OBJECTIVE Youth with chronic medical conditions (CMCs) have been reported to be at increased risk for developing anxiety disorders. Importantly, suffering from anxiety may also have an impact on their disease-related outcomes. This study set out to systematically review the literature on anxiety and seven CMCs (asthma, congenital heart disease, diabetes, epilepsy, inflammatory bowel disease, juvenile idiopathic arthritis, and sickle cell disease) among youth. METHOD A systematic review was performed according to the PRISMA statement. Searches were conducted across PubMed, PsycNET, Embase, and reference lists of the included studies (1990-2018). Three independent reviewers screened titles and abstracts and conducted full-text assessment. Studies were included if they reported the prevalence of anxiety or the association of anxiety on disease-related outcomes in children and/or adolescents with the focal CMCs. RESULTS A total of 53 studies met the predetermined inclusion criteria. Across the CMCs, the prevalence of anxiety disorder was increased in youths with CMCs compared to the general population. Evidence for a relationship between anxiety and adverse disease-related outcomes was limited. For asthma, inflammatory bowel disease, and sickle cell disease, there was some evidence indicating that anxiety was associated with adverse outcomes; supported by two longitudinal studies, one in asthma and one in inflammatory bowel disease. For diabetes, results were inconsistent; with some studies indicating that anxiety was associated with worse and others with better treatment adherence. CONCLUSION The prevalence of anxiety disorders in youth with CMCs is higher than that in the general population. Anxiety may also be associated with adverse disease-related outcomes for youths, but it is not possible to draw definitive conclusions. Longitudinal studies making use of parent/youth composite anxiety measures and a combination of parent/youth reported and objective measures of disease-related outcomes are needed. Given the burden of disease of anxiety disorders, regardless of the impact on the disease outcomes, screening for and treatment of anxiety is recommended in youths with CMCs.

中文翻译：

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系统评价：患有慢性疾病的儿童和青少年的焦虑。

目的据报道，患有慢性病（CMC）的青年患焦虑症的风险增加。重要的是，患有焦虑症也可能对其疾病相关的预后产生影响。这项研究着手系统地回顾青年中有关焦虑和七个CMC（哮喘，先天性心脏病，糖尿病，癫痫，炎性肠病，幼年特发性关节炎和镰状细胞病）的文献。方法根据PRISMA声明进行系统评价。在PubMed，PsycNET，Embase和纳入研究的参考文献列表中进行检索（1990-2018年）。三名独立审稿人筛选了标题和摘要，并进行了全文评估。如果他们报告了焦点性CMC在儿童和/或青少年中焦虑症的患病率或焦虑症与疾病相关结果的关联，则纳入研究。结果共有53项研究符合预定的纳入标准。在整个CMC中，与普通人群相比，患有CMC的年轻人焦虑症的患病率增加。焦虑和与疾病相关的不良后果之间关系的证据有限。对于哮喘，炎性肠病和镰状细胞病，有证据表明焦虑与不良结局有关。两项纵向研究支持，一项涉及哮喘，一项涉及炎症性肠病。对于糖尿病，结果不一致。一些研究表明焦虑症与病情加重有关，而另一些研究则表明依从性更好。结论CMC患者的焦虑症患病率高于普通人群。焦虑症也可能与青少年与疾病相关的不良后果有关，但不可能得出明确的结论。需要利用父母/青少年综合焦虑测量方法，以及将父母/青年报告的方法与疾病相关预后的客观测量方法相结合的纵向研究。考虑到焦虑症的疾病负担，无论对疾病结果的影响如何，建议对患有CMC的年轻人进行焦虑症的筛查和治疗。需要利用父母/青少年综合焦虑测量方法，以及将父母/青年报告的方法与疾病相关预后的客观测量方法相结合的纵向研究。考虑到焦虑症的疾病负担，无论对疾病结果的影响如何，建议对患有CMC的年轻人进行焦虑症的筛查和治疗。需要利用父母/青少年综合焦虑量度以及报告的父母/青少年与疾病相关结果的客观量度相结合的纵向研究。考虑到焦虑症的疾病负担，无论对疾病结果的影响如何，建议对患有CMC的年轻人进行焦虑症的筛查和治疗。