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Long-Term Outcomes of Youth Treated for an Anxiety Disorder: A Critical Review

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Abstract

Pediatric anxiety disorders are common, disabling, and chronic conditions. Efforts over the past two decades have focused on developing and testing effective treatments. Short-term efficacy of both Cognitive Behavioral Therapy (CBT) and selective serotonin reuptake inhibitors has been established. Data are emerging on the long-term (i.e., 2 years or longer) effectiveness of these treatments, but this literature has yet to be adequately synthesized. This study presents a systematic and critical qualitative review of published long-term follow-up (LTFU) studies of youth treated for an anxiety disorder. A comprehensive search of several databases identified 21 published reports (representing 15 LTFU cohorts of treated youth) meeting specified inclusion criteria. LTFU assessments occurred a mean of 5.85 years after initial treatment (range 2–19 years). Diagnostic rates at LTFU and predictors (e.g., demographic, baseline child clinical variables, treatment type) of outcomes at LTFU were also examined. A discussion of the limitations of this literature is provided to qualify interpretations of findings and to inform future studies. Findings can aid clinicians and families in making treatment decisions and setting reasonable expectations for the long-term prognosis after treatment for anxiety.

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Notes

  1. Several DSM-III anxiety disorders (i.e., overanxious disorder, avoidant disorder, simple phobia) were retained in DSM-IV and DSM-5 as GAD, SOP, and SP, respectively. LTFU studies were included if youth met criteria for any of the DSM-III, DSM-IV, or DSM-5 versions of these disorders. However, DSM-5 no longer classifies obsessive-compulsive (e.g., OCD) or trauma-related disorders (e.g., PTSD) as anxiety disorders. Thus, studies of youth treated for primary obsessive-compulsive or trauma-related disorders did not fulfill this second inclusion criterion.

  2. An unweighted average age was calculated using the mean age from each LTFU, unadjusted for LTFU sample size.

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Acknowledgements

We thank Erin Santana and Courtney P. Keeton, Ph.D., for their assistance on an earlier version of this paper. Preparation of this manuscript was supported in part by a grant (K24MH096760) awarded to Dr. Golda Ginsburg by the National Institute of Mental Health.

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  1. Florida State University, 1107 West Call Street, Tallahassee, FL, 32303, USA

    Brittany A. Gibby

  2. University of Connecticut Health, 65 Kane Street, West Hartford, CT, 06119, USA

    Elizabeth P. Casline & Golda S. Ginsburg

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Gibby, B.A., Casline, E.P. & Ginsburg, G.S. Long-Term Outcomes of Youth Treated for an Anxiety Disorder: A Critical Review. Clin Child Fam Psychol Rev 20, 201–225 (2017). https://doi.org/10.1007/s10567-017-0222-9

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