Evidence map›Paper›PMID 18974308›Full record

Trial reportThe New England journal of medicine2008

Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety.

John T Walkup, Anne Marie Albano, John Piacentini, Boris Birmaher, Scott N Compton, Joel T Sherrill, Golda S Ginsburg, Moira A Rynn, James McCracken, Bruce Waslick and 3 more

Erratum issued 5 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 5 registered trials, which are not on this map. Cited by 501 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
501citing papers in PubMed, 11 pooled it
73.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00052078 phase3completednot on this map

Child/Adolescent Anxiety Multimodal Treatment Study

TypeinterventionalSponsorJohns Hopkins UniversityRan2003 to 2008Enrolled488ConditionsAnxiety Disorders, Social Phobia, Generalized Anxiety DisorderArmsSertraline (SRT), Cognitive Behavioral Therapy (CBT), Placebo
NCT01999920 phase4completednot on this mapstarted 2013, after this paper: background citation

Vilazodone for Separation Anxiety Disorder

TypeinterventionalSponsorNew York State Psychiatric InstituteRan2013 to 2017Enrolled24ConditionsSeparation Anxiety DisorderArmsVilazodone, Placebo
NCT02631785 naunknown statusnot on this mapstarted 2016, after this paper: background citation

Fear Conditioning, Extinction and Its Recall in Anxious Youth: Identifying Neuro- Cognitive Abnormalities and Their Relation to Pediatric Anxiety Treatment Outcomes

TypeinterventionalSponsorUniversity of HaifaRan2016 to 2020Enrolled60ConditionsPediatric Anxiety DisordersArmsCognitive Behavioral Therapy
NCT03412227 naunknown statusnot on this mapstarted 2018, after this paper: background citation

Randomized Clinical Trial of Transdiagnostic Behavioral Activation and Exposure Therapy for Youth: A Comparison of Effects and Mediators

TypeinterventionalSponsorRutgers UniversityRan2018 to 2025Enrolled200ConditionsAnxiety Disorders, DepressionArmsIndividual Behavioral Activation Therapy (IBAT), The PASCET Program for Youth Depressive Disorders, The Coping Cat Program for Youth Anxiety Disorders, 14-week waitlist (WL) condition
NCT04598230 phase3active not recruitingnot on this mapstarted 2021, after this paper: background citation

Partners in Caring for Anxious Youth

TypeinterventionalSponsorAnn & Robert H Lurie Children's Hospital of ChicagoRan2021 to 2026Enrolled468ConditionsAnxiety, Separation, Anxiety, Generalized, Anxiety, SocialArmsCognitive Behavioral Therapy (CBT), Combination therapy (COMB)
3 · Its place in the literature

Who cites it

501 citing papers in PubMed, 11 syntheses or guidelines pooled it, 1,429 citations in OpenAlex.

  1. Pooled it
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  3. Cognitive Functioning in Youth with Anxiety Disorders: A Systematic Review.Clinical child and family psychology review · 2024
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441 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 1 country.

John T WalkupDivision of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, 600 N. Wolfe St., Baltimore, MD 21287, USA.
Anne Marie Albano
John Piacentini
Boris Birmaher
Scott N Compton
Joel T Sherrill
Golda S Ginsburg
Moira A Rynn
James McCracken
Bruce Waslick
Satish Iyengar
John S March
Philip C Kendall
Columbia University Irving Medical Center · USDuke Medical Center · USJohns Hopkins University · USUniversity of California, Los Angeles · USUniversity of Pittsburgh Medical Center · USBaystate Medical Center · USNational Institute of Mental Health · USTemple University · US

Funding

Child/Adolescent Anxiety Multimodal Treatment StudyU01MH064089 · NIMH · JOHNS HOPKINS UNIVERSITY · PI GINSBURG, GOLDA SUSAN · 2002 to 2007
$3.1M
Child/Adolescent Anxiety Multimodal Treatment StudyU01MH064003 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI BIRMAHER, BORIS · 2002 to 2007
$2.7M
Child/Adolescent Anxiety Multimodal Treatment Study (CAMS)U01MH064092 · NIMH · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI ALBANO, ANNE MARIE · 2002 to 2007
$2.4M
Child and Adolescent Anxiety Multisite Study (CAMS)U01MH064107 · NIMH · DUKE UNIVERSITY · PI MARCH, JOHN S · 2002 to 2007
$2.4M
Child/Adolescent Anxiety Multimodal Treatment StudyU01MH063747 · NIMH · TEMPLE UNIV OF THE COMMONWEALTH · PI KENDALL, PHILIP C · 2002 to 2007
$2.2M
Child/Adolescent Anxiety Multimodal Treatment StudyU01MH064088 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI PIACENTINI, JOHN C. · 2002 to 2007
$2.1M
Statistics and Methodology in Clinical TrialsK23MH075843 · NIMH · DUKE UNIVERSITY · PI COMPTON, SCOTT N · 2007 to 2011
$819k
NIMH NIH HHS K23 MH075843NIMH NIH HHS L40 MH072315NIMH NIH HHS U01 MH063747NIMH NIH HHS U01 MH064003NIMH NIH HHS U01 MH064088NIMH NIH HHS U01 MH064089NIMH NIH HHS U01 MH064092NIMH NIH HHS U01 MH064107NIMH NIH HHS U01 MH63747NIMH NIH HHS U01 MH64003NIMH NIH HHS U01 MH64088NIMH NIH HHS U01 MH64092NIMH NIH HHS U01 MH64107
6 · The paper itself

Abstract

backgroundAnxiety disorders are common psychiatric conditions affecting children and adolescents. Although cognitive behavioral therapy and selective serotonin-reuptake inhibitors have shown efficacy in treating these disorders, little is known about their relative or combined efficacy.

methodsIn this randomized, controlled trial, we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis of separation anxiety disorder, generalized anxiety disorder, or social phobia to receive 14 sessions of cognitive behavioral therapy, sertraline (at a dose of up to 200 mg per day), a combination of sertraline and cognitive behavioral therapy, or a placebo drug for 12 weeks in a 2:2:2:1 ratio. We administered categorical and dimensional ratings of anxiety severity and impairment at baseline and at weeks 4, 8, and 12.

resultsThe percentages of children who were rated as very much or much improved on the Clinician Global Impression-Improvement scale were 80.7% for combination therapy (P<0.001), 59.7% for cognitive behavioral therapy (P<0.001), and 54.9% for sertraline (P<0.001); all therapies were superior to placebo (23.7%). Combination therapy was superior to both monotherapies (P<0.001). Results on the Pediatric Anxiety Rating Scale documented a similar magnitude and pattern of response; combination therapy had a greater response than cognitive behavioral therapy, which was equivalent to sertraline, and all therapies were superior to placebo. Adverse events, including suicidal and homicidal ideation, were no more frequent in the sertraline group than in the placebo group. No child attempted suicide. There was less insomnia, fatigue, sedation, and restlessness associated with cognitive behavioral therapy than with sertraline.

conclusionsBoth cognitive behavioral therapy and sertraline reduced the severity of anxiety in children with anxiety disorders; a combination of the two therapies had a superior response rate. (ClinicalTrials.gov number, NCT00052078.)

Indexed as

Cognitive Behavioral TherapyAdolescentAnxiety DisordersChildCombined Modality TherapyFemaleHumansMaleSelective Serotonin Reuptake InhibitorsSertralineTreatment OutcomeSelective Serotonin Reuptake InhibitorsSertraline

Identifiers

PMID18974308
PMCPMC2702984
OpenAlexW2131873172

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.