Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders

Arne Kodal; Krister Fjermestad; Ingvar Bjelland; Rolf Gjestad; Lars-Göran Öst; Jon F Bjaastad; Bente S M Haugland; Odd E Havik; Einar Heiervang; Gro Janne Wergeland

doi:10.1016/j.janxdis.2017.11.003

Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders

J Anxiety Disord. 2018 Jan:53:58-67. doi: 10.1016/j.janxdis.2017.11.003. Epub 2017 Nov 26.

Authors

Affiliations

¹ Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, N-5021 Bergen, Norway; Anxiety Research Network, Research Department, Division of Psychiatry, Haukeland University Hospital, N-5036 Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, N-5020 Bergen, Norway. Electronic address: [email protected].
² Anxiety Research Network, Research Department, Division of Psychiatry, Haukeland University Hospital, N-5036 Bergen, Norway; Department of Psychology, University of Oslo, N-0373 Oslo, Norway.
³ Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, N-5021 Bergen, Norway; Anxiety Research Network, Research Department, Division of Psychiatry, Haukeland University Hospital, N-5036 Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, N-5020 Bergen, Norway.
⁴ Research Department, Division of Psychiatry, Haukeland University Hospital, N-5036 Bergen, Norway.
⁵ Anxiety Research Network, Research Department, Division of Psychiatry, Haukeland University Hospital, N-5036 Bergen, Norway; Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden.
⁶ Anxiety Research Network, Research Department, Division of Psychiatry, Haukeland University Hospital, N-5036 Bergen, Norway; Regional Center for Child and Youth Mental Health and Child Welfare, Uni Research Health, N-5008 Bergen, Norway; Division of Psychiatry, Stavanger University Hospital, N-4068 Stavanger, Norway.
⁷ Anxiety Research Network, Research Department, Division of Psychiatry, Haukeland University Hospital, N-5036 Bergen, Norway; Regional Center for Child and Youth Mental Health and Child Welfare, Uni Research Health, N-5008 Bergen, Norway.
⁸ Anxiety Research Network, Research Department, Division of Psychiatry, Haukeland University Hospital, N-5036 Bergen, Norway; Department of Clinical Psychology, Faculty of Psychology, University of Bergen, N-5020 Bergen, Norway.
⁹ Anxiety Research Network, Research Department, Division of Psychiatry, Haukeland University Hospital, N-5036 Bergen, Norway; Institute of Clinical Medicine, University of Oslo, and Oslo University Hospital, N-0450 Oslo, Norway.
¹⁰ Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, N-5021 Bergen, Norway; Anxiety Research Network, Research Department, Division of Psychiatry, Haukeland University Hospital, N-5036 Bergen, Norway; Regional Center for Child and Youth Mental Health and Child Welfare, Uni Research Health, N-5008 Bergen, Norway.

PMID: 29195188
DOI: 10.1016/j.janxdis.2017.11.003

Abstract

Cognitive behavioral therapy (CBT) has demonstrated favorable long-term outcomes in youth with anxiety disorders in efficacy trials. However, long-term outcomes of CBT delivered in a community setting are uncertain. This study examined the long-term outcomes of individual (ICBT) and group CBT (GCBT) in youth with anxiety disorders treated in community mental health clinics. A total of 139 youth (mean age at assessment 15.5 years, range 11-21 years) with a principal diagnosis of separation anxiety disorder (SAD), social anxiety disorder (SOP), and/or generalized anxiety disorder (GAD) were evaluated, on average, 3.9 years post-treatment (range 2.2-5.9 years). Outcomes included loss of all inclusion anxiety diagnoses, loss of the principal anxiety diagnosis and changes in youth- and parent-rated youth anxiety symptoms. At long-term follow-up, there was loss of all inclusion anxiety diagnoses in 53%, loss of the principal anxiety diagnosis in 63% of participants as well as significant reductions in all anxiety symptom measures. No statistical significant differences in outcome were obtained between ICBT and GCBT. Participants with a principal diagnosis of SOP had lower odds for recovery, compared to those with a principal diagnosis of SAD or GAD. In conclusion, outcomes of CBT for youth anxiety disorders delivered in community mental health clinics were improved at nearly 4 years post-treatment, and recovery rates at long-term follow-up were similar to efficacy trials.

Trial registration: ClinicalTrials.gov NCT00586586.

Keywords: Anxiety disorders; Cognitive behavioral therapy; Community clinic; Long-term follow-up; Youth.

Publication types

Controlled Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Anxiety / psychology
Anxiety / therapy
Anxiety Disorders / psychology*
Anxiety Disorders / therapy*
Anxiety, Separation / psychology*
Anxiety, Separation / therapy*
Child
Cognitive Behavioral Therapy*
Data Collection
Female
Follow-Up Studies
Humans
Male
Phobia, Social / psychology*
Phobia, Social / therapy*
Psychotherapy, Group*
Treatment Outcome
Young Adult

Associated data

ClinicalTrials.gov/NCT00586586