Child & Youth Care Forum

, Volume 47, Issue 5, pp 633–644 | Cite as

Pharmacotherapy Adherence for Pediatric Anxiety Disorders: Predictors and Relation to Child Outcomes

  • Asima Zehgeer
  • Golda S. Ginsburg
  • Phyllis Lee
  • Boris Birmaher
  • John Walkup
  • Philip C. Kendall
  • Dara Sakolsky
  • Tara Peris
Original Paper



Pharmacotherapy is considered an evidenced-based treatment for anxious youth. There is a need to better understand the relation between medication adherence and child outcomes.


This study prospectively examined: (1) baseline predictors of adherence and (2) the relation between medication adherence and clinical outcomes in children and adolescents with anxiety disorders.


Participants were 349 youth randomized to sertraline, pill placebo, or sertraline plus cognitive behavioral therapy in the Child/Adolescent Anxiety Multimodal Study and followed over 12 weeks. The measure of pharmacotherapy adherence used was pharmacotherapist (PT) ratings of adherence at each session. Four domains of baseline predictors were examined (demographics, child clinical variables, family/parent variables, and treatment variables).


Multiple regression analyses revealed few significant predictors of adherence. The most robust predictors of greater adherence were living with two parents and parents’ positive expectations that medication would lead to better outcomes. PTs ratings of higher adherence predicted higher global functioning at post treatment and treatment responder status.


In order to increase adherence, improving expectations and instilling hope for positive outcomes and problem solving ways to overcome pragmatic barriers associated with single parent families is recommended. Number



Anxiety Adherence Selective serotonin reuptake inhibitors 



This research was supported the National Institute of Mental Health Grants U01MH64089, U01MH64107, U01MH64003, U01MH63747, U01MH064092, and U01MH64088 awarded to the PIs of the Child/Adolescent Anxiety Multimodal Study.

Compliance with Ethical Standards

Conflict of interest

None of the authors have potential conflicts of interest to report.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Asima Zehgeer
    • 1
  • Golda S. Ginsburg
    • 1
    • 6
  • Phyllis Lee
    • 1
  • Boris Birmaher
    • 2
  • John Walkup
    • 3
  • Philip C. Kendall
    • 4
  • Dara Sakolsky
    • 2
  • Tara Peris
    • 5
  1. 1.Department of PsychiatryUniversity of Connecticut School of MedicineFarmingtonUSA
  2. 2.Department of PsychiatryUniversity of Pittsburgh Medical CenterPittsburghUSA
  3. 3.Department of PsychiatryAnn and Robert H. Lurie Children’s HospitalChicagoUSA
  4. 4.Department of PsychologyTemple UniversityPhiladelphiaUSA
  5. 5.Department of PsychiatryUniversity of California, Los AngelesLos AngelesUSA
  6. 6.Department of PsychiatryUniversity of Connecticut School of MedicineWest HartfordUSA

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