Mixed Therapy Often Works for Anxious Kids

For most children, the spine-tingling frissons induced on Friday by ghoulies and ghosties and long-leggedy beasties disappeared by the end of the night. For others, worry is a way of life, undermining their success at school and jeopardizing their friendships. For those with common anxiety disorders, a combination of psychotherapy and antidepressant medication is the most effective treatment, according to a recent study funded by the National Institute of Mental Health.

About 13 of every 100 children and adolescents ages 9 to 17 suffer from some kind of anxiety disorder, according to the National Mental Health Information Center; left untreated, childhood anxiety can develop into more serious problems in adulthood.

In the Child/Adolescent Anxiety Multimodal Study, 488 children who had received a diagnosis of separation anxiety disorder, generalized anxiety disorder or social phobia, were randomly assigned to one of four treatments for 12 weeks: cognitive behavior therapy, or CBT, designed to teach the children specific anxiety management skills and to face their fears by putting them in the situations that make them anxious; the antidepressant Zoloft; a combination of CBT and Zoloft; or a placebo drug.

Eighty-one percent of the children who received the combination treatment improved, compared with 60 percent in the CBT-only group, 55 percent in the Zoloft-only group and 24 percent in the placebo group.

John T. Walkup, first author on the paper and deputy director of the Division of Child and Adolescent Psychiatry at Johns Hopkins Medical Institutions, emphasized how common and destructive anxiety disorders are. The takeaway message for parents is "that we have three great treatments," he said. "The best of the lot uses medications and psychotherapy together."

The study was released online last week by the New England Journal of Medicine.

-- Frances Stead Sellers