Effective treatment for youth anxiety disorders has lasting benefit

Reports new study in Journal of the American Academy of Child and Adolescent Psychiatry

2014-02-27

(Press-News.org) 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."

INFORMATION: 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. 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, 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.

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 publication should not be released to or by the media or government agencies prior 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.

About Elsevier

Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet and Cell, and 25,000 book titles, including major reference works from Mosby and Saunders. Elsevier's online solutions include ScienceDirect, Scopus, SciVal, Reaxys, ClinicalKey and Mosby's Suite, which enhance the productivity of science and health professionals, helping research and health care institutions deliver better outcomes more cost-effectively.

A global business headquartered in Amsterdam, Elsevier employs 7,000 people worldwide. The company is part of Reed Elsevier Group PLC, a world leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media contact

Mary Billingsley
JAACAP Editorial Office
+1 202 966 7300 x105
mbillingsley@jaacap.org

ELSE PRESS RELEASES FROM THIS DATE:

New invasive species breakthrough sparks interest around the world

2014-02-27

A research breakthrough at Queen's University Belfast has sparked interest among aquatic biologists, zoologists and ecologists around the world. The joint research between Queen's and several South African institutions centred on the behaviour of some of the "world's worst" invasive species, including the large-mouth bass, an invasive fish which typically devastates invertebrate and other fish communities wherever it is introduced. Previously, the search for general characteristics of invasive species had been elusive, but work carried out by Professor Jaimie Dick ...

More dangerous chemicals in everyday life: Now experts warn against nanosilver

2014-02-27

Endocrine disrupters are not the only worrying chemicals that ordinary consumers are exposed to in everyday life. Also nanoparticles of silver, found in e.g. dietary supplements, cosmetics and food packaging, now worry scientists. A new study from the University of Southern Denmark shows that nano-silver can penetrate our cells and cause damage. Silver has an antibacterial effect and therefore the food and cosmetic industry often coat their products with silver nanoparticles. Nano-silver can be found in e.g. drinking bottles, cosmetics, band aids, toothbrushes, running ...

Probing the edge of chaos

2014-02-27

The edge of chaos—right before chaos sets in—is a unique place. It is found in many dynamical systems that cross the boundary between a well-behaved dynamics and a chaotic one. Now, physicists have shown that the distribution—or frequency of occurrence—of the variables constituting the physical characteristics of such systems at the edge of chaos has a very different shape than previously reported distributions. The results, by Miguel Angel Fuentes from the Santa Fe Institute in New Mexico, USA, and Universidad del Desarrollo, Chile, and Alberto Robledo from the National ...

A novel treatment may reduce myocardial infarction size

2014-02-27

Researchers at the University of Eastern Finland (UEF) have developed a novel treatment for myocardial infarction. In a study carried out at the UEF, virus vectors were used in a mouse model to deliver small RNA molecules into the heart, and this significantly reduced the size of myocardial infarction. In the novel treatment method, RNA molecules are targeted at the regulatory area of the vascular endothelial growth factor gene (VEGF-A). These molecules use epigenetic mechanisms to enhance the production of the growth factor in cells. The study also focused on the mechanisms ...

Over-80s often over-treated for stroke prevention

2014-02-27

People in their 80s are often prescribed drugs to ward off a stroke when the risk of a stroke is not that high and the drugs have other side effects, finds a perspective published online in Evidence Based Medicine. People in this age group are being "over-treated," and doctors need to actively rethink their priorities and beliefs about stroke prevention, argues Dr Kit Byatt of the Department of Geriatric Medicine, The County Hospital in Hereford, UK. Statins and antihypertensive drugs were the most commonly prescribed cardiovascular drugs in the UK in 2006. And they ...

Cesarean babies are more likely to become overweight as adults

2014-02-27

Babies born by caesarean section are more likely to be overweight or obese as adults, according to a new analysis. The odds of being overweight or obese are 26 per cent higher for adults born by caesarean section than those born by vaginal delivery, the study found (see footnote). The finding, reported in the journal PLOS ONE, is based on combined data from 15 studies with over 38,000 participants. The researchers, from Imperial College London, say there are good reasons why many women should have a C-section, but mothers choosing a caesarean should be aware that ...

A road map -- and dictionary -- for the arthropod brain

2014-02-27

When you're talking about something as complex as the brain, the task isn't any easier if the vocabulary being used is just as complex. An international collaboration of neuroscientists has not only tripled the number of identified brain structures, but created a simple lexicon to talk about them, which will be enormously helpful for future research on brain function and disease. Nick Strausfeld and Linda Restifo, both professors in the Department of Neuroscience at the University of Arizona, worked with colleagues in Japan who led the project, and colleagues in Germany ...

Low birth weight reduces ability to metabolize drugs

2014-02-27

PORTLAND, Ore. – Researchers have identified another concern related to low birth weight – a difference in how the body reacts to drugs, which may last a person's entire life and further complicate treatment of illnesses or diseases that are managed with medications. The findings add to the list of health problems that are already known to correspond to low birth weight, such as a predisposition for adult-onset diabetes, hypertension, and obesity. The implication, researchers say, is that low birth weight may not only cause increased disease, but it may also lessen the ...

Experimental treatment developed at UCLA eradicates acute leukemia in mice

2014-02-27

A diverse team of scientists from UCLA's Jonsson Comprehensive Cancer Center has developed an experimental treatment that eradicates an acute type of leukemia in mice without any detectable toxic side effects. The drug works by blocking two important metabolic pathways that the leukemia cells need to grow and spread. The study, led by Dr. Caius Radu, an associate professor of molecular and medical pharmacology at UCLA, and Dr. David Nathanson, an assistant professor of molecular and medical pharmacology, was published in the Journal of Experimental Medicine. Elements ...

Huntington proteins and their nasty 'social network'

2014-02-27

Researchers at the Buck Institute have identified and categorized thousands of protein interactions involving huntingtin, the protein responsible for Huntington's disease (HD). To use an analogy of a human social network, the identified proteins are like "friends" and "friends of friends" of the HD protein. The network provides an invaluable resource for identifying targets to treat the disease and has been used to implicate a particular signaling pathway involved in cell motility. HD is an incurable, fatal, inherited neurological disorder that causes severe degeneration ...

Effective treatment for youth anxiety disorders has lasting benefit

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: