Remission of Pediatric Anxiety Disorders More Likely With Response to Treatment

Youths who responded to treatment during the acute phase of a pediatric anxiety disorder in a clinical trial were more likely than those who did not to be in remission from those disorders an average six years later, according to a study by Golda S. Ginsburg, Ph.D., of The Johns Hopkins University School of Medicine, Baltimore, and colleagues.

Pediatric anxiety disorders are prevalent in childhood and can disrupt development and be associated with adult mental health problems, according to the study background.

The authors examined long-term outcomes among youths diagnosed with an anxiety disorder and randomized to one of four treatments (cognitive behavioral therapy, the medication sertraline, a combination of both or a placebo) as part of the Child/Adolescent Anxiety Multimodal Study (CAMS), an anxiety treatment study. The follow-up study included 288 youths (11-26 years, average age 17) who were evaluated an average six years after randomization.

Nearly half the youths (46.5 percent) were in remission (defined as the absence of all anxiety disorders present at the start of the study) an average six years following randomization. Participants who initially responded to treatment were more likely to be in remission and have less severe anxiety symptoms and higher functioning, regardless of treatment type, according to the results.

Study results also indicate that the most consistent factors associated with remission were male sex and family functioning (families that had clear rules, more trust and higher-quality interactions) based on parent reports at baseline.

Still, the authors note that almost half of the youths relapsed, which they suggest highlights the need for more intensive or continued treatment for a large proportion of anxious youth.

“Predictors of remission (e.g. male sex and better family functioning) suggest potential targets for intervention and identify risk factors for poorer outcomes related to anxiety disorders,” the authors conclude.

(JAMA Psychiatry. Published online January 29, 2014. doi:10.1001/jamapsychiatry.2013.4186.