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Ouida Lecture: Treatment of Anxiety Disorders in Children: Update on the Child/Adolescent Anxiety Multimodal Study (CAMS)

John T. Walkup, M.D.
Associate Professor,
Johns Hopkins University School of Medicine,
Department of Psychiatry and Behavioral Sciences

Although extremely common, anxiety in children and adolescents frequently remains undiagnosed. The Child Adolescent Anxiety Multimodal Study (CAMS) sought to examine the effectiveness of various treatments for separation anxiety, generalized anxiety disorder, and social phobia. Data were taken from a sample of 488 boys and girls around the U.S., ranging in age from seven to seventeen who were experiencing anxiety disorders. Children with ADHD were included in the study, but children with depression were excluded. The majority of the sample had comorbid disorders. The treatment conditions consisted of SSRI, cognitive-behavioral therapy (CBT), both SSRI’s and CBT, and a placebo. Results of the study were not yet available. Complications of treatment were discussed and consisted of the acronym A-I: activation, bipolar switching, celebration, dimensional issues and comorbid disorders, evolving psychopathology, frontal lobe symptoms, gastrointestinal symptoms, hematological risk, and inhibited growth. Conclusions emphasized that anxiety is common and easy to miss, anxiety disorders are responsive to treatment, side effects and unusual complications are possible, and SSRI’s and psychotherapy are effective.