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Mood and suicidality outcomes 3–11 years following pediatric anxiety disorder treatment
Author(s) -
Keeton Courtney P.,
Caporino Nicole E.,
Kendall Philip C.,
Iyengar Satish,
Lee Phyllis,
Peris Tara,
Sakolsky Dara,
Piacentini John,
Compton Scott N.,
Albano Anne Marie,
Birmaher Boris,
Ginsburg Golda S.
Publication year - 2019
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.22944
Subject(s) - suicidal ideation , anxiety , mood , psychiatry , clinical psychology , psychology , major depressive disorder , mood disorders , poison control , medicine , suicide prevention , environmental health
Background Youth anxiety interventions have potential to reduce risk for depression and suicidality. Methods This naturalistic follow‐up of the multi‐site, comparative treatment trial, Child/Adolescent Anxiety Multimodal Study (CAMS), reports rates and predictors of mood disorders, suicidal thinking and behavior, and depressive symptoms 3–11 years (mean 6.25 years) following 12‐week evidence‐based youth anxiety treatment. Participants ( N = 319; 10–26 years, mean 17 years) completed semiannual questionnaires and annual diagnostic interviews for 4 years. Results One‐fifth (20.4%) of the sample met DSM‐IV criteria for a mood disorder, 32.1% endorsed suicidal ideation, and 8.2% reported suicidal behavior. Latent class growth analysis yielded two linear trajectories of depressive symptoms, and 85% of the sample demonstrated a persistent low‐symptom course over seven assessments. Child/Adolescent Anxiety Multimodal Study (CAMS) 12‐week treatment outcome (positive response, remission) and treatment condition (cognitive behavior therapy [CBT], medication, CBT + medication, pill placebo) were not associated with subsequent mood disorder or suicidal thinking. CAMS remission predicted absence of suicidal behavior, and treatment response and remission predicted low depressive symptom trajectory. Greater baseline self‐reported depressive symptoms predicted all long‐term mood outcomes, and more negative life events predicted subsequent mood disorder, depressive symptom trajectory, and suicidal ideation. Conclusions Effective early treatment of youth anxiety, including CBT, medication, or CBT + medication, reduces risk for subsequent chronic depressive symptoms and suicidal behavior. Attention to (sub)clinical depressive symptoms and management of negative life events may reduce odds of developing a mood disorder, chronic depressive symptoms, and suicidality. Findings contribute to evidence that early intervention for a primary disorder can serve as secondary prevention.