TY - JOUR
T1 - 24- and 36-week outcomes for the child/adolescent anxiety multimodal study (CAMS)
AU - Piacentini, John
AU - Bennett, Shannon
AU - Compton, Scott N.
AU - Kendall, Phillip C.
AU - Birmaher, Boris
AU - Albano, Anne Marie
AU - March, John
AU - Sherrill, Joel
AU - Sakolsky, Dara
AU - Ginsburg, Golda
AU - Rynn, Moira
AU - Bergman, R. Lindsey
AU - Gosch, Elizabeth
AU - Waslick, Bruce
AU - Iyengar, Satish
AU - McCracken, James
AU - Walkup, John
PY - 2014/3
Y1 - 2014/3
N2 - Objective We report active treatment group differences on response and remission rates and changes in anxiety severity at weeks 24 and 36 for the Child/Adolescent Anxiety Multimodal Study (CAMS). Method CAMS youth (N = 488; 74% ≤12 years of age) with DSM-IV separation, generalized, or social anxiety disorder were randomized to 12 weeks of cognitive-behavioral therapy (CBT), sertraline (SRT), CBT+SRT (COMB), or medication management/pill placebo (PBO). Responders attended 6 monthly booster sessions in their assigned treatment arm; youth in COMB and SRT continued on their medication throughout this period. Efficacy of COMB, SRT, and CBT (n = 412) was assessed at 24 and 36 weeks postrandomization. Youth randomized to PBO (n = 76) were offered active CAMS treatment if nonresponsive at week 12 or over follow-up and were not included here. Independent evaluators blind to study condition assessed anxiety severity, functioning, and treatment response. Concomitant treatments were allowed but monitored over follow-up. Results The majority (>80%) of acute responders maintained positive response at both weeks 24 and 36. Consistent with acute outcomes, COMB maintained advantage over CBT and SRT, which did not differ, on dimensional outcomes; the 3 treatments did not differ on most categorical outcomes over follow-up. Compared to COMB and CBT, youth in SRT obtained more concomitant psychosocial treatments, whereas those in SRT and CBT obtained more concomitant combined (medication plus psychosocial) treatment. Conclusions COMB maintained advantage over CBT and SRT on some measures over follow-up, whereas the 2 monotherapies remained indistinguishable. The observed convergence of COMB and monotherapy may be related to greater use of concomitant treatment during follow-up among youth receiving the monotherapies, although other explanations are possible. Although outcomes were variable, most CAMS-treated youth experienced sustained treatment benefit. Clinical trial registration information - Child and Adolescent Anxiety Disorders (CAMS); URL: http://clinicaltrials. gov. Unique identifier: NCT00052078.
AB - Objective We report active treatment group differences on response and remission rates and changes in anxiety severity at weeks 24 and 36 for the Child/Adolescent Anxiety Multimodal Study (CAMS). Method CAMS youth (N = 488; 74% ≤12 years of age) with DSM-IV separation, generalized, or social anxiety disorder were randomized to 12 weeks of cognitive-behavioral therapy (CBT), sertraline (SRT), CBT+SRT (COMB), or medication management/pill placebo (PBO). Responders attended 6 monthly booster sessions in their assigned treatment arm; youth in COMB and SRT continued on their medication throughout this period. Efficacy of COMB, SRT, and CBT (n = 412) was assessed at 24 and 36 weeks postrandomization. Youth randomized to PBO (n = 76) were offered active CAMS treatment if nonresponsive at week 12 or over follow-up and were not included here. Independent evaluators blind to study condition assessed anxiety severity, functioning, and treatment response. Concomitant treatments were allowed but monitored over follow-up. Results The majority (>80%) of acute responders maintained positive response at both weeks 24 and 36. Consistent with acute outcomes, COMB maintained advantage over CBT and SRT, which did not differ, on dimensional outcomes; the 3 treatments did not differ on most categorical outcomes over follow-up. Compared to COMB and CBT, youth in SRT obtained more concomitant psychosocial treatments, whereas those in SRT and CBT obtained more concomitant combined (medication plus psychosocial) treatment. Conclusions COMB maintained advantage over CBT and SRT on some measures over follow-up, whereas the 2 monotherapies remained indistinguishable. The observed convergence of COMB and monotherapy may be related to greater use of concomitant treatment during follow-up among youth receiving the monotherapies, although other explanations are possible. Although outcomes were variable, most CAMS-treated youth experienced sustained treatment benefit. Clinical trial registration information - Child and Adolescent Anxiety Disorders (CAMS); URL: http://clinicaltrials. gov. Unique identifier: NCT00052078.
KW - anxiety
KW - Child/Adolescent Anxiety Multimodal Study (CAMS)
KW - cognitive-behavioral therapy (CBT)
KW - follow-up
KW - selective serotonin reuptake inhibitor (SSRI)
UR - http://www.scopus.com/inward/record.url?scp=84894587187&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84894587187&partnerID=8YFLogxK
U2 - 10.1016/j.jaac.2013.11.010
DO - 10.1016/j.jaac.2013.11.010
M3 - Article
C2 - 24565357
AN - SCOPUS:84894587187
SN - 0890-8567
VL - 53
SP - 297
EP - 310
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
IS - 3
ER -