Anxiety is a chronic condition, yet only a little more than a third of young people who had received early evidence-based treatment for anxiety reported consistent use of services into early adulthood, according to a study in the Journal of the American Academy of Child and Adolescent Psychiatry.
Tara Peris, Ph.D., of the University of California, Los Angeles, and colleagues wrote that experience with quality mental health treatment early in life should encourage people to seek out such services when necessary as they grow older. “Findings from this large multi-site study indicate that this is not always the case. … On the whole, rates of service use for these youth did not appear to match their level of clinical need.”
Peris and colleagues assessed long-term use of mental health services by 318 young people who had received evidence-based anxiety treatment when they were 7 to 17 years old through the Child/Adolescent Anxiety Multimodal Study (CAMS). CAMS was a six-site, randomized, controlled trial that compared the effects of cognitive-behavioral therapy (CBT), sertraline (SRT), a combination of CBT and sertraline (COMB), and placebo (PBO) on youth with pediatric anxiety disorders.
“[CAMS] youth had generally favorable acute treatment outcomes, with 59.7% of those assigned CBT, 54.9% in SRT, and 80.7% of those in COMB [groups] demonstrating clinically significant response compared with only 23.7% of those receiving PBO,” they noted. However, when following up with these participants some 6.5 years later, the researchers found 58.3% met the criteria for an anxiety disorder.
Overall, 65.1% of participants endorsed ever receiving some form of anxiety treatment over the course of the follow-up period, with more youth reporting medication use than psychotherapy. These rates did not differ by original CAMS treatment assignment, acute treatment response, or remission status, other than that those who did not go into remission reported higher rates of SSRI usage than those in remission. Only 35.2% of participants reported consistent use of anxiety treatment across the course of the study, with no differences based on original treatment condition, response, or remission.
“This study provides the first view of long-term mental health service use among youth previously treated for anxiety,” the researchers wrote. “It suggests that the type of evidence-based treatment and initial response do not influence subsequent decisions about care, and it raises important questions about how to encourage continued engagement and improve outcomes for chronically ill youth.”
For related information, see the Psychiatric News article “Childhood Anxiety Can Be Treated—the Challenge is to Recognize It.”
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