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Short term CBT and sertraline, alone or in combination, reduce anxiety in children and adolescents

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QUESTION

Question:

Do cognitive behavioural therapy (CBT) and sertraline, alone or in combination, reduce symptoms of anxiety disorder in children and adolescents?

Patients:

488 children, aged 7–17 years with DSM-IV moderate to severe separation anxiety (3.3%), generalised anxiety disorder (6.8%), social phobia (11.3%), or more than one (78.8%) of these disorders (51.4% male; mean age 10.7 years; 74% under 13 years; 78.9% white; 74.6% middle and upper class). Exclusions: unstable medical condition; refusing to attend school; no response to two adequate trials of selective serotonin reuptake inhibitors; no response to an adequate trial of CBT; receiving other psychoactive medications; current major depressive disorder; substance abuse; unmedicated attention deficit hyperactivity disorder; lifetime history of bipolar, psychotic or pervasive developmental disorder; pregnant or sexually active without using effective contraception; or presenting acute risk to themselves or others.

Setting:

6 clinical centres in New York, Durham, Baltimore, Philadelphia, Los Angeles and Pittsburgh, USA; recruitment December 2002 to May 2007.

Intervention:

CBT alone, sertraline alone, CBT plus sertraline or placebo. CBT involved 14, 60 min sessions delivered by an experienced …

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