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.

中文翻译：

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儿童/青少年焦虑症多模式扩展长期研究（CAMELS）的结果：原发性焦虑症结局

客观的

从多站点儿童/青少年焦虑多模式长期研究（CAMELS）中报告焦虑结果。稳定的焦虑症缓解率（严格定义为在所有随访年中均不存在所有DSM-IV TR焦虑症）和4年期焦虑症缓解的预测指标，从随机分配药物至12周后的4至12年开始，认知行为疗法（CBT），它们的组合或药丸安慰剂进行了检查。检查缓解的预测因素包括急性治疗反应，治疗分配，基线儿童和家庭变量以及中期阴性生活事件。

方法

数据来自319名青年（年龄范围10.9-25.2岁；平均年龄17.12岁），他们最初被诊断出患有分离，社交和/或广泛性焦虑症，并参加了多站点儿童/青少年焦虑多模式研究（CAMS）。参加者由独立评估人员使用与年龄相称的焦虑症访谈时间表和完成的调查表（例如，有关家庭功能，生活事件和心理健康服务使用情况）的方式，每年对参与者进行评估。

结果

几乎有22％的年轻人处于稳定状态，有30％患有慢性病，有48％是复发者。急性治疗应答者不太可能出现在慢性病组中（优势比= 2.73；置信区间= 1.14−6.54；p  <.02）；在整个随访过程中，治疗类型均与缓解状态无关。几个变量（例如，男性）预测焦虑症会稳定缓解。

结论

研究结果表明，对焦虑治疗的急性阳性反应可以减少慢性焦虑障碍的风险。明确的预测因素可以帮助为患有慢性病风险最高的年轻人量身定制治疗方案。

临床试验注册信息

儿童和青少年焦虑症（CAMS）。http://clinicaltrials.gov/; NCT00052078。