Combined Therapy Eases Anxiety in Children

January 1, 2009

A combination of cognitive-behavioral therapy (CBT) and antidepressants to treat anxiety disorders in youngsters has yielded positive results in a government-funded study that was published online by the New England Journal of Medicine.1

A combination of cognitive-behavioral therapy (CBT) and antidepressants to treat anxiety disorders in youngsters has yielded positive results in a government-funded study that was published online by the New England Journal of Medicine.1

John T. Walkup, MD, and colleagues conducted a randomized, controlled trial of 488 children aged 7 to 17 years for whom a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia had been made. Participants received 14 sessions of CBT, sertraline, a combination of sertraline and CBT, or placebo for 12 weeks. The researchers assessed categorical and dimensional ratings of anxiety severity and impairment at baseline and again at 4, 8, and 12 weeks.

Children were rated using the Clinician Global Impression–Improvement scale; 80.7% of those who received combination therapy were much or very much improved. Only 59.7% of children who received CBT and 54.9% of children who were treated with sertraline showed such improvement. All therapies were superior to placebo.

Adverse events, including suicidal and homicidal ideation, were no more frequent in the sertraline group than in the placebo group. There was less insomnia, fatigue, sedation, and restlessness associated with CBT than with sertraline treatment.