling the kids."

Those students who skip school are too often labelled as merely lazy, he said.

Dr. Van Ameringen suggested establishing some form of referral or formal follow-up for students who wish to leave school.

According to recent studies, social phobia, which is one type of anxiety disorder, affects one in 10 people, Dr. Van Ameringen said. Social phobics are extremely nervous around people because they're worried about being judged or evaluated.

In some cases, social phobics succeed in arranging their lives around having little or no contact with people. "So you find them as computer programmers or people who work the night shifts," Dr. Van Ameringen said.

Although monoamine oxidase (MAO) inhibitors have proven effective in the treatment of social phobia, these drugs can have significant side effects. Dr. Ameringen's group has researched selective serotonin reuptake inhibitors (SSRIs), including fluoxetine and paroxetine, as possible alternative therapies.

In one of their most recent studies-a 12-week open trial in 18 patients-paroxetine achieved a 83.3% response rate. Measures of social anxiety, depression and social functioning all improved in patients taking the drug.

In another of the clinic's trials the drug buspirone, a 5-HT partial agonist, augmented the response of social phobics to SSRIs.

Copyright 1995 Maclean Hunter Publishing Limited
Reprinted with permission.

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