@article{d16d28f3128d407888c100dddb99d17e,
title = "Long-term Service Use Among Youths Previously Treated for Anxiety Disorder",
abstract = "Objective: (1) To describe rates of long-term service use among subjects previously enrolled in a landmark study of youth anxiety disorder treatment and followed into early adulthood; (2) to examine predictors of long-term service use; and (3) to examine the relationship between anxiety diagnosis and service use over time. Method: The Child/Adolescent Anxiety Multimodal Extended Long-term Study prospectively assessed youths treated through the Child/Adolescent Anxiety Multimodal Study at ages 7–17 years into early adulthood. A total of 319 youths (mean age 17.7, 55.2% female) previously randomized to cognitive-behavioral therapy, sertraline, combination, or placebo for the treatment of anxiety participated; 318 had service use data. Four annual clinic assessments were conducted along with telephone check-ins every 6 months. Results: Overall, 65.1% of participants endorsed receiving some form of anxiety treatment over the course of the follow-up period, with more subjects reporting medication use than psychotherapy; 35.2% reported consistent use of services over the course of the study. Overall, service use declined over time in subjects with less severe anxiety but remained more steady in those with recurrent/chronic symptoms. Levels of life stress and depressive symptoms were associated with amount of service use over time whereas treatment-related variables (type of initial intervention, acute response, remission) were not. A subset of youths remained chronically anxious despite consistent service use. Conclusion: These findings point to the need to develop models of care that approach anxiety disorders as chronic health conditions in need of active long-term management.",
keywords = "anxiety, cognitive-behavioral therapy, service use",
author = "Peris, {Tara S.} and Sugar, {Catherine A.} and Rozenman, {Michelle S.} and Walkup, {John T.} and Albano, {Anne Marie} and Scott Compton and Dara Sakolsky and Golda Ginsburg and Courtney Keeton and Kendall, {Philip C.} and McCracken, {James T.} and John Piacentini",
note = "Funding Information: This work was funded by the National Institute of Mental Health (NIMH; R01MH064088 ) to John Piacentini. Funding Information: Disclosure: Dr. Peris has received research funding from NIMH and the TLC Foundation for Body-Focused Repetitive Behaviors, consulting fees from Luminopia, and royalties from Oxford University Press. Dr. Sugar has received research grant support from NIH through multiple divisions, including NIMH, National Institute of General Medical Sciences, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Allergy and Infectious Diseases, and National Institute of Diabetes and Digestive and Kidney Diseases, the Health Resources and Services Administration, the Food and Drug Administration), and the Department of Veterans Affairs and has served on technical expert panels for CMS and on data safety and monitoring boards for academic institutions and Kaiser Permanente. Dr. Walkup has received funding from the Hartwell Foundation and the Tourette Syndrome Association, has served on the speakers{\textquoteright} bureau for the Tourette Syndrome Association, and has received book royalties from Guilford Press and Oxford University Press. Dr. Albano has received grant support from NIMH and Duke University, royalties from Oxford University Press and Lynn Sonberg Books, and honoraria from the American Psychological Association and Brackett Global. Dr. Compton has received research support from NIH and the NC GlaxoSmithKline Foundation, has consulted for Mursion, Luminopia, and Shire (a Takeda company), has received honoraria from the Journal of Consulting and Clinical Psychology, the Nordic Long-Term OCD Treatment Study Research Group, and the Center for Child and Adolescent Mental Health, Eastern and Southern Norway, has served on the scientific advisory board of the Tourette Association of America, the Anxiety and Depression Association of America, and Mursion, and has given expert testimony for Duke University. Dr. Sakolsky has received funding from NIMH, has received an honorarium from Northwell Health for a child and adolescent lecture at Zucker Hillside Hospital in 2018, and has served as an editorial board member of Child and Adolescent Psychopharmacology News. Dr. Ginsburg has received funding from NIMH and the Department