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A study found a 47% prevalence of anxiety in children with CVS.11 In adults, the prevalence of anxiety varies widely, from 15% to 84%, and was significantly associated in a multivariate analysis.61,62 Similarly, up to 78% of adults with CVS have been reported to present with mild-to-severe depression.62 Although the direct pathophysiologic mechanisms of anxiety or depression in CVS remain nuclear, the elevated incidence of these disorders suggests that emotional regulation plays an important role in the pathophysiology and development of CVS