Increased anxiety symptoms in adolescents led by school phobia: a community-based study

Background: Increasing number of outpatient visits has been related to mental health crisis in adolescents. However, little is known for the chronological changes in adolescent anxiety symptoms in community samples, especially in China. Methods: Students from the 4th to the 11th grade were recruited from representative local schools in Zhejiang province. Screen for Child Anxiety-Related Emotional Disorders (SCARED) were used to collect the scores of panic anxiety, generalized anxiety, separation anxiety, social anxiety and school phobia, and were compared with the records of 2001. Results: Data from 8287 students showed that the anxiety symptoms were more frequent in girls and in higher grades. Chronological comparison suggested that all sub-types of anxiety have increased in girls, and symptoms of school phobia have increased in boys in middle schools. Largest size-effect of increase was seen for school anxiety. Conclusion: This study demonstrates a substantial increase in anxiety symptoms among Chinese adolescents over time, particularly among girls, with school-related anxiety showing the most pronounced rise. These findings indicate a growing mental health burden in community-based adolescent populations and underscore the importance of early identification and school-based preventive strategies.