Combining CBT and sertraline does not enhance outcomes for anxious youth: a double-blind randomised controlled trial.

Jennifer L Hudson,Valsamma Eapen,Heidi J Lyneham,Ronald M Rapee,Viviana Wuthrich,Lauren F Mclellan

doi:10.1017/s0033291721003329

Jennifer L Hudson, Valsamma Eapen + Show 4 more

Open Access

https://doi.org/10.1017/s0033291721003329

Copy DOI

Abstract

Anxiety disorders are the most prevalent mental disorder in children and young people. Developing effective therapy for these children is critical to reduce mental disorders across the lifespan. The study aimed to evaluate the efficacy of combining cognitive behavioural therapy (CBT) and sertraline (SERT) in the treatment of anxiety in youth, using a double-blind randomised control trial design. Ninety-nine youth (ages 7-15 years) with an anxiety disorder were randomly allocated to either individual (CBT) and SERT or individual CBT and pill placebo and assessed again immediately and 6 months after treatment. There were no significant differences between conditions in remission of primary anxiety disorder or all anxiety disorders. Furthermore, there were no significant differences in rates of change in diagnostic severity, parent-reported anxiety symptoms, child-reported anxiety symptoms or life interference due to anxiety. The efficacy of CBT for children and adolescents with anxiety disorders is not significantly enhanced by combination with a short-term course of anti-depressants over and above the combined effects of pill placebo.

Highlights

Anxiety disorders are the most prevalent mental disorder in children and young people
The current study aimed to evaluate the efficacy of combination treatment for youth anxiety using a double-blind randomised control trial design
Walkup and colleagues observed a distinct advantage of combining medication and cognitive behavioural therapy (CBT) over either monotherapy, yet failed to adequately control for expectancy effects as well as number of treatment visits (Walkup et al, 2008)

Summary

Participants

Participants in the study were 99 children aged 7–15 years = 2.05; 54 boys) meeting criteria for a primary anxiety disorder, OCD or PTSD according to DSM-5 (American Psychiatric Association, 1994). The primary diagnoses were as follows: generalised anxiety disorder (GAD) (48.5%), social anxiety disorder (23.2%), separation anxiety disorder (SAD) (14.1%), specific phobia (5%), panic disorder (2%), OCD (3%), PTSD (1%) and other specified anxiety disorder (3%).

Study design and implementation

Results

36. Thoughts of killing someone else

Discussion