title: Eight years later: outcomes of CBT-treated versus untreated anxious children.
abstract: BACKGROUND
  Anxiety disorders are the most common psychiatric disorders of childhood, generate significant distress, are considered precursors to diverse psychiatric disorders, and lead to poor social and employment outcomes in adulthood. Although childhood anxiety has a significant impact on a child's developmental trajectory, only a handful of studies examined the long-term impact of treatment and none included a control group. The aim of this study was to conduct a long-term follow-up (LTFU) of anxious children who were treated with Cognitive-Behavioral Therapy (CBT) compared to a matched group of children who were not.
  
  
  METHODS
  Subjects comprised 120 children: a treatment group which included the first 60 consecutive consenting children who were diagnosed with an anxiety disorder and treated with CBT between the years 1997 and 2003 and a control group, 60 matched children who were assessed but not treated with CBT. An "ex-post-facto" design was used to compare the two groups.
  
  
  RESULTS
  Children showed lower rates of anxiety diagnosis (about 50% for both groups) and significantly improved functioning at LTFU (time effect P < 0.0001; no group difference). Anxiety levels were significantly lower in the nontreatment group at LTFU as compared to initial assessment (P = 0.02), but not in the treatment group, and a significant between-group difference was found (P = 0.01) according to child. An inverse relationship was found between self-efficacy/self-esteem and anxiety outcome ([P = 0.0008] and [P = 0.04], respectively).
  
  
  CONCLUSIONS
  This study supports the assumption that childhood anxiety disorders may improve without treatment and highlights self-efficacy/self-esteem as potential factors in recovery.
authors.affiliation: University of Toronto Toronto, ON, Canada ; Department of Psychiatry, Sunnybrook Health Sciences Centre Toronto, ON, Canada.
authors.forename: Gili W
authors.initials: GW
authors.lastname: Adler Nevo
authors.affiliation: Department of Psychiatry, The Hospital for Sick Children Toronto, ON, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Avery
authors.affiliation: York University Toronto, ON, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Fiksenbaum
authors.affiliation: University of Toronto Toronto, ON, Canada ; Department of Psychiatry, Sunnybrook Health Sciences Centre Toronto, ON, Canada.
authors.forename: Alex
authors.initials: A
authors.lastname: Kiss
authors.affiliation: University of Toronto Toronto, ON, Canada ; Department of Psychiatry, The Hospital for Sick Children Toronto, ON, Canada.
authors.forename: Sandra
authors.initials: S
authors.lastname: Mendlowitz
authors.affiliation: University of Toronto Toronto, ON, Canada ; Department of Psychiatry, The Hospital for Sick Children Toronto, ON, Canada.
authors.forename: Suneeta
authors.initials: S
authors.lastname: Monga
authors.affiliation: University of Toronto Toronto, ON, Canada ; Department of Psychiatry, The Hospital for Sick Children Toronto, ON, Canada.
authors.forename: Katharina
authors.initials: K
authors.lastname: Manassis
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000628:therapy*; D016022:Case-Control Studies; D002648:Child; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D012649:Self Concept; D020377:Self Efficacy; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adolescents; anxiety; children; cognitive–behavioral therapy; long-term follow-up; youth