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Predictors and moderators of outcome in child and adolescent anxiety and depression: a systematic review of psychological treatment studies

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Abstract

The aim of this literature review was to examine pre-treatment child and adolescent characteristics as predictors and moderators of outcome in psychotherapy treatment trials of anxiety and depressive disorders. A literature search was conducted using several databases and resulted in 45 published studies (32 anxiety studies and 13 depression studies) meeting predefined methodological criteria. Ten client demographic (age, gender, ethnicity, IQ) and clinical factors (duration, type of diagnosis, pre-treatment severity, comorbidity) were examined across studies. The majority of findings showed non-significant associations between demographic factors (gender and age) with treatment outcome for both the anxiety and the depression treatment trials. Some important differences between the results of the anxiety and depression treatment trials were found. The majority of findings for the anxiety studies suggest that there are no demographic or clinical factors that predict or moderate treatment outcome. For the depression studies, however, the findings suggest that baseline symptom severity and comorbid anxiety may impact on treatment response. Overall, existing studies of pre-treatment patient variables as predictors and moderators of anxiety and depression treatment outcome provide little consistent knowledge concerning for what type of patients and under what conditions treatments work. Suggestions for future research are discussed.

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Acknowledgments

This study was supported by “The National Program for Integrated Clinical Specialist and PhD-training for Psychologists” in Norway. This program is a joint cooperation between the Universities of Bergen, Oslo, Tromsø, The Norwegian University of Science and Technology (Trondheim), the Regional Health Authorities, and the Norwegian Psychological Association. The program is funded jointly by The Ministry of Education and Research and The Ministry of Health and Care Services.

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The authors declare that they have no conflict of interest.

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  1. Research Group for Clinical Psychology, Department of Psychology, Faculty of Health Sciences, University of Tromsø, 9037, Tromsö, Norway

    Toril Sørheim Nilsen

  2. Research Group for Mental e-Health, Department of Psychology, University of Tromsø, Tromsö, Norway

    Martin Eisemann

  3. Research Group of Paediatrics, Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsö, Norway

    Siv Kvernmo

  4. Division of Child and Adolescent Health, Department of Child and Adolescent Psychiatry, University Hospital of North, Tromsö, Norway

    Siv Kvernmo

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  1. Toril Sørheim Nilsen
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Correspondence to Toril Sørheim Nilsen.

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Nilsen, T.S., Eisemann, M. & Kvernmo, S. Predictors and moderators of outcome in child and adolescent anxiety and depression: a systematic review of psychological treatment studies. Eur Child Adolesc Psychiatry 22, 69–87 (2013). https://doi.org/10.1007/s00787-012-0316-3

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