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Anxiety disorder symptoms in children and adolescents: Differences by age and gender in a community sample
Síntomas de trastornos de ansiedad en niños y adolescentes: diferencias en función de la edad y el sexo en una muestra comunitaria
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However, most of these studies focus on a specific anxiety disorder. Consequently, there is a great deal of data on, for example, separation anxiety,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> social anxiety<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> or specific fears,<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,9</span></a> while others such as generalised anxiety, obsessive-compulsive disorder and panic disorder have been the object of fewer studies.</p><p id="par0010" class="elsevierStylePara elsevierViewall">There are numerous tools with good psychometric properties for assessing anxiety in children and adolescents. Among them, the Spence Children's Anxiety Scale (SCAS) stands out because of its advantages compared with other assessment measurements.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> The SCAS was originally created to apply with Australian community populations, but it has been translated and validated for its application to children and adolescents in 17 countries; it is considered one of the self-report measurements most utilised internationally. In contrast to other scales, the SCAS is not an adaptation of a test designed for adults, so it takes into consideration the differential symptoms in anxiety disorders in children and adults. In creating the SCAS, its author based it on the symptoms of the anxiety disorders most common in childhood and adolescence according to the categories diagnosed in the DSM-IV.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> The test therefore permits assessing, through 6 domains, the symptoms of the anxiety disorders most frequently found in children and adolescents. The scale has been used in numerous international studies for research and clinical purposes. Although it is not a diagnostic test, the SCAS has been used clinically as a screening tool to identify children and adolescents with high levels of anxiety symptoms who may need intervention. At the research level, the scale has been applied to study cultural differences of anxiety in childhood.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12,13</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In spite of the prevalence of anxiety disorders in Spanish children and adolescents and the demand for services in our country, there are no recent studies that examine the characteristics of the most frequent disorders using measurement tools based on the APA manual diagnostic categories. Our study updates the literature on the prevalence and characteristics of some anxiety disorders studied over a decade ago and provides information on disorders for which fewer data are available with the Spanish population. The objectives of this study were therefore to examine, in a community sample of Spanish children and adolescents from 8 to 17 years old, the following: (1) the frequency of the symptoms of the main anxiety disorders using the SCAS, an internationally recognised self-report tool based on the APA manual diagnostic categories, and (2) the differences in the anxiety disorder symptoms depending on age and sex.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Participants</span><p id="par0020" class="elsevierStylePara elsevierViewall">This was a non-interventionist transversal study in which the participants were 2522 children and adolescents from 8 to 17 years old, 49% being males. The age distribution was as follows: 5.9% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>149) 8 years old, 9.1% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>229) 9 years, 9.4% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>237) 10 years, 13% (329) 11 years, 17.6% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>444) 12 years, 10.5% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>265) 13 years, 10% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>251) 14 years, 11.3% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>284) 15 years, 8.2% (208) 16 years, and 5% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>126) 17 years old. As to nationality, 85.3% were Spanish and the remaining participants had been born in other countries. The socio-economic level, based on the parents’ labour situation and the location of the school the children attended, was middle class. With respect to family, 74% had married parents; 18%, separated or divorced parents; 5% lived with their parents, who were not married; 1% had a single parent situation with the mother; and 2% were orphans, lacking 1 parent or both. Most of the children and adolescents had only 1 brother or sister (59%), 19% had 2 siblings, 13% were the only children, 6% had 3 siblings, and the remaining participants had more than 4 siblings.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Procedure</span><p id="par0025" class="elsevierStylePara elsevierViewall">We recruited the participants in 15 schools (state schools and non-state schools that received state funding) in the province of Alicante, randomly chosen from rural and city areas, from the coastal and inner regions. The school directors gave their authorisation and the children's parents gave their informed consent, with 95% of the parents consenting that their children could participate in the study. The participants filled out the questionnaires anonymously in the classrooms. The questionnaires were handed out and the instructions were read out loud. The participants were asked to answer honestly and openly and to raise a hand if they had any doubts. No participant left more than 20% of the items blank, so no questionnaire was excluded from the data analysis. The Ethics Committee of the institution to which the authors form a part had previously approved the study.