of Education and has served as a paid consultant for Syneos Health. Dr. Kendall has received author royalties from the sales of treatment materials (Guilford Press, Oxford University Press, and Workbook Publishing); his spouse has a financial interest in and is affiliated with Workbook Publishing. Dr. McCracken has received consultant income from Roche, Octapharma, GW Biosciences, and Tris Pharmaceuticals and has received clinical trial research contracts from Roche. Dr. Piacentini has received research support from NIMH, the TLC Foundation for Body-Focused Repetitive Behaviors, and Pfizer Pharmaceuticals, book royalties from Guilford Press and Oxford University Press, and speaking honoraria and travel expenses from the International OCD Foundation and the Tourette Association of America. Drs. Rozenman and Keeton have reported no biomedical financial interests or potential conflicts of interest. Funding Information: This work was funded by the National Institute of Mental Health (NIMH; R01MH064088) to John Piacentini. Funding acquisition: Walkup. Disclosure: Dr. Peris has received research funding from NIMH and the TLC Foundation for Body-Focused Repetitive Behaviors, consulting fees from Luminopia, and royalties from Oxford University Press. Dr. Sugar has received research grant support from NIH through multiple divisions, including NIMH, National Institute of General Medical Sciences, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Allergy and Infectious Diseases, and National Institute of Diabetes and Digestive and Kidney Diseases, the Health Resources and Services Administration, the Food and Drug Administration), and the Department of Veterans Affairs and has served on technical expert panels for CMS and on data safety and monitoring boards for academic institutions and Kaiser Permanente. Dr. Walkup has received funding from the Hartwell Foundation and the Tourette Syndrome Association, has served on the speakers{\textquoteright} bureau for the Tourette Syndrome Association, and has received book royalties from Guilford Press and Oxford University Press. Dr. Albano has received grant support from NIMH and Duke University, royalties from Oxford University Press and Lynn Sonberg Books, and honoraria from the American Psychological Association and Brackett Global. Dr. Compton has received research support from NIH and the NC GlaxoSmithKline Foundation, has consulted for Mursion, Luminopia, and Shire (a Takeda company), has received honoraria from the Journal of Consulting and Clinical Psychology, the Nordic Long-Term OCD Treatment Study Research Group, and the Center for Child and Adolescent Mental Health, Eastern and Southern Norway, has served on the scientific advisory board of the Tourette Association of America, the Anxiety and Depression Association of America, and Mursion, and has given expert testimony for Duke University. Dr. Sakolsky has received funding from NIMH, has received an honorarium from Northwell Health for a child and adolescent lecture at Zucker Hillside Hospital in 2018, and has served as an editorial board member of Child and Adolescent Psychopharmacology News. Dr. Ginsburg has received funding from NIMH and the Department of Education and has served as a paid consultant for Syneos Health. Dr. Kendall has received author royalties from the sales of treatment materials (Guilford Press, Oxford University Press, and Workbook Publishing); his spouse has a financial interest in and is affiliated with Workbook Publishing. Dr. McCracken has received consultant income from Roche, Octapharma, GW Biosciences, and Tris Pharmaceuticals and has received clinical trial research contracts from Roche. Dr. Piacentini has received research support from NIMH, the TLC Foundation for Body-Focused Repetitive Behaviors, and Pfizer Pharmaceuticals, book royalties from Guilford Press and Oxford University Press, and speaking honoraria and travel expenses from the International OCD Foundation and the Tourette Association of America. Drs. Rozenman and Keeton have reported no biomedical financial interests or potential conflicts of interest. Publisher Copyright: {\textcopyright} 2020 American Academy of Child and Adolescent Psychiatry",
year = "2021",
month = apr,
doi = "10.1016/j.jaac.2020.07.911",
language = "English (US)",
volume = "60",
pages = "501--512",
journal = "Journal of the American Academy of Child and Adolescent Psychiatry",
issn = "0890-8567",
publisher = "Elsevier Limited",
number = "4",
}