Mood and suicidality outcomes 3–11 years following pediatric anxiety disorder treatment

Abstract

Background Youth anxiety interventions have potential to reduce risk for depression and suicidality. Methods This naturalistic follow‐up of the multi‐site, comparative treatment trial, Child/Adolescent Anxiety Multimodal Study (CAMS), reports rates and predictors of mood disorders, suicidal thinking and behavior, and depressive symptoms 3–11 years (mean 6.25 years) following 12‐week evidence‐based youth anxiety treatment. Participants (N = 319; 10–26 years, mean 17 years) completed semiannual questionnaires and annual diagnostic interviews for 4 years. Results One‐fifth (20.4%) of the sample met DSM‐IV criteria for a mood disorder, 32.1% endorsed suicidal ideation, and 8.2% reported suicidal behavior. Latent class growth analysis yielded two linear trajectories of depressive symptoms, and 85% of the sample demonstrated a persistent low‐symptom course over seven assessments. Child/Adolescent Anxiety Multimodal Study (CAMS) 12‐week treatment outcome (positive response, remission) and treatment condition (cognitive behavior therapy [CBT], medication, CBT + medication, pill placebo) were not associated with subsequent mood disorder or suicidal thinking. CAMS remission predicted absence of suicidal behavior, and treatment response and remission predicted low depressive symptom trajectory. Greater baseline self‐reported depressive symptoms predicted all long‐term mood outcomes, and more negative life events predicted subsequent mood disorder, depressive symptom trajectory, and suicidal ideation. Conclusions Effective early treatment of youth anxiety, including CBT, medication, or CBT + medication, reduces risk for subsequent chronic depressive symptoms and suicidal behavior. Attention to (sub)clinical depressive symptoms and management of negative life events may reduce odds of developing a mood disorder, chronic depressive symptoms, and suicidality. Findings contribute to evidence that early intervention for a primary disorder can serve as secondary prevention.

Internalizing Symptom Profiles Among Youth in Foster Care: A Comparison Study

“…Moreover, their levels of depressive symptoms follow their levels of anxiety symptom subtypes and do not seem to be separate from the different anxiety symptom subtypes. This is in line with research indicating that anxiety is a predictor of depression ( 59 , 60 ). It may seem that those suffering from internalizing symptoms have overall high symptom levels across subtypes, also including depressive symptoms.…”

The p Factor Consistently Predicts Long-Term Psychiatric and Functional Outcomes in Anxiety-Disordered Youth

“…Future LTFUs should emphasize recruitment and retention of more diverse populations, with a particular focus on the barriers that these populations face to participation in research more generally. 50 Finally, the predictive power of p should be examined alongside predictor variables other than those used here (eg, depression 51 ) and in relation to a broader set of outcomes, and by including variables that may mediate outcome (eg, interim negative life events). Furthermore, p may be reciprocally or causally related to some of the factors included as covariates in this study (eg, family and overall functioning).…”

Roles of preoperative anxiety and depression in the outcomes of microvascular decompression in hemifacial spasm for adolescent patients

“…There are often negative emotions, such as anxiety and depression caused by various reasons, for adolescent patients. [ 12 ] Some previous studies have reported the effect of preoperative anxiety and depression in patients with trigeminal neuralgia on the outcome of MVD, but no studies have been conducted on patients with HFS. [ 13 ] As a result, the current work was conducted to examine the roles of preoperative anxiety and depression in the postoperative outcomes of MVD among HFS adolescent patients.…”

“…In some studies, HFS patients undergoing MVD have worse outcomes than those in older patients, [11] and such a phenomenon is worth exploring. There are often negative emotions, such as anxiety and depression caused by various reasons, for adolescent patients [12] . Some previous studies have reported the effect of preoperative anxiety and depression in patients with trigeminal neuralgia on the outcome of MVD, but no studies have been conducted on patients with HFS [13] .…”