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Assessment tools</span><p id="par0030" class="elsevierStylePara elsevierViewall">The participants filled in a brief socio-demographic questionnaire, providing information as to age, gender, mother and father's employment, family situation, number of siblings and country of birth.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The anxiety disorder symptoms were assessed using the Spanish version of the Spence Children's Anxiety Scale.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> The SCAS is a 44-item scale designed to measure anxiety disorder symptoms in community samples of children and adolescents. The maximum score is 114. The scale consists of 5 subscales that correspond to the DSM-IV anxiety disorders most frequently in the child-adolescent population: generalised anxiety disorder (range: 0–18), obsessive-compulsive disorder (range: 0–18), panic and agoraphobia (range: 0–27), social phobia (range: 0–18), separation anxiety disorder (range: 0–18) and physical fears (range: 0–15). For each item, the children had to indicate how often each symptom occurred, using a Likert-style 4-point scale: never, sometimes, often or always. The psychometric properties of the scale are good with Spaniards, with high internal consistency (Cronbach's alpha<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.89) and appropriate convergent validity with another anxiety disorder measurement (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.41). The factorial structure of the Spanish version maintains the 6 factors used in the original test version.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Statistical analysis</span><p id="par0040" class="elsevierStylePara elsevierViewall">We established 3 age groups based on the level of development and in agreement with other authors’ classification<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>: preadolescence (from 8 to 11 years old), middle adolescence (12–13) and adolescence (14–17 years old). The mean scores, standard deviations (SD) and percentage of sample subjects showing symptoms of each disorder were found; the criterion of the mean plus 2 SD was used as recommended by the author of the test. To ascertain the differences by age and gender, we performed multivariate variance analysis (MANOVA), including sex and gender as fixed factors and the SCAS subscales as dependent variables. We found the Cohen's size effect for the comparisons that were significant, considering 0.20 as a small size, 0.50 as medium and 0.80 as big.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> All the statistical analyses were performed using the program PASW.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">The mean participant score obtained on the scale was 25.15 (SD<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13.54). <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> indicates the mean scores on the test subscales, as well as the percentage of children and adolescents that showed high symptoms in each disorder. The cut-off point for considering anxiety disorder symptoms elevated was 12.8 for the separation anxiety disorder subscale, 11.2 for social phobia, 11.3 for obsessive-compulsive disorder, 7.4 for physical fears, 9.4 for panic and agoraphobia, and 52.2 for the total score. Out of the total for the sample, 26.41% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>666) of the participants had high scores on some type of anxiety disorder. We did not find any high percentages of comorbidity between the symptoms of the disorders. The comorbidity most frequently found was between separation anxiety disorder and physical fears (1.6%), between separation anxiety disorder and panic disorder (1.5%), and between panic disorder and obsessive-compulsive disorder (1.4%).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Significant differences were found in all the dependent variables based on the gender of the participants (<span class="elsevierStyleItalic">F</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>37.435; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001), on age (<span class="elsevierStyleItalic">F</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>4416; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001) and on the interaction between both factors (<span class="elsevierStyleItalic">F</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.657; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001). Looking at gender, the differences were significant in all the subscales, with higher scores by the girls than the boys (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001); the only exception was in the symptoms for the obsessive-compulsive disorder, in which there were no significant differences. <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the means and SDs for males and females, as well as the result of the comparisons in each subscale and in the total score, plus the size of the effect. Based on age, the differences were significant for all the variables except for physical fears. In the subscales for separation anxiety disorder, obsessive-compulsive disorder and panic/agoraphobia, the pre-adolescents presented higher score than the participants in middle adolescence (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001) or adolescence (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001). In social phobia, the adolescents presented higher scores than those in middle adolescence (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.01). In generalised anxiety disorder, the differences were significant between all the developmental stages, the older the child, the higher the score (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001). The means and SDs for each age group, as well as the post hoc comparisons and the size of the effect are presented in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>. The interaction between the factors of age and gender was significant only in the subscale for separation anxiety disorder (<span class="elsevierStyleItalic">F</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>4.672; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.01).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0055" class="elsevierStylePara elsevierViewall">The objective of this study was to examine the characteristics of the symptoms of the main types of anxiety disorder in a wide sample of children and adolescents with ages that ranged from 8 to 17 years old. Our study results show that the symptoms of separation anxiety disorder are the most frequent, followed by the symptoms of physical fears. These findings coincide with the results of previous studies that indicated that separation anxiety disorder, together with specific phobias, is the most frequent anxiety disorder in children and adolescents.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Our study also provides information on the frequency of the symptoms of other types of anxiety disorder less studied in Spanish children and adolescents, such as generalised anxiety disorder or panic disorder (the latter being the one of least prevalence, along with social phobia). The percentage of children and adolescents with high scores in one of the types of anxiety disorder is greater in our study as compared to previous studies.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–5</span></a> The higher prevalence found could be due to the fact that our study assessed symptoms of anxiety disorders and not diagnosed disorders.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Looking at the differences by gender, the girls showed more anxiety than did the boys in all the disorders, except for in obsessive-compulsive disorder. Numerous international studies<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17,18</span></a> state that anxiety disorders are more frequent in females, which coincides with our findings. The absence of significant differences in the symptoms of obsessive-compulsive disorder in function of gender coincides with the results of previous studies in which boys and girls do not differ in the percentage that manifest the symptoms of this disorder.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">The results indicate that, the older the child, the fewer the symptoms of separation, obsessive-compulsive and panic disorders, but the greater the symptoms of social phobia and anxiety disorder. The sizes of the effect also suggest that it is in the symptoms for separation and generalised anxiety disorders where the differences by age are greatest. The fact that separation anxiety disorder symptoms decrease with age is a common finding in previous studies.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The explanation is that this disorder is considered a developmental fear that tends to disappear as the child matures, but it can constitute an anxiety disorder typical in childhood, with onset before the age of 18 years. Despite previous studies<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20,21</span></a> indicating that the risk of having an obsessive-compulsive disorder and a panic disorder increase with age, in our study the prevalence was lower as children's ages increased, although the size of the effect indicated only very small differences. The discrepancy between our results and previous findings could be due to the fact that we used a self-report instrument that evaluates elevated anxiety disorder symptoms in a community sample, not clinical disorders. With respect to obsessive–compulsive disorder symptoms, prior studies indicated that rituals and manias are common in small children<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>; these could therefore have considered such rituals as excessive, thereby obtaining higher scores than the adolescents. The higher scores in social phobia and generalised anxiety disorder reached at older ages coincides with the published scientific literature that indicates that both the social fears and the excessive worries characteristic of generalised anxiety disorder usually appear from pre-adolescence on.<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">23,24</span></a> Lastly, the physical fears in our study participants are constant with age, in agreement with the data in the literature indicating that the fears and phobias that occur in adults might derive from intense fears that appeared in childhood or adolescence.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">This study presents certain limitations and strengths. The main limitation lies in that the information was collected through a report from the children and adolescents and anxiety disorder measurements were not obtained through the parents. It is true that it would have been helpful to have included more than one source of information in the assessment. In spite of this, given the subjective component of discomfort inherent in anxiety disorders, we considered assessment by the subjects themselves an appropriate option. As a study strength, we can emphasise that it updates data on the frequency and characteristics of the symptoms of anxiety disorders in a community sample of children and adolescents, based on the APA manual classification; this in turns makes it possible to know, in greater detail, specific anxiety disorders little studied in Spanish children and adolescents. Greater knowledge of such symptoms makes it easier for mental health professionals to detect and treat them earlier, preventing such subclinical manifestations from constituting clinical anxiety disorders in later developmental stages.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Funding</span><p id="par0075" class="elsevierStylePara elsevierViewall">This research was funded by a <span class="elsevierStyleGrantSponsor">Bancaja-UMH</span> project and a <span class="elsevierStyleGrantSponsor" id="gs0005">Spanish Scientific Research, Development and Technological Innovation Plan</span> project (<span class="elsevierStyleGrantNumber" refid="gs0005">EDU2008-05060</span>).</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ethical responsibilities</span><p id="par0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Protection of people and animals</span>. The authors declare that no experiments were performed on humans or animals for this study.