Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety

John T. Walkup, Anne Marie Albano, John Piacentini, Boris Birmaher, Scott N. Compton, Joel T. Sherrill, Golda S. Ginsburg, Moira A. Rynn, James McCracken, Bruce Waslick, Satish Iyengar, John S. March, Philip C. Kendall

Research output: Contribution to journalArticlepeer-review


Background: Anxiety disorders are common psychiatric conditions affecting children and adolescents. Although cognitive behavioral therapy and selective serotonin-reuptake inhibitors have shown efficacy in treating these disorders, little is known about their relative or combined efficacy. Methods: In this randomized, controlled trial, we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia to receive 14 sessions of cognitive behavioral therapy, sertraline (at a dose of up to 200 mg per day), a combination of sertraline and cognitive behavioral therapy, or a placebo drug for 12 weeks in a 2:2:2:1 ratio. We administered categorical and dimensional ratings of anxiety severity and impairment at baseline and at weeks 4, 8, and 12. Results: The percentages of children who were rated as very much or much improved on the Clinician Global Impression-Improvement scale were 80.7% for combination therapy (P

Original languageEnglish (US)
Pages (from-to)2753-2766
Number of pages14
JournalNew England Journal of Medicine
Issue number26
StatePublished - Dec 25 2008

ASJC Scopus subject areas

  • Medicine(all)


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