The Cochrane Library and the treatment of childhood and adolescent anxiety disorders: an overview of reviews
Bibliographic record
Abstract
Abstract Background Anxiety disorders are among the most common psychiatric disorders diagnosed during childhood and adolescence. Reported lifetime prevalence of children or adolescents meeting criteria for at least one anxiety disorder in industrialized countries ranges from 8–27%. Current treatment includes psychotherapy (cognitive and behavioural therapies) as well as medication which is almost always used together with psychotherapy, rather than as a stand‐alone treatment. Objective To synthesize the evidence currently in the Cochrane Database of Systematic Reviews (CDSR) related to the question: ‘In the treatment of childhood and adolescent anxiety disorders, which pharmacologic or nonpharmacologic treatments are known to improve symptom response, response rates, functional capacity, adherence, persistence, and acceptability as well as increase diagnostic remission and decrease adverse events?’. Methods The CDSR was searched using the term ‘anxiety disorders’ in the title for all systematic reviews examining pharmacologic and nonpharmacologic interventions for the treatment of anxiety disorders in children and adolescents, including pharmacotherapy and psychotherapy. Data were extracted and entered into tables; data were synthesized using qualitative and quantitative methods. Main Results Of the studies included in the CDSR, treatment of childhood and adolescent anxiety disorders with cognitive behavioural therapy (CBT) led to significant reductions in anxiety symptoms and increased recovery. Treatment with CBT or behavioural therapy (BT) led to notable reductions in Obsessive–Compulsive Disorder (OCD) severity and a reduced risk of treatment failure. Use of selective serotonin reuptake inhibitors (SSRIs) and the selective norepinephrine reuptake inhibitor (SNRI) venlafaxine were superior to placebo in treating OCD and other anxiety disorders. There was no clear evidence that any particular SSRI or venlafaxine was most efficacious or best tolerated. While few studies were available, CBT combined with a SSRI or SNRI led to significant reductions in both anxiety and OCD symptoms. Psychotherapy (CBT/BT), used alone or in combination with medication, had a mixed impact on reducing risk of treatment failure for OCD. Author's Conclusions For childhood and adolescent anxiety disorders, including OCD, the CDSR reviews suggest that psychotherapy treatments are efficacious in reducing symptom severity. Although the CDSR does not include a number of recent research publications on CBT, these newer studies further reinforce CBT efficacy. Pharmacotherapy evidence from the CDSR supports using medication in treating anxiety disorders, and while few studies examined combined pharmacological and psychological treatment, results to date are also favourable for this combination. Clinicians should rely on expert consensus guidelines vis‐à‐vis this evidence as treatment decision‐making should be moderated by the patient's illness severity. Psychotherapy remains the first line treatment for mild to moderate symptoms, whereas pharmacotherapy is used for severe or treatment‐resistant disorders. In conclusion, there is a body of literature in the CDSR to support evidence‐based treatment decisions for pediatric anxiety disorders; however, as this is a field that is rapidly expanding its knowledge base, efforts must be made to ensure the most recent evidence is consistently incorporated. Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".