</p><p id="par0085" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Data confidentiality.</span> The authors declare that no patient data appear in this article.</p><p id="par0090" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Right to privacy and informed consent.</span> The authors declare that no patient data appear in this article.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interest</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:2 [ "identificador" => "xres115316" "titulo" => array:5 [ 0 => "Abstract" 1 => "Introduction" 2 => "Materials and methods" 3 => "Results" 4 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec102607" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres115317" "titulo" => array:5 [ 0 => "Resumen" 1 => "Introducción" 2 => "Material y métodos" 3 => "Resultados" 4 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec102608" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Participants" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Procedure" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Assessment tools" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0040" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0045" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0050" "titulo" => "Ethical responsibilities" ] 10 => array:2 [ "identificador" => "sec0055" "titulo" => "Conflict of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-10-04" "fechaAceptado" => "2012-01-24" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec102607" "palabras" => array:5 [ 0 => "Anxiety disorders" 1 => "Anxiety symptoms" 2 => "Childhood" 3 => "Adolescence" 4 => "Self-report" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec102608" "palabras" => array:5 [ 0 => "Trastornos de ansiedad" 1 => "Sintomatología ansiosa" 2 => "Infancia" 3 => "Adolescencia" 4 => "Autoinforme" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Anxiety symptoms in childhood and adolescence are an important risk factor for developing anxiety disorders in subsequent developmental stages. This study examines the frequency and characteristics of the symptoms of the principal anxiety disorders in children and adolescents using a self-report questionnaire based on the diagnostic categories of the American Psychiatric Association (APA) manual.</p> <span class="elsevierStyleSectionTitle">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A cross-sectional, non-interventional study was conducted on 2522 children and adolescents aged 8 to 17 years (49% males), enrolled from different schools in the Province of Alicante who completed the Spence Children's Anxiety Scale.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The mean score obtained on the scale (range: 0–114) was 25.15 (standard deviation (SD)<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13.54). More than one in four (26.41%) of the children and adolescents showed high scores in any anxiety disorder. The anxiety symptoms due to separation were the most frequent in the sample (5.5%), followed by physical fears (5.1%). Girls scored significantly higher in all disorders (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001), except in obsessive-compulsive disorder. Differences were found as regards to age in all disorders, except physical fears, but the effect sizes were only in anxiety due to separation, which decreased with age, and generalised anxiety, which was higher in adolescents than in children.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">From the mental health perspective, it is important to be able to detect anxiety symptoms in children from 8 years onwards, in order to intervene early and prevent the development of anxiety disorders in later life.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los síntomas de ansiedad en la infancia y adolescencia constituyen un importante factor de riesgo para el desarrollo de los trastornos de ansiedad en etapas evolutivas posteriores. Este estudio examina la frecuencia y características de los síntomas de los principales trastornos de ansiedad en niños y adolescentes empleando una medida de autoinforme basada en las categorías diagnósticas del manual de la APA.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se trata de un estudio transversal no intervencionista. Participaron 2.522 niños y adolescentes de 8 a 17 años (49% varones), reclutados de diversos colegios de la provincia de Alicante, que completaron la Escala de Ansiedad Infantil de Spence.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La puntuación media obtenida en la escala (rango: 0-114) fue 25,15 (<span class="elsevierStyleItalic">DT</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13,54). El 26,41% de los niños y adolescentes mostraron puntuaciones elevadas en cualquier trastorno de ansiedad. Los síntomas de ansiedad por separación son los más frecuentes en la muestra (5,5%), seguidos por los miedos físicos (5,1%). Las niñas puntúan significativamente más alto en todos los trastornos (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>,001), excepto en el trastorno obsesivo-compulsivo. Se hallaron diferencias en función de la edad en todos los trastornos, excepto en los miedos físicos, pero los tamaños del efecto fueron medios únicamente en la ansiedad por separación, que desciende con la edad, y en la ansiedad generalizada, mayor en los adolescentes que en los niños.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se destaca la importancia de que, desde el ámbito de salud mental, se lleve a cabo una detección temprana de los síntomas de ansiedad en los niños a partir de 8 años para facilitar la intervención y evitar el desarrollo posterior de los trastornos de ansiedad.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Orgilés M, et al. Síntomas de trastornos de ansiedad en niños y adolescentes: diferencias en función de la edad y el sexo en una muestra comunitaria. Rev Psiquiatr Salud Ment (Barc.). 2012;5:115–20.