Assessment and Treatment of Anxiety Disorders in Children and Adolescents
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Recent advances in the developmental epidemiology, neurobiology, and treatment of pediatric anxiety disorders have increased our understanding of these conditions and herald improved outcomes for affected children and adolescents. This article reviews the current epidemiology, longitudinal trajectory, and neurobiology of anxiety disorders in youth. Additionally, we summarize the current evidence for both psychotherapeutic and psychopharmacologic treatments of fear-based anxiety disorders (e.g., generalized, social, and separation anxiety disorders) in children and adolescents. Current data suggest that these disorders begin in childhood and adolescence, exhibit homotypic continuity, and increase the risk of secondary anxiety and mood disorders. Psychopharmacologic trials involving selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SSNRIs) are effective in pediatric patients with anxiety disorders and have generally demonstrated moderate effect sizes. Additionally, current data support cognitive behavioral therapy (CBT) for the treatment of these conditions in youth and suggest that the combination of psychotherapy + an SSRI may be associated with greater improvement than would be expected with either treatment as monotherapy.
KeywordsAntidepressant Anxiety disorders
Selective serotonin reuptake inhibitor
Separation anxiety disorder
Generalized anxiety disorder
Compliance with Ethics Guidelines
Conflict of Interest
Katja Beesdo-Baum and Meghann M. Hennelly declare that they have no conflict of interest.
Anna M. Wehry has received a grant from the American Academy of Child and Adolescent Psychiatry.
Sucheta D. Connolly has received a grant from the National Institute of Mental Health, 1R01MH086517, (01 Jul. 2010–31 Mar. 2015) (Phan and Monk, co-PIs) Brain Markers of Anxiety Disorders and SSRI Treatment in Children and Adolescents. Role: coinvestigator.
Jeffrey R. Strawn has received research support from Edgemont, Eli Lilly, Shire, Forest Research Institute and the National Institute of Mental Health (NIMH).
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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