Evidence map›Paper›PMID 31364169›Full record

Trial reportJournal of child psychology and psychiatry, and allied disciplines2020

A randomised controlled trial of treatments of childhood anxiety disorder in the context of maternal anxiety disorder: clinical and cost-effectiveness outcomes.

Cathy Creswell, Mara Violato, Susan Cruddace, Stephen Gerry, Lynne Murray, Roz Shafran, Alan Stein, Lucy Willetts, Emma McIntosh, Peter J Cooper

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of child psychology and psychiatry, and allied disciplines, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
2.9field-weighted citation impact, top 10% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 2 countries.

Cathy CreswellDepartment of Psychiatry, University of Oxford, Oxford, UK.
Mara ViolatoNuffield Department of Population Health, University of Oxford, Oxford, UK.
Susan CruddaceSchool of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
Stephen GerryNuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Science, University of Oxford, Oxford, UK.
Lynne MurraySchool of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
Roz ShafranPopulation, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK.
Alan SteinDepartment of Psychiatry, University of Oxford, Oxford, UK.
Lucy WillettsBerkshire Healthcare NHS Foundation Trust, Berkshire, UK.
Emma McIntoshInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Peter J CooperSchool of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
University of Reading · GBAgincourt Health and Socio-Demographic Surveillance System · ZABerkshire Healthcare NHS Foundation Trust · GBNuffield Orthopaedic Centre · GBUniversity College London · GBUniversity of Glasgow · GBUniversity of Oxford · GB

Funding

Department of Health PB-PG-0110-21190Department of Health RP_2014-04-018Medical Research Council 09/800/17Medical Research Council G0601874
6 · The paper itself

Abstract

backgroundThis study evaluated whether clinical and economic outcomes from CBT for child anxiety disorders in the context of maternal anxiety disorders are improved by adding treatment focused on (a) maternal anxiety disorders or (b) mother-child interactions.

methodsTwo hundred and eleven children (7-12 years, 85% White British, 52% female) with a primary anxiety disorder, whose mothers also had a current anxiety disorder, were randomised to receive (a) child-focused CBT with nonspecific control interventions (CCBT+Con), (b) CCBT with CBT for the maternal anxiety disorder (CCBT+MCBT), or (c) CCBT with an intervention targeting the mother-child interaction (CCBT+MCI). A cost-utility analysis from a societal perspective was conducted using mother/child combined quality-adjusted life years (QALYs). [Trial registration: https://doi.org/10.1186/isrctn19762288].

resultsMCBT was associated with immediate reductions in maternal anxiety compared to the nonspecific control; however, after children had also received CCBT, maternal outcomes in the CCBT+MCI and CCBT+Con arms improved and CCBT+MCBT was no longer superior. Neither CCBT+MCBT nor CCBT+MCI conferred a benefit over CCBT+Con in terms of child anxiety disorder diagnoses post-treatment [primary outcome] (adj RR: 1.22 (95% CI: 0.88, 1.67), p = .23; adj RR: 1.21 (95% CI: 0.88, 1.65), p = .24, respectively) or global improvement ratings (adj RR: 1.25 (95% CI: 0.99, 1.57), p = .06; adj RR: 1.18 (95% CI: 0.93, 1.50), p = .17) or six and 12 months later. No significant differences between the groups were found on the main economic outcome measures (child/mother combined QALY mean difference: CCBT+MCBT vs. CCBT+Con: -0.04 (95% CI: -0.12, 0.04), p = .29; CCBT+MCI vs. CCBT+Con: 0.02 (95% CI: -0.05, -0.09), p = .54). CCBT+MCI was associated with nonsignificantly higher costs than CCBT (mean difference: £154 (95% CI: -£1,239, £1,547), p = .83) but, when taking into account sampling uncertainty, it may be cost-effective compared with CCBT alone.

conclusionsGood outcomes were achieved for children and their mothers across treatment arms. There was no evidence of significant clinical benefit from supplementing CCBT with either CBT for the maternal anxiety disorder or treatment focussed on mother-child interactions, but the addition of MCI (and not MCBT) may be cost-effective.

Indexed as

Child of Impaired ParentsCognitive Behavioral TherapyCost-Benefit AnalysisMother-Child RelationsMothersOutcome Assessment, Health CareAdultAnxiety DisordersChildFemaleHumansMaleanxietyChildcognitive behaviour therapymotherparent-child interaction

Identifiers

PMID31364169
PMCPMC6916180
OpenAlexW2966000359

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.