title: Assessment and treatment of anxiety disorders in children and adolescents.
abstract: Recent advances in the developmental epidemiology, neurobiology, and treatment of pediatric anxiety disorders have increased our understanding of these conditions and herald improved outcomes for affected children and adolescents. This article reviews the current epidemiology, longitudinal trajectory, and neurobiology of anxiety disorders in youth. Additionally, we summarize the current evidence for both psychotherapeutic and psychopharmacologic treatments of fear-based anxiety disorders (e.g., generalized, social, and separation anxiety disorders) in children and adolescents. Current data suggest that these disorders begin in childhood and adolescence, exhibit homotypic continuity, and increase the risk of secondary anxiety and mood disorders. Psychopharmacologic trials involving selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SSNRIs) are effective in pediatric patients with anxiety disorders and have generally demonstrated moderate effect sizes. Additionally, current data support cognitive behavioral therapy (CBT) for the treatment of these conditions in youth and suggest that the combination of psychotherapy + an SSRI may be associated with greater improvement than would be expected with either treatment as monotherapy.
authors.affiliation: College of Medicine, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, 45219, USA.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Wehry
authors.forename: Katja
authors.initials: K
authors.lastname: Beesdo-Baum
authors.forename: Meghann M
authors.initials: MM
authors.lastname: Hennelly
authors.forename: Sucheta D
authors.initials: SD
authors.lastname: Connolly
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Strawn
mesh_terms: D000293:Adolescent; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000175:diagnosis / Q000628:therapy; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D006801:Humans; D008403:Mass Screening; D064866:Mindfulness; D019964:Mood Disorders / Q000188:drug therapy; D010698:Phobic Disorders / Q000175:diagnosis / Q000628:therapy; D064889:Psychotherapy, Psychodynamic; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors