Feeling nervous or being worried about events such as school tests or soccer games is a natural response for many children and teenagers. For some children and teenagers, however, feeling nervous and worried is a day-to-day experience that causes distress and interferes with their quality of life. For these children and teenagers, the experience can reflect an anxiety disorder.
Anxiety disorders are the number one mental health problem identified in children and teenagers before the age of 18. They are also very treatable. Different approaches to treat anxiety disorders have been evaluated. Expert consensus guidelines recommend behavioural and cognitive-behavioural therapies as the first line treatment for children and teens with mild to moderate anxiety symptoms. These therapies teach children and teens how to replace anxious thoughts with more helpful ones, face feared situations, and self-reward to offset discomfort. For children and teens that are severely impaired by an anxiety disorder, one of these therapies is often used together with medication to treat the disorder.
In 2010, an overview of Cochrane systematic reviews was conducted to compile evidence from reviews that focused on treating childhood anxiety disorders. The reviewers identified three systematic reviews published from 2006 to 2008 that included 39 studies involving 3,550 children and teenagers with the following disorders:
- Generalized Anxiety Disorder
- Separation Anxiety Disorder
- Social Phobia
- Specific Phobia
- Panic Disorder
- Obsessive-Compulsive Disorder (OCD)
Findings from the overview included:
- Cognitive-behavioural treatment delivered one-on-one with the child/teen, in a group setting with other children/teens, or as a family treatment (with parents) increased recovery.
- Behavioural and cognitive-behavioural treatment delivered one-on-one or in a group setting for OCD reduced symptom severity and the child/teen’s risk of not completing treatment (treatment failure).
- Use of selective serotonin reuptake inhibitors (SSRIs) and the selective norepinephrine reuptake inhibitor (SNRI) venlafaxine were superior to receipt of no medication for treating OCD and other anxiety disorders, but which medication was most efficacious or best tolerated by children and teens was unclear.
- Cognitive-behavioural treatment combined with a SSRI or SNRI reduced anxiety and OCD symptom severity, and had a mixed impact on reducing the child/teen’s risk of treatment failure for OCD.
The authors concluded that the treatments reviewed were shown to benefit children and teenagers with anxiety disorders, but cautioned that clinicians should explain to children, teenagers and families that treatment response is individual, and could range from reduced symptom severity to complete disorder remission.
They also recommended that clinicians encourage children, teenagers and families to persevere with treatment by focusing on treatment gains as they are realized. Because treatments in this area are continually being evaluated, the authors also noted that updating the evidence base is critical.
Read the full overview here.
For more information about the three systematic reviews included in the overview (note: the review on cognitive behavioural therapy was updated in 2013 following publication of the overview; the link below is for the updated review):
- Cognitive behavioural therapy for anxiety disorders in children and adolescents
- Behavioural and cognitive behavioural therapy for obesessive compulsive disorder in children and adolescents
- Pharmacotherapy for anxiety disorders in children and adolescents
Find out more about anxiety disorders at: