A new study confirms that current treatment strategies for youth with moderate to severe anxiety disorders are effective and provide long-term benefits.
As published in the Journal of the American Academy of Child and Adolescent Psychiatry, researchers found that the majority of youth anxiety disorders responded well to acute treatment with cognitive behavioral therapy (CBT), medication (sertraline), or a combination of both.
Investigators found that youth participants maintained positive treatment response over a six month follow-up period with the help of monthly booster sessions.
As part of the NIMH Child/Adolescent Anxiety Multimodal Study (CAMS), researchers followed 412 children and adolescents ages 7-17 after they completed 12 weeks of acute treatment.
Treatment responders were offered six additional monthly booster sessions, with those initially on medication continuing this treatment; all youth, regardless of status at week 12, were re-evaluated three and six months later by trained clinicians.
Twenty-seven percent of study participants also reported receiving outside (e.g. nonstudy) psychotherapy and/or medication for mental health symptoms over the six month follow-up period.
The study found that over 80 percent of youth rated as positive responders to one of the three CAMS treatments at Week 12 were also rated as responders at both the three and six month follow-up evaluations.
Conversely, only five percent of youth who received combined CBT plus sertraline, and 15-16 percent of youth receiving either CBT-only or sertraline-only, failed to achieve responder status at any time during the study.
Youth in the combined CBT+sertraline group showed greater treatment benefits on some, but not all outcome measures, and used less nonstudy treatments than those in the CBT-only and sertraline-only groups.
Collectively, anxiety disorders are the most common mental disorders in children and adolescents. Often overlooked, severe anxiety can significantly impair children’s school, social, and family functioning, and if untreated, can increase the risk of depression, alcohol and substance abuse, and occupational difficulties in adulthood.
CAMS is the largest randomized controlled comparative treatment trial for child/adolescent anxiety disorders ever conducted.
Participants were recruited at six regionally dispersed sites throughout the United States (University of California Los Angeles, Duke University, Columbia University/New York University, Johns Hopkins University, Temple University, and the Western Psychiatric Institute and Clinics/University of Pittsburgh).
They were randomly assigned to 12 weeks of treatment with cognitive behavioral therapy (Coping cat), the selective serotonin reuptake-inhibiting [SSRI] medication sertraline, cognitive behavioral therapy combined with sertraline, or pill placebo.
All participants had moderate to severe separation anxiety disorder, generalized anxiety disorder or social phobia, with most having multiple anxiety, or other mental health disorders.
“The results of this study provide further evidence of the benefits of cognitive behavioral therapy and SSRI medication, alone or in combination, for treating clinically significant anxiety in children and adolescents,” said Dr. John Piacentini of the University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior.
“A separate project by the CAMS researchers is now gathering information on how study participants are doing up to 10 years after study participation.”