Editor's note
Treatment of anxiety disorders in children and adolescence is dominated by treatment with cognitive-behavioural therapy or with techniques from cognitive-behavioral therapy. These types of therapies are the first-line treatments among youth with a variety of anxiety disorders including school phobia, elective mutism, PTSD, social phobia, generalized anxiety disorder, panic disorder and obsessive-compulsive disorder. As the disorders become more severe, then medications are recommended, but psychopharmacologic treatment in children is not as widely encouraged as in adults. Also, given that the SSRIs are, in general, the major class used in the treatment of anxiety disorders, and given that there are concerns with respect to suicidal ideation and acts among young people on SSRIs, these pharmacologic interventions are not viewed as first-line treatments. And yet there is much more methodologically sound evidence for pharmacologic treatment than for CBT. The best data we have, for both behavioural/cognitive behavioural as well as psychopharmacological intervention is, with obsessive-compulsive disorder.
Introduction
Anxiety disorders are common in childhood occurring in 3%–13% of all children and adolescents (Anderson et al., 1987; Costello & Angold, 1995; Kashani & Orvashel, 1990). Children typically present with more than one anxiety disorder. Co-morbidity, primarily with depression, is common. Anxiety disorders are associated with significant impairments in multiple functional domains (Costello et al., 1999; Klein & Pine, 2002). Since anxiety disorders may persist into adulthood (Pine et al., 1998), effective treatment is important.
