Under the Hood

Young People With Anxiety May Benefit From Regular Check-Ups

Only 20 percent of young people who receive treatment for anxiety stay well over the next four years, according to researchers from the University of Connecticut. The team conducted the first-ever study to reassess youth treated for anxiety every year for a period of four years.

The findings were published in the Journal of the American Academy of Child and Adolescent Psychiatry on May 9.

Over 300 participants aged 10 to 25 were followed in the study. All were receiving treatment after being diagnosed with one of three types of anxiety disorders: separation, social, or general. The evidence-based treatment involved either sertraline (the generic form of Zoloft) or cognitive behavioral therapy, or a combination of the two.

Participants had annual follow-ups with the researchers for four years where they were assessed for anxiety levels but not provided any treatment. This was different from other studies which conducted a single follow-up at one, two, five, or 10 years out, the researchers stated.

The closer, sequential structure allowed them to identify those who stayed anxious, those who recovered but relapsed, and those who recovered and stayed well. Overall, 20 percent of the patients got well and remained so after treatment. Roughly half the patients relapsed at least once over the course of follow-ups. Another 30 percent were chronically anxious as they met the diagnostic criteria for an anxiety disorder at every follow-up.

"When you see so few kids stay non-symptomatic after receiving the best treatments we have, that’s discouraging," said Golda Ginsburg, a health psychologist from the university.

The study noted female patients were more likely to be chronically ill compared to their male counterparts.

Those who did respond to treatment were more likely to stay well. Long-term outcomes also saw no difference between treatment types, meaning treatment with medication could be just as effective as cognitive behavioral therapy (CBT). Both forms have their own advantages and drawbacks.

"If we can get them well, how do we keep them well?" said Ginsburg, suggesting that regular mental health check-ups may be a better way to treat anxiety than the current model.

Negative life events, poor family communication, and having a diagnosis of social phobia were other predictors of chronic disorder. Experts have suggested anxiety is often underestimated or ignored, leaving children and adolescents particularly vulnerable when they do not receive adequate support.

The study found evidence that kids saw better chances of recovery when their families were supportive and had positive communication styles. The takeaway was sometimes, a single intervention may not be enough.

Ginsburg advised parents to ask questions and have discussions with their children as well as the therapist. Understanding why a certain type of treatment is suggested, learning how to reinforce what was learned in therapy, and being aware of whether the therapist is trained in CBT can make a difference, she said.