Effective Treatment for Youth Anxiety Disorders has Lasting Benefit
Reports new
study in Journal of the American
Academy of Child and Adolescent Psychiatry
Washington D.C., February 27, 2013
A study published in the
March 2014 issue of the Journal of the
American Academy of Child and Adolescent Psychiatry found that the majority
of youth with moderate to severe anxiety disorders responded well to acute
treatment with cognitive behavioral therapy (CBT), medication (sertraline), or a
combination of both. They maintained positive treatment response over a 6 month
follow-up period with the help of monthly booster sessions.
As
part of the NIMH
Child/Adolescent Anxiety Multimodal Study (CAMS), a group of researchers led by
Dr. John Piacentini of the UCLA Semel Institute for Neuroscience and Human
Behavior, followed 412 children and adolescents ages 7-17 after they completed 12
weeks of acute treatment. Treatment responders were offered 6 additional monthly
booster sessions, with those initially on medication continuing this treatment;
all youth, regardless of status at week 12, were re-evaluated 3 and 6 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 6 month follow-up period.
The
study found that over 80% of youth rated as positive responders to one of the
three CAMS treatments at Week 12 were also rated as responders at both the 3
and 6 month follow-up evaluations.
Conversely, only 5% of youth who received combined CBT plus sertraline,
and 15-16% 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 (UCLA, Duke University, Columbia
University/New York University, Johns Hopkins University, Temple University,
and the Western Psychiatric Institute and Clinics/University of Pittsburgh) and
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. Piacentini. "A separate project by the CAMS researchers
is now gathering information on how study participants are doing up to 10 years
after study participation."
The
article "24 and 36 Week Outcomes for the
Child/Adolescent Anxiety Multimodal Study (CAMS)" by John Piacentini, Ph.D., Shannon Bennett, Ph.D., Scott
Compton, Ph.D., Philip C. Kendall, Ph.D., Boris Birmaher, M.D., Anne Marie
Albano, Ph.D., John March, M.D., M.P.H., Joel Sherrill, Ph.D., Dara Sakolsky,
M.D., Golda Ginsburg, Ph.D., Moira Rynn, M.D., R. Lindsey Bergman, Ph.D.,
Elizabeth Gosch, Ph.D., Bruce Waslick, M.D., Satish Iyengar, Ph.D., James
McCracken, M.D., and John Walkup, M.D. (http://dx.doi.org/10.1016/j.jaac.2013.11.010)
appears in the Journal of the American Academy of Child and Adolescent
Psychiatry, Volume 53, Issue 3 (March 2014), published by Elsevier.
A
related editorial, "Treating Anxiety in Youth: Does Maintenance Treatment
Maintain?" by Dr. Neal D. Ryan, (http://dx.doi.org/10.1016/j.jaac.2013.11.008)
is published in the same issue.
Funding:
This research was supported by National Institute of Mental Health (NIMH)
grants U01 MH64088 (J.P.), U01 MH064003 (S.C.), U01 MH63747 (P.K.), U01 MH64003
(B.B.), U01 MH64092 (A.M.A.), U01 MH64107 (J.M.), and U01 MH064089 (J.W.). Sertraline
and matching placebo were supplied free of charge by Pfizer.
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Notes
for editors
Full text of the article is available to credentialed
journalists upon request; contact Mary Billingsley at +1 202 966 7300 x105 or mbillingsley@jaacap.org.
Journalists wishing to interview the authors may contact John Piacentini at jpiacentini@mednet.ucla.edu.
All articles published in JAACAP are embargoed until the day they are published as in press
corrected proofs online at http://jaacap.org/inpress.
Articles cannot be publicized as in press accepted manuscripts. Contents of the
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to the embargo date.
About JAACAP
Journal of the American Academy of Child and Adolescent
Psychiatry (JAACAP) is the official publication of the American Academy of
Child and Adolescent Psychiatry. JAACAP is the leading journal focusing
exclusively on today's psychiatric research and treatment of the child and
adolescent. Published twelve times per year, each issue is committed to its
mission of advancing the science of pediatric mental health and promoting the
care of youth and their families.
The journal's purpose is to advance research,
clinical practice, and theory in child and adolescent psychiatry. It is
interested in manuscripts from diverse viewpoints, including genetic, epidemiological,
neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and
economic. Studies of diagnostic reliability and validity, psychotherapeutic and
psychopharmacological treatment efficacy, and mental health services
effectiveness are encouraged. The journal also seeks to promote the well-being
of children and families by publishing scholarly papers on such subjects as
health policy, legislation, advocacy, culture and society, and service
provision as they pertain to the mental health of children and families.
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Media contact
Mary Billingsley
JAACAP Editorial Office
+1 202 966 7300 x105
mbillingsley@jaacap.org