Social and academic functioning in adolescents with anxiety disorders: A systematic review

Background: Anxiety disorders are highly prevalent during adolescence. Although literature points out that anxiety symptoms are related to problems in social and academic functioning, the extent of these problems among adolescents with clinical anxiety disorders has not been systematically reviewed before. Methods: Electronic databases were searched up to October 2017, with keywords representing anxiety disorders, adolescents, and social or academic functioning. The inclusion criteria were studies with a sample of adolescents (10–19 years) with anxiety disorders that provided data regarding their social or academic functioning. 3431 studies were examined, of which 19 met the inclusion criteria. Results: Adolescents with anxiety disorders had a lower social competence relative to their healthy peers. They reported more negativity within interpersonal relationships, higher levels of loneliness, and victimization. Most adolescents with anxiety disorders felt impaired at school, however, findings of their average school results, compared to peers, were mixed. In addition, they had a higher risk for school refusal and entered higher education less often. Impairments in social and academic functioning differed across type and the number of anxiety disorders. Limitations: Most studies examined social phobia or anxiety disorders in general and methodological approaches varied widely between studies. Conclusions: This systematic review indicates that adolescents with anxiety disorders experience a range of significant problems in both social and academic functioning. These findings suggest that the assessment and treatment of anxiety disorders in adolescence should focus on improving functioning across domains.