Treating child and adolescent anxiety effectively: Overview of systematic reviews

Kathryn Bennett, Katharina Manassis, Stephanie Duda, Alexa Bagnell, Gail A. Bernstein, E. Jane Garland, Lynn D. Miller, Amanda Newton, Lehana Thabane, Pamela Wilansky

Research output: Contribution to journalReview article

10 Scopus citations

Abstract

We conducted an overview of systematic reviews about child and adolescent anxiety treatment options (psychosocial; medication; combination; web/computer-based treatment) to support evidence informed decision-making. Three questions were addressed: (i) Is the treatment more effective than passive controls? (ii) Is there evidence that the treatment is superior to or non-inferior to (i.e., as good as) active controls? (iii) What is the quality of evidence for the treatment? Pre-specified inclusion criteria identified high quality systematic reviews (2000–2015) reporting treatment effects on anxiety diagnosis and symptom severity. Evidence quality (EQ) was rated using Oxford evidence levels [EQ1 (highest); EQ5 (lowest)]. Twenty-two of 39 eligible reviews were high quality (AMSTAR score ≥ 3/5). CBT (individual or group, with or without parents) was more effective than passive controls (EQ1). CBT effects compared to active controls were mixed (EQ1). SSRI/SNRI were more effective than placebo (EQ1) but comparative effectiveness remains uncertain. EQ for combination therapy could not be determined. RCTs of web/computer-based interventions showed mixed results (EQ1). CBM/ABM was not more efficacious than active controls (EQ1). No other interventions could be rated. High quality RCTs support treatment with CBT and medication. Findings for combination and web/computer-based treatment are encouraging but further RCTs are required. Head-to-head comparisons of active treatment options are needed.

Original languageEnglish (US)
Pages (from-to)80-94
Number of pages15
JournalClinical Psychology Review
Volume50
DOIs
StatePublished - Dec 1 2016

Keywords

  • Adolescent
  • Anxiety
  • Child
  • Clinical decision making
  • Review
  • Therapeutics

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    Bennett, K., Manassis, K., Duda, S., Bagnell, A., Bernstein, G. A., Garland, E. J., Miller, L. D., Newton, A., Thabane, L., & Wilansky, P. (2016). Treating child and adolescent anxiety effectively: Overview of systematic reviews. Clinical Psychology Review, 50, 80-94. https://doi.org/10.1016/j.cpr.2016.09.006