TY - JOUR
T1 - Results From the Child/Adolescent Anxiety Multimodal Extended Long-Term Study (CAMELS)
T2 - Primary Anxiety Outcomes
AU - Ginsburg, Golda S.
AU - Becker-Haimes, Emily M.
AU - Keeton, Courtney
AU - Kendall, Philip C.
AU - Iyengar, Satish
AU - Sakolsky, Dara
AU - Albano, Anne Marie
AU - Peris, Tara
AU - Compton, Scott N.
AU - Piacentini, John
N1 - Funding Information:
This research was supported by the National Institute of Mental Health (NIMH) grants MH064089 to Dr. Ginsburg, MH064003 to Dr. Sakolsky, MH64088 to Dr. Piacentini, MH64092 to Dr. Albano, MH64107 to Dr. Compton, and MH063747 to Dr. Kendall. The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Funding Information:
Disclosure: Dr. Ginsburg has received support from NIMH and from the US Department of Education/Institute of Education Sciences. Dr. Becker-Haimes has received support from NIMH. Dr. Keeton has received support from NIMH. Dr. Kendall has received support from NIMH and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). He has received royalties from the sales of materials related to the treatment of anxiety disorders in youth (eg, Guilford Press; Workbook Publishing; Gyldendal Norsk; Gyldendal Akademisk). Dr. Iyengar has received support from NIMH. Dr. Sakolsky has received support from NIMH and NARSAD. She has served as a consultant for LEK Consulting Inc. Dr. Albano has received royalties from Oxford University Press for the Anxiety Disorders Interview Schedule, Child and Parent Versions. She has received an editor’s honorarium from the American Psychological Association. Dr. Peris has received support from NIMH, the Society for Clinical Child and Adolescent Psychology, and the TLC Foundation for Repetitive Behavior Disorders. She has received royalties from Oxford University Press. Dr. Compton has received support from NIMH, NC GlaxoSmithKline Foundation, Pfizer, Neurocrine Biosciences, and Mursion, Inc. He has served as a consultant for Shire and Mursion, Inc. He has received honoraria from the Nordic Long-Term OCD Treatment Study Research Group and the Centre for Child and Adolescent Mental Health, Eastern and Southern Norway. He has served on the scientific advisory board of Tourette Association of America, Anxiety and Depression Association of America, and Mursion, Inc. He has presented expert testimony for Duke University. Dr. Piacentini has received support from NIMH, the TLC Foundation for Body-Focused Repetitive Behaviors, the Tourette Association of America, the Pettit Family Foundation, and Pfizer Pharmaceuticals through the Duke University Clinical Research Institute Network. He is a co-author of the Child OCD Impact Scale−Revised (COIS-R), the Child Anxiety Impact Scale−Revised (CAIS-R), the Parent Tic Questionnaire (PTQ), and the Premonitory Urge for Tics Scale (PUTS) assessment tools, all of which are in the public domain therefore no royalties are received. He has received royalties from Guilford Press and Oxford University Press. He has served on the speakers’ bureau of the Tourette Association of America, the International Obsessive-Compulsive Disorder Foundation, and the TLC Foundation for Body-Focused Repetitive Behaviors.
Publisher Copyright:
© 2018 American Academy of Child and Adolescent Psychiatry
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/7
Y1 - 2018/7
N2 - Objective: To report anxiety outcomes from the multisite Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS). Rates of stable anxiety remission (defined rigorously as the absence of all DSM-IV TR anxiety disorders across all follow-up years) and predictors of anxiety remission across a 4-year period, beginning 4 to 12 years after randomization to 12 weeks of medication, cognitive-behavioral therapy (CBT), their combination, or pill placebo were examined. Examined predictors of remission included acute treatment response, treatment assignment, baseline child and family variables, and interim negative life events. Method: Data were from 319 youths (age range 10.9−25.2 years; mean age 17.12 years) originally diagnosed with separation, social, and/or generalized anxiety disorders and enrolled in the multi-site Child/Adolescent Anxiety Multimodal Study (CAMS). Participants were assessed annually by independent evaluators using the age-appropriate version of the Anxiety Disorders Interview Schedule and completed questionnaires (eg, about family functioning, life events, and mental health service use). Results: Almost 22% of youth were in stable remission, 30% were chronically ill, and 48% were relapsers. Acute treatment responders were less likely to be in the chronically ill group (odds ratio = 2.73; confidence interval = 1.14−6.54; p <.02); treatment type was not associated with remission status across the follow-up. Several variables (eg, male gender) predicted stable remission from anxiety disorders. Conclusion: Findings suggest that acute positive response to anxiety treatment may reduce risk for chronic anxiety disability; identified predictors can help tailor treatments to youth at greatest risk for chronic illness. Clinical Trial Registration Information: Child and Adolescent Anxiety Disorders (CAMS). http://clinicaltrials.gov/; NCT00052078.
AB - Objective: To report anxiety outcomes from the multisite Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS). Rates of stable anxiety remission (defined rigorously as the absence of all DSM-IV TR anxiety disorders across all follow-up years) and predictors of anxiety remission across a 4-year period, beginning 4 to 12 years after randomization to 12 weeks of medication, cognitive-behavioral therapy (CBT), their combination, or pill placebo were examined. Examined predictors of remission included acute treatment response, treatment assignment, baseline child and family variables, and interim negative life events. Method: Data were from 319 youths (age range 10.9−25.2 years; mean age 17.12 years) originally diagnosed with separation, social, and/or generalized anxiety disorders and enrolled in the multi-site Child/Adolescent Anxiety Multimodal Study (CAMS). Participants were assessed annually by independent evaluators using the age-appropriate version of the Anxiety Disorders Interview Schedule and completed questionnaires (eg, about family functioning, life events, and mental health service use). Results: Almost 22% of youth were in stable remission, 30% were chronically ill, and 48% were relapsers. Acute treatment responders were less likely to be in the chronically ill group (odds ratio = 2.73; confidence interval = 1.14−6.54; p <.02); treatment type was not associated with remission status across the follow-up. Several variables (eg, male gender) predicted stable remission from anxiety disorders. Conclusion: Findings suggest that acute positive response to anxiety treatment may reduce risk for chronic anxiety disability; identified predictors can help tailor treatments to youth at greatest risk for chronic illness. Clinical Trial Registration Information: Child and Adolescent Anxiety Disorders (CAMS). http://clinicaltrials.gov/; NCT00052078.
KW - anxiety
KW - cognitive-behavior therapy
KW - follow-up
KW - sertraline
KW - treatment
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U2 - 10.1016/j.jaac.2018.03.017
DO - 10.1016/j.jaac.2018.03.017
M3 - Article
C2 - 29960692
AN - SCOPUS:85049093335
SN - 0890-8567
VL - 57
SP - 471
EP - 480
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
IS - 7
ER -