Oxidative Stress and Thiol-Disulphide Hemostasis in Children with Anxiety Disorders

Abstract

Introduction: Anxiety disorders (AD) constitute a significant part of mental health problems; however, their pathogenesis remains not fully elucidated. The balance between the oxidative and antioxidative systems are disrupted in children with AD. The total oxidant/antioxidant status (TOS/TAS) and thiol/disulphide homeostasis (TDH) show oxidative stress through different mechanisms. To date, research in this context has tended to focus on adults rather than children. Despite this, understanding oxidative stress in pediatric populations is increasingly emphasized. Therefore, this research aims to investigate TOS/TAS and TDH in children with AD. Methods: The study included 40 treatment-naive children with AD and 40 healthy controls matched by age and sex. Sociodemographic data and The Screen for Child Anxiety-Related Emotional Disorders (SCARED) were used for assessment. Results: The results showed that TOS and the Oxidative Stress Index (OSI) were elevated, and TAS was reduced in children with AD compared to controls. However, when evaluated in terms of TDH, there was no significant difference. Logistic regression analysis identified TOS as a significant predictor of AD (p=0.027; OR=5.49, 95% CI: 1.21–24.84). Although dynamic-disulphide level improved the model’s predictive accuracy, they did not reach statistical significance (p=0.063). Conclusion: These findings suggest a potential oxidative dysfunction in AD. The study highlights the potential utility of TOS as a robust biomarker for distinguishing pediatric AD from HC. Furthermore, the absence of significant changes in TDH suggests that oxidative stress in pediatric AD may primarily involve alternative pathways. This may involve a complex interplay of DNA damage, lipid peroxidation, and protein oxidation processes contributing to the oxidative stress observed in AD. To explore the potential for using oxidative stress markers as novel targets for treatment and diagnostic tools for AD, prospective, large-scale, randomized trials are required. © 2025 by Turkish Association of Neuropsychiatry.