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Six decades of preventing and treating childhood anxiety disorders: A systematic review and meta-analysis to inform policy and practice

Date created
2019
Authors/Contributors
Author (aut): Schwartz, C.
Author (aut): Barican, J.
Author (aut): Yung, D.
Author (aut): Zheng, Y.
Author (aut): Waddell, C.
Abstract
Question Anxiety disorders are the most prevalent childhood mental disorders. They also start early and persist, causing high individual and collective costs. To inform policy and practice, we therefore asked: What is the best available research evidence on preventing and treating these disorders?Methods We sought randomised controlled trials (RCTs) evaluating interventions addressing anxiety problems in young people. We identified RCTs by searching CINAHL, ERIC, MEDLINE, PsycINFO and Web of Science. Thirty-three RCTs met inclusion criteria—evaluating 8 prevention programmes, 12 psychosocial treatments and 7 pharmacological treatments. We then conducted meta-analyses by intervention type.Findings For prevention, the cognitive-behavioural therapy (CBT) programme Coping and Promoting Strength stood out for reducing anxiety diagnoses. For psychosocial treatment, 9 CBT interventions also reduced diagnoses: Cool Kids; Cool Little Kids Plus Social Skills; Coping Cat; Coping Koala; One-Session Treatment; Parent Education Program; Skills for Academic and Social Success; Strongest Families and Timid to Tiger. Successful CBT interventions were used with children ranging from pre-schoolers to teens in homes, communities/schools and clinics. For pharmacological treatment, selective-serotonergic-reuptake-inhibitors (SSRIs) significantly improved symptoms. Fluoxetine stood out for also reducing post-test diagnoses, but caused adverse events. Meta-analyses indicated strongest effects for CBT (Log OR=0.95; 95% CI, 0.69 to 1.21) and SSRI treatments (1.57; 1.09 to 2.06).Conclusions CBT is effective for preventing and treating childhood anxiety—across a range of ages and formats. Fluoxetine is also an effective treatment but side effects must be managed. CBT prevention and treatment interventions should be made widely available, adding fluoxetine in severe cases.
Document
Published as
Schwartz, C., Barican, J., Yung, D., Zheng, Y., Waddell, C. (2019). Six decades of preventing and treating childhood anxiety disorders: a systematic review and meta-analysis to inform policy and practice. Evidence-Based Mental Health, 22(3), 103–110. https://ebmh.bmj.com/content/22/3/103
Publication title
Evidence-Based Mental Health
Document title
Six decades of preventing and treating childhood anxiety disorders: A systematic review and meta-analysis to inform policy and practice
Date
2019
Volume
22
Issue
3
First page
103
Last page
110
Copyright statement
Copyright is held by the author(s).
Permissions
You are free to copy, distribute and transmit this work under the following conditions: You must give attribution to the work (but not in any way that suggests that the author endorses you or your use of the work); You may not use this work for commercial purposes.
Scholarly level
Peer reviewed?
Yes
Language
English
Download file Size
ebmental-2019-300096.full_.pdf 367.58 KB

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