Treating concurrent mental disorders in children

Background: Approximately 26.5 percent of children who meet diagnostic criteria for one mental disorder, meet criteria for two or more. Children with multiple disorders often face added challenges, including poorer quality of life and more peer problems. To better assist these young people, we set out to identify effective interventions for treating co-occurring disorders.
Methods: We used systematic review methods to identify randomized controlled trials (RCTs) evaluating treatments designed to address two disorders in a single intervention. After applying our rigorous inclusion criteria, we accepted five RCTs evaluating three treatments.
Results: The effects of the interventions were mixed. Both Brief Behavioral Therapy for anxiety and depression and Risk Reduction through Family Therapy for posttraumatic stress disorder (PTSD) and substance use resulted in some symptom reduction. Multidimensional Family Therapy, which aimed to reduce substance use disorders and behaviour problems, similarly showed mixed outcomes. In one of three RCTs, substance use was reduced while in all three RCTs there were at least one indicator of reductions in behaviour concerns.
Conclusions: Transdiagnostic treatments can be effective for young people experiencing co-occurring disorders, including for symptoms of anxiety, behaviour problems, substance use and PTSD. Given the “double” challenges facing young people with co-occurring mental disorders building capacity to address them is essential.