Abstract: Objective To explore the relationship between diagnostic stability and symptom variation in childhood anxiety disorder(AD).Methods With cluster sampling, 5233 pupils aged 7-13 years(grade 3-6) were recruited from 2 primary schools in Pingyang district of Xinyang municipality, Henan province and screened for AD using Strengths and Difficulties Questionnaire(SDQ) for students; the pupils with SDQ positive score were then tested with Development and Well-Being Assessment(DAWBA) between October 2012 and October 2014.Of 101 pupils with AD diagnosis based on DAWBA test, 86 were further assessed with Screen for Child Anxiety Related Emotional Disorder(SCARED) and followed-up for 2 times of assessment with SCARED during October 2013 and 2014; the symptom variations and interaction between the variations and diagnosis among the 83 AD pupils with different clinic outcomes were analyzed using repeated measurement data.Chi-square tests, t test, and analysis of variance were adopted in the study.Results Totally 73 AD pupils completed the whole follow-up, of which, 45 and 50(61.64% and 68.49%) were self-cured and no significant associations of gender and age with the self-cure were observed.The SCARED scores were 27.40±11.62, 19.88±7.32 and 17.61±5.54 for the self-cured AD pupils and 30.05±13.43, 22.52±10.02 and 22.62±7.38 for the uncured AD pupils at the basic measurement, first and second follow-up, respectively.There was a significant interaction between AD diagnosis and SCARED scores among the 73 AD pupils(P=0.041); but no significant associations of AD diagnosis with SCARED scores among the uncured AD pupils(P=0.067).Conclusion The diagnostic stability of childhood AD is low and lack of clinical and pathological validity.