Abstract
Objective To conduct a systematic review about the long-term response to cognitive-behavioral therapy (CBT) for anxiety disorders (ADs) in children and adolescents. Methods The PubMed and ISI Web of Science databases were consulted. Search in the databases was performed in November 2012 and included cohort studies after CBT for ADs in children and adolescents with a follow-up period over 12 months. Results A total of 10 papers met the inclusion criteria. The follow-up period ranged from 12 months to 13 years and the results generally showed maintenance of the short-term benefits with CBT. However, the studies presented limitations, especially regarding methods, such as lack of a control group and losses to follow-up. Conclusion The long-term benefits of CBT were identified, however it would be interesting to conduct other studies with more frequent assessment periods, in order to minimize losses to follow-up, in addition to evaluating children and adolescents in the various stages of their development.
Highlights
Anxiety and fear are emotions inherent to human nature, which become pathological when they are disproportionate to the stimulus or qualitatively differ from that which is observed in a given age group[1], characterizing anxiety disorders (ADs)
The authors suggest that more follow-up studies are needed in order to confirm the predictors of long-term results. Considering these gaps, which are still observed in the literature, this study aims to carry out a systematic review of follow-up studies assessing cognitive-behavioral therapy (CBT) for ADs in children and adolescents
Search in the databases was conducted in November 2012 and 72 abstracts were found: 34 in PubMed and 38 in ISI Web of Science
Summary
Anxiety and fear are emotions inherent to human nature, which become pathological when they are disproportionate to the stimulus or qualitatively differ from that which is observed in a given age group[1], characterizing anxiety disorders (ADs). Retrospective[5] and prospective studies[6,7,8] show that ADs in childhood and adolescence are chronic conditions that do not spontaneously present remission over time If these disorders are not treated in their early stages, they increase the risk of school dropout or predict significant setbacks in academic life[4], as well as psychopathologies in adulthood, such as depression[6,7,8,9,10,11] and substance abuse[12]. In another meta-analysis, with 13 randomized clinical trials (498 patients and 311 controls), the response to CBT for any AD was 56%, compared to 28.2% in the control group (RR: 0.6; CI 95%: 0.53-0.69), with a number needed to treat (NNT) of 3 (CI 95%: 2.5-4.5)[17]
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