Predicting Anxiety Later On

Anxiety disorders in children may decrease in adulthood with adequate treatment

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Children with anxiety disorders are more likely to be adults with anxiety disorders. But what might stop that trend?

A recent study found a couple factors that related to how well youth did six years after being treated for an anxiety disorder.

Those who responded well to their treatment as youth were more likely to be doing well as adults. Having a healthy, functioning family also appeared helpful.

Yet, many of the participants still experienced anxiety symptoms later on if they had an anxiety disorder in their youth.

"Seek treatment for your child's anxiety."

This study, led by Golda S. Ginsburg, PhD, of the Division of Child and Adolescent Psychiatry at the Johns Hopkins University School of Medicine, looked at the long-term outcomes of children with anxiety disorders.

The researchers tracked 288 youths, aged 11 to 26, who had been randomly assigned to receive one of four different treatments or interventions for their anxiety disorders.

They either received a placebo pill (a fake pill with no medicinal effect), anti-anxiety medication, cognitive behavioral therapy or received both therapy and the medication.

Six years after the study began, the researchers followed up with a little more than half of the original participants (59 percent).

The participants were assessed for their current anxiety symptoms and overall functioning as well as their families, life events and use of mental health services.

Just under half of those during follow-up (47 percent) were in remission, meaning that they no longer showed active symptoms of their anxiety disorder. The participants most likely to have been in remission were those who responded to their treatment initially, when the study began.

In fact, those who had shown a response to their treatment at the start of the study had almost twice better odds of being in remission. These participants also had fewer symptoms of anxiety in general and better overall functioning six years after the treatment had begun.

However, the particular treatment that the participants had received did not seem to affect their outcomes. When the researchers looked at all participants except those who received the placebo, they found that participants who responded to their initial treatment only fared better later on in terms of their anxiety symptoms (not in terms of remission or overall functioning).

Also, despite the better remission rate among those who responded to their initial treatment, about half of the responders (48 percent) still experienced a relapse six years later.

This finding suggested "the need for more intensive or continued treatment for a sizable proportion of youths with anxiety disorders," the authors wrote.

The researchers also identified other factors that seemed linked to how the participants were doing six years later.

Those in higher socioeconomic groups or living in families with healthier functioning were less likely to have anxiety symptoms and more likely to be functioning well.

Unsurprisingly, those with fewer or milder symptoms at the start were more likely to experience recovery, and those who experienced more negative life events had greater anxiety and a harder time functioning in general. In addition, males seemed more likely to be in remission from their anxiety disorders than females.

The researchers concluded that these findings may help in identifying who will need additional treatment and what factors will help youth successfully manage or recover from anxiety disorders.

“Results from this study make two key but somewhat disparate points," noted Glen Elliott, MD, PhD, a clinical professor at the Stanford University Department of Psychiatry and Behavioral Sciences.

"First, treatment of anxiety can help both in the short term and in improving functioning over the long term," he said. "Second, anxiety is a chronic illness that, even when treated, has a high probability of recurring in many individuals."

Dr. Elliott continued, "In sum, that means we still need better, more effective interventions for this common disorder whose potential impact on function all too often is underestimated.”

The study was published January 29 in the journal JAMA Psychiatry. The research was funded by the National Institute of Mental Health.

Four authors have received research funding, consulting fees or honoraria from companies including Pfizer, Bayer Schering Pharma, Shire Pharmaceuticals, Bracket Global, Eli Lilly, Merck.

Several authors also disclosed income from book royalties or research funding from various foundations, including the International OCD Foundation and the Brain & Behavior Research Foundation.

Review Date: 
January 28, 2014
Last Updated:
January 30, 2014