Childhood Anxiety, Cognitive Behavioral Therapy and/or Pharmacological Treatment

Objective: Evaluate best practice in managing anxiety in the pediatric population, including both school age children and adolescents. This literature review compared pharmacological treatment and cognitive behavioral therapy (CBT)’s effectiveness on the management of anxiety within the pediatric population. Background: Up to 25% of children in the United States are affected by a mental health disorder, anxiety being the most prevalent. Childhood anxiety can have a distressing impact on social, family, and academic functioning. If persisting into adulthood it increases the risk of developing other co-occurring mental health conditions, substance abuse issues, and contributes to impaired employment retention and socioeconomic burden. Addressing anxiety early has shown to have a lasting positive effect that carries forward into adulthood. Method: Five databases were selected to yield the highest levels of evidence. Key words from the clinical question were searched which generated the most prevalent hits. Sixty-five studies were identified, 16 were duplicates. Of the 49 studies reviewed, 22 met the inclusion criteria. A literature review of the 22 studies was conducted and synthesized. Results: The combination of CBT and pharmacotherapy are far superior for pediatric anxiety than either treatment alone. Individually, CBT is more effective than pharmacotherapy with a longer lasting benefit and should be offered to all children with anxiety. Children with severe anxiety should utilize both CBT and pharmacotherapy as together they improve the likelihood of response and remission