Racial/Ethnic differences in the prevalence of anxiety using the Vanderbilt ADHD scale in a diverse community outpatient setting

Abstract

Objective Pediatric anxiety is prevalent but frequently under-diagnosed compared to other behavioral conditions in primary care practice. Pediatricians routinely screen for attention deficit hyperactivity disorder using the Vanderbilt Rating Scale, which includes a short screen for anxiety. We sought to examine the prevalence of potential anxiety among patients whose parents originally had concerns of disruptive behavior in a diverse setting and examine differences in anxiety across ethnic groups using the Vanderbilt ADHD Diagnostic Rating Scale (VADRS). Methods This was a cross-sectional analysis of medical records data of children between the ages of 5–12 years whose parents had concerns of disruptive behavior and received primary care from May 25, 2010 to January 31, 2014 at 2 pediatric community health clinics in Indianapolis. Results 16% of children whose parents had concerns for disruptive behavior screened positive for anxiety based on the VADRS screen. Hispanic parents were less likely to report symptoms of anxiety (Spanish-speaking: AOR 0.4, 95% CI 0.2 – 0.8; English-speaking: AOR 0.3, 95% CI 0.1 – 0.9) compared to white and black families. Conclusion Anxiety is detected at a lower rate among Hispanic pediatric patients using the VADRS. This may suggest differences in the performance of the VADRS among Spanish speaking families.