Intensive treatments for children and adolescents with anxiety or obsessive-compulsive disorders: A systematic review and meta-analysis.

Journal: Journal of anxiety disorders

Volume: 108

Issue: 

Year of Publication: 

Affiliated Institutions:  University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Grote Kruisstraat /, Groningen TS, the Netherlands; Accare Child Study Center, Lübeckweg , Groningen HE, the Netherlands. Electronic address: c.o.w.ganzevoort@rug.nl. University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Grote Kruisstraat /, Groningen TS, the Netherlands; Accare Child Study Center, Lübeckweg , Groningen HE, the Netherlands. Accare Child Study Center, Lübeckweg , Groningen HE, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Hanzeplein , Groningen GZ, the Netherlands. Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Palle Juul-Jensens Boulevard , entrance K, Aarhus , Denmark. Faculty of Psychology, University of Iceland, Saemundargata (Nyi-Gardur),, Reykjavik, Iceland. Regional Centre for Child and Youth Mental Health, Norwegian University of Science and Technology, and St. Olav's University Hospital, Department of Child and Adolescent Psychiatry, Klostergate , Trondheim , Norway. Department of Experimental Psychology, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX GG, UK. School of Psychology, University of New South Wales, Sydney , Australia; Black Dog Institute, Hospital Road, Randwick, NSW , Australia. Institute for Life Course Health Research, Stellenbosch University, South Africa; School of Nursing and Midwifery, Queens University,  Lisburn Road, Belfast BT BL, UK.

Abstract summary 

Anxiety and obsessive-compulsive disorders have a significant negative impact on youth. Cognitive behavioural therapy (CBT) is recommended and established as effective first-step treatment, but persistent symptoms and non-response are common. Intensive psychological treatments deliver more or longer sessions over a shorter time span, with fewer session gaps. However, an understanding of their effectiveness, characteristics, acