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Evidence summaries

Cognitive Behavioural Therapy for Anxiety Disorders in Children and Adolescents

Cognitive behavioural therapy is an effective treatment for mild to moderate anxiety disorders in childhood and adolescence, in comparison to waiting list control. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 41 studies with a total of 1 806 subjects. The studies involved children and adolescents with anxiety of mild to moderate severity in university and community clinics and school settings. Intention-to-treat (ITT) analyses showed that CBT increased remission of any anxiety diagnosis compared with waiting list controls (OR 7.85, 95% CI 5.31 to 11.60; 26 studies, n=1 350; NNT 6.0, 95% CI 7.5 to 4.6). No difference in outcome was noted between individual, group and family/parental formats. ITT analyses revealed that CBT was no more effective than non-CBT active control treatments (6 studies, n=426) or treatment as usual (2 studies, n=88) in reducing anxiety diagnoses. Only four studies looked at longer-term outcomes after CBT. No clear evidence showed maintained improvement in symptoms of anxiety among children and young people.The small number of studies meant the review authors could not compare CBT with medication.

    References

    • James AC, James G, Cowdrey FA et al. Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev 2015;(2):CD004690 [PubMed].

Primary/Secondary Keywords