Golda S. Sinsburg
Of more than 300 youths who received 12-weeks of evidence-based treatments for anxiety disorders, only 21.7% were consistently anxiety free after a 4-year follow-up period, while the rest showed a pattern of relapse or chronic illness, study findings showed.
“Pediatric anxiety disorders are very common and impair the lives and youth and their families,” Golda S. Ginsburg, PhD, of the child division in the department of psychiatry at University of Connecticut School of Medicine, told Healio Psychiatry. “Finding treatments that work and are durable over time can relieve this suffering.”
The researchers reported anxiety outcomes data from 319 youths diagnosed with separation, social and/or generalized anxiety disorders who were enrolled in the multi-site Child/Adolescent Anxiety Multimodal Extended Long-Term Study.
Ginsburg and colleagues examined the rates of consistent anxiety remission and predictors of remission over a 4-year follow-up period, beginning 4 to 12 years after randomization to 12 weeks of treatment with medication, cognitive behavioral therapy, combination medication/CBT or placebo. Predictors of remission included acute treatment response, treatment assignment, baseline child/family variables and negative life events. Participants were evaluated yearly via Anxiety Disorders Interview Schedule and completed questionnaires regarding family functioning, life events and mental health service use.
Analysis showed that remission rates ranged from 42% in year one to 48.8% in year 4 for the total sample. Across all 4 years, the results indicated that 21.7% youth were in stable remission, 30% were chronically ill and 48% relapsed. According to the findings, treatment type was not tied to remission status across the follow-up period.
“We learned that in the short-term, our treatments are helpful. This study found that a majority of anxious youth are likely to have a recurrence of impairing anxiety even after their initial course of treatment,” Ginsburg told Healio Psychiatry. “Consequently, efforts to develop better treatments and relapse prevention approaches seem warranted.”
Youth who responded to acute treatment were less likely to be in the chronically ill group (OR = 2.73; 95% CI, 1.14-6.54; P < .02). Some factors predicted stable remissions from anxiety disorders, including male gender (OR = 3.85, 95% CI = 1.59-9.35), younger age, higher global functioning and fewer interim negative life events. Males and children who were younger at the start of treatment were also more likely to be in stable remission over the 4 years of the follow-up study compared to chronically ill youth, analysis revealed.
“Findings from this study may be used to inform clinical research and practice by providing patients with estimates of prognosis,” Ginsburg and colleagues wrote in the full study. “Further in-depth analyses of these data will follow for years to come, providing additional insights into how we can improve the long-term outcomes for anxious youth.” – by Savannah Demko
: Ginsburg reports support from NIMH and from the U.S. Department of Education/Institute of Education Sciences. Please see the full study for all other authors’ relevant financial disclosures.