Treating Youth Anxiety in the Real World

Studies of youth anxiety have shown equal benefit from cognitive behavioral therapy (CBT) and medication, but these studies have been limited by short treatment durations (12 weeks) and homogeneous study populations (Figure 1). Now, researchers have conducted a 24-week sequential randomized trial among 316 youth with anxiety (age range, 8–17), 60% of whom were Hispanic. Two thirds had depression, and 40% had medical problems. More than half were on public insurance.

Patients were randomized to fluoxetine or CBT for 12 weeks. If their symptoms persisted, they were randomized to optimize their initial treatment alone or also add the other treatment. Adherence was high for all groups.