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Means (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Percentage of subjects with elevated scores \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Separation anxiety \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.27 (2.64) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Social phobia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.94 (3.15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Obsessive-compulsive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.60 (3.35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Generalised anxiety \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.13 (3.31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Physical fears \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.57 (2.40) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Panic/agoraphobia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.69 (3.33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab203105.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Means (standard deviations) and sample percentage with elevated anxiety disorder symptoms.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">d</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>Cohen's effect size; n.s.<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>non-significant differences.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Males (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1234) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Females (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1288) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">t</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">d</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Separation anxiety \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.91 (2.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.62 (2.75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40.42<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.25 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Social phobia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.39 (2.94) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.47 (3.24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.28<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Obsessive-compulsive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.50 (3.29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 (3.42) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">n.s. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Generalised anxiety \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.47 (3.12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.76 (3.37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">82.47<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.40 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Physical fears \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.94 (2.05) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.18 (2.56) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">168.12<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.53 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Panic/agoraphobia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.18 (3.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.17 (3.53) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56.90<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.30 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab203104.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara"><span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Differences by gender: means (standard deviations), statistical significance and size of the effect.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">GAD: generalised anxiety disorder; OCD: obsessive-compulsive disorder; P/A: panic/agoraphobia; PF: physical fears; SAD: separation anxiety disorder; SP: social phobia.</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">d</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>Cohen's effect size; n.s.<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>non-significant differences.</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">The means that share the same superscript are statistically significant.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Age</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">t</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">d</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Pre-adolescence (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>944) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Middle adolescence (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>702) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Adolescence (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>861) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SAD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.17<span class="elsevierStyleSup">a,b</span> (3.12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.79<span class="elsevierStyleSup">a</span> (2.16) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.68<span class="elsevierStyleSup">b</span> (2.12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSup">a</span>1.43<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.51 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSup">b</span>1.47<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.56 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.73<span class="elsevierStyleSup">a</span> (3.28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.91 (3.08) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.20<span class="elsevierStyleSup">a</span> (3.03) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.47<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">OCD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.24<span class="elsevierStyleSup">a,b</span> (3.67) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.26<span class="elsevierStyleSup">a</span> (3.12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.16<span class="elsevierStyleSup">b</span> (3.06) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSup">a</span>1.08<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.29 