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Twelve weeks' sertraline and CBT in young people with anxiety disorders increases likelihood of no longer having the diagnosis compared with placebo or monotherapy, but residual symptoms remain

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Question

Question

Is sertraline (SRT), cognitive behavioural therapy (CBT) or a combination of the two, effective at inducing remission among children and adolescents with anxiety disorders compared with placebo?

Patients

488 children and adolescents aged between 7 and 17 years who met DSM-IV criteria for generalised anxiety disorder, social phobia and/or separation anxiety disorder.

Setting

Six sites, USA; from 2003 to 2008.

Intervention

SRT only, CBT only, SRT and CBT (COMB) or placebo pill treatment for 12 weeks.

Outcomes

Remission, defined in three different ways: (A) loss of all targeted anxiety disorders, assessed using the Anxiety Disorders Interview Schedule; (B) Clinical Global Impression Severity Scale (CGI-S) score of 1 (no symptoms) or 2 (minimal symptoms); (C) Clinical Global Impression Improvement Scale (CGI-I) score of 1 (very much improved).

Patient follow-up

90% completed the study; 100% included in the analysis.

Methods

Design

Randomised controlled trial (the Child/Adolescent Anxiety Multimodal Study, CAMS).

Allocation

Unclear.

Blinding

The SRT and PBO arms were double blinded while the CBT and COMB arms were single blinded (assessors only).

Follow-up period

12 weeks.

Main results

Using the loss of anxiety disorder diagnoses as the …

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