title: Cognitive-behavioral treatment of persistent functional somatic complaints and pediatric anxiety: an initial controlled trial.
abstract: BACKGROUND
  Children and adolescents who seek medical treatment for persistent physical distress often suffer from co-occurring anxiety disorders. Treatment options for this impaired population are limited. This study tests the feasibility and potential efficacy of a cognitive-behavioral intervention targeting pain and anxiety for youth with impairing functional physical symptoms and anxiety disorders presenting to pediatricians for medical care.
  
  
  METHODS
  Children and adolescents (aged 8-16) experiencing somatic complaints, without an explanatory medical disorder (i.e., functional), were recruited from primary care and specialty (gastroenterologists and cardiologists) pediatricians. Forty children, primarily with gastrointestinal symptoms, who met criteria for a co-occurring anxiety disorder, were randomly assigned to a cognitive-behavioral treatment addressing pain and anxiety, Treatment of Anxiety and Physical Symptoms (TAPS), or to a waiting list control.
  
  
  RESULTS
  TAPS was found to be an acceptable treatment for this population and was superior to the waiting list condition. Eighty percent of children in TAPS were rated as treatment responders by independent evaluators compared with none of the controls. Overall, self- and parent ratings indicated reductions in children's somatic discomfort and anxiety following intervention. TAPS participants maintained clinical gains 3 months following treatment.
  
  
  CONCLUSIONS
  The study supports the feasibility and preliminary efficacy of a cognitive-behavioral intervention targeting co-occurring physical distress and anxiety in youth presenting for medical treatment. Such an approach has the potential to exert broad impact on children's dysfunction and to minimize exposure to invasive, ineffective, and costly medical procedures and treatments.
authors.affiliation: Department of Child and Adolescent Psychiatry, NYU Child Study Center, New York, New York 10016, USA. carrie.masia@nyumc.org
authors.forename: Carrie Masia
authors.initials: CM
authors.lastname: Warner
authors.forename: Daniela
authors.initials: D
authors.lastname: Colognori
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Kim
authors.forename: Laura C
authors.initials: LC
authors.lastname: Reigada
authors.forename: Rachel G
authors.initials: RG
authors.lastname: Klein
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Browner-Elhanan
authors.forename: Amy
authors.initials: A
authors.lastname: Saborsky
authors.forename: Eva
authors.initials: E
authors.lastname: Petkova
authors.forename: Philip
authors.initials: P
authors.lastname: Reiss
authors.forename: Manoj
authors.initials: M
authors.lastname: Chhabra
authors.forename: Yvonne B
authors.initials: YB
authors.lastname: McFarlane-Ferreira
authors.forename: Colin K
authors.initials: CK
authors.lastname: Phoon
authors.forename: Nanci
authors.initials: N
authors.lastname: Pittman
authors.forename: Keith
authors.initials: K
authors.lastname: Benkov
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D001010:Anxiety, Separation / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D002648:Child; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*