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Combined Psychological and Pharmacological Treatment of Pediatric Anxiety Disorders

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Handbook of Child and Adolescent Anxiety Disorders

Abstract

The identification of efficacious psychological and psychiatric therapies is arguably one of the most significant achievements in the pediatric anxiety disorders field. Controlled trials have supported the usefulness of psychological and pharmacological monotherapies for pediatric obsessive–compulsive disorder, social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder, specific phobia, posttraumatic stress disorder, and separation anxiety disorder (Compton et al., 2004; Feeney, Foa, Treadwell, & March, 2004; In-Albon & Schneider, 2007; Reinblatt & Riddle, 2007; Seidel & Walkup, 2006; Watson & Rees, 2008). Clinical practice guidelines, developed from a synthesis of research evidence and expert opinion, have recommended cognitive-behavioral therapy (CBT) as the first line psychotherapy and treatment of choice (American Academy of Child and Adolescent Psychiatry (AACAP), 2007; Canadian Psychiatric Association (CPA), 2006). The selective serotonin reuptake inhibitors (SSRIs) are the recommended first-line pharmacological agents for pediatric anxiety disorders. Second or third-line pharmacotherapy alternatives include noradrenergic antidepressants (tricyclic antidepressants (TCAs), venlafaxine), benzodiazepines, and buspirone.

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Notes

  1. 1.

     In the POTS (2004) trial, there were 154 youth screened. Of these, 112 were randomized to treatment, 31 were deemed ineligible, 10 were not interested in participating, and 1 was asymptomatic at baseline. Of those contactable and able to participate in treatment (n  =  143), 78% (n  =  122 of 143) were randomized and 22% (n  =  31 of 143) were deemed ineligible. In the CAMS (2008) trial, 3,066 youth were screened. Of these, 488 were randomized to treatment, 1,223 were deemed ineligible, 817 were not interested in participating, 462 were not contactable, and 73 could not participate for other reasons, and 3 were asymptomatic at baseline. Of those who were contactable and able to participate in treatment (n  =  1711), 29% (n  =  488 of 1711) were deemed eligible and were randomized to treatment, and 71% (n  =  1223 of 1711) were deemed ineligible and were not included in the study.

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  1. Department of Health in Western Australia, Centre for Clinical Interventions, 223 James Street, Northbridge, Perth, WA, Australia

    Hunna J. Watson

  2. Psychological Medicine Clinical Care Unit, Princess Margaret Hospital for Children, Perth, WA, Australia

    Hunna J. Watson

  3. School of Paediatrics and Child Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, WA, Australia

    Hunna J. Watson

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  1. , Department of Psychology, Fordham University, East Fordham Road 441, Bronx, 10458, New York, USA

    Dean McKay

  2. , Departments of Pediatrics, Psychiatry, a, University of South Florida, Tampa, 33612, Florida, USA

    Eric A. Storch

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Watson, H.J. (2011). Combined Psychological and Pharmacological Treatment of Pediatric Anxiety Disorders. In: McKay, D., Storch, E. (eds) Handbook of Child and Adolescent Anxiety Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7784-7_26

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