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSup">b</span>1.17<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.32 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GAD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.32<span class="elsevierStyleSup">a,b</span> (3.47) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.10<span class="elsevierStyleSup">a,c</span> (3.17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.04<span class="elsevierStyleSup">b,c</span> (2.99) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSup">a</span>−0.68<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.23 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSup">b</span>−1.78<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.53 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSup">c</span>−1.10<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.31 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.66 (2.54) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.36 (2.22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.66 (2.38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">n.s. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">P/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.13<span class="elsevierStyleSup">a,b</span> (3.67) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.30<span class="elsevierStyleSup">a</span> (2.94) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.43<span class="elsevierStyleSup">b</span> (3.10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSup">a</span>0.82<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.25 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSup">b</span>0.77<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.21 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab203103.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara"><span 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 11 | 4 | 15 |
| 2024 October | 29 | 14 | 43 |
| 2024 September | 42 | 10 | 52 |
| 2024 August | 28 | 11 | 39 |
| 2024 July | 32 | 15 | 47 |
| 2024 June | 24 | 16 | 40 |
| 2024 May | 43 | 13 | 56 |
| 2024 April | 42 | 11 | 53 |
| 2024 March | 39 | 12 | 51 |
| 2024 February | 29 | 14 | 43 |
| 2024 January | 30 | 8 | 38 |
| 2023 December | 64 | 7 | 71 |
| 2023 November | 25 | 7 | 32 |
| 2023 October | 40 | 18 | 58 |
| 2023 September | 26 | 9 | 35 |
| 2023 August | 16 | 6 | 22 |
| 2023 July | 12 | 9 | 21 |
| 2023 June | 18 | 9 | 27 |
| 2023 May | 22 | 12 | 34 |
| 2023 April | 56 | 16 | 72 |
| 2023 March | 39 | 7 | 46 |
| 2023 February | 34 | 17 | 51 |
| 2023 January | 23 | 11 | 34 |
| 2022 December | 34 | 23 | 57 |
| 2022 November | 26 | 16 | 42 |
| 2022 October | 36 | 20 | 56 |
| 2022 September | 35 | 12 | 47 |
| 2022 August | 35 | 18 | 53 |
| 2022 July | 29 | 9 | 38 |
| 2022 June | 36 | 9 | 45 |
| 2022 May | 22 | 22 | 44 |
| 2022 April | 30 | 9 | 39 |
| 2022 March | 58 | 12 | 70 |
| 2022 February | 59 | 17 | 76 |
| 2022 January | 49 | 18 | 67 |
| 2021 December | 42 | 12 | 54 |
| 2021 November | 45 | 16 | 61 |
| 2021 October | 50 | 16 | 66 |
| 2021 September | 68 | 19 | 87 |
| 2021 August | 64 | 7 | 71 |
| 2021 July | 38 | 15 | 53 |
| 2021 June | 41 | 11 | 52 |
| 2021 May | 40 | 11 | 51 |
| 2021 April | 196 | 39 | 235 |
| 2021 March | 77 | 15 | 92 |
| 2021 February | 63 | 20 | 83 |
| 2021 January | 62 | 16 | 78 |
| 2020 December | 52 | 17 | 69 |
| 2020 November | 48 | 13 | 61 |
| 2020 October | 60 | 29 | 89 |
| 2020 September | 36 | 17 | 53 |
| 2020 August | 47 | 10 | 57 |
| 2020 July | 35 | 11 | 46 |
| 2020 June | 30 | 12 | 42 |
| 2020 May | 42 | 11 | 53 |
| 2020 April | 47 | 14 | 61 |
| 2020 March | 61 | 13 | 74 |
| 2020 February | 60 | 28 | 88 |
| 2020 January | 63 | 17 | 80 |
| 2019 December | 56 | 14 | 70 |
| 2019 November | 37 | 12 | 49 |
| 2019 October | 14 | 3 | 17 |
| 2019 September | 36 | 11 | 47 |
| 2019 August | 10 | 7 | 17 |
| 2019 July | 29 | 12 | 41 |
| 2019 June | 34 | 21 | 55 |
| 2019 May | 79 | 41 | 120 |
| 2019 April | 71 | 19 | 90 |
| 2019 March | 21 | 5 | 26 |
| 2019 February | 8 | 11 | 19 |
| 2019 January | 14 | 10 | 24 |
| 2018 December | 14 | 9 | 23 |
| 2018 November | 22 | 11 | 33 |
| 2018 October | 18 | 5 | 23 |
| 2018 September | 11 | 5 | 16 |
| 2018 August | 4 | 3 | 7 |
| 2018 July | 18 | 7 | 25 |
| 2018 June | 3 | 1 | 4 |
| 2018 May | 5 | 10 | 15 |
| 2018 April | 11 | 3 | 14 |
| 2018 March | 9 | 1 | 10 |
| 2018 February | 5 | 4 | 9 |
| 2018 January | 13 | 0 | 13 |
| 2017 December | 6 | 1 | 7 |
| 2017 November | 20 | 2 | 22 |
| 2017 October | 11 | 2 | 13 |
| 2017 September | 8 | 6 | 14 |
| 2017 August | 9 | 4 | 13 |
| 2017 July | 10 | 2 | 12 |
| 2017 June | 26 | 7 | 33 |
| 2017 May | 20 | 14 | 34 |
| 2017 April | 18 | 11 | 29 |
| 2017 March | 18 | 13 | 31 |
| 2017 February | 18 | 4 | 22 |
| 2017 January | 23 | 1 | 24 |
| 2016 December | 30 | 5 | 35 |
| 2016 November | 19 | 10 | 29 |
| 2016 October | 37 | 5 | 42 |
| 2016 September | 33 | 5 | 38 |
| 2016 August | 18 | 4 | 22 |
| 2016 July | 32 | 2 | 34 |
| 2016 June | 24 | 10 | 34 |
| 2016 May | 31 | 22 | 53 |
| 2016 April | 24 | 10 | 34 |
| 2016 March | 24 | 17 | 41 |
| 2016 February | 30 | 13 | 43 |
| 2016 January | 23 | 14 | 37 |
| 2015 December | 27 | 15 | 42 |
| 2015 November | 16 | 16 | 32 |
| 2015 October | 18 | 10 | 28 |
| 2015 September | 20 | 11 | 31 |
| 2015 August | 19 | 3 | 22 |
| 2015 July | 15 | 5 | 20 |
| 2015 June | 14 | 2 | 16 |
| 2015 May | 14 | 5 | 19 |
| 2015 April | 20 | 8 | 28 |
| 2015 March | 20 | 12 | 32 |
| 2015 February | 27 | 1 | 28 |
| 2015 January | 29 | 9 | 38 |
| 2014 December | 58 | 10 | 68 |
| 2014 November | 23 | 6 | 29 |
| 2014 October | 33 | 3 | 36 |
| 2014 September | 34 | 7 | 41 |
| 2014 August | 24 | 4 | 28 |
| 2014 July | 29 | 3 | 32 |
| 2014 June | 16 | 4 | 20 |
| 2014 May | 24 | 5 | 29 |
| 2014 April | 24 | 2 | 26 |
| 2014 March | 25 | 7 | 32 |
| 2014 February | 23 | 5 | 28 |
| 2014 January | 18 | 5 | 23 |
| 2013 December | 23 | 4 | 27 |
| 2013 November | 36 | 1 | 37 |
| 2013 October | 23 | 6 | 29 |
| 2013 September | 45 | 3 | 48 |
| 2013 August | 39 | 7 | 46 |
| 2013 July | 22 | 1 | 23 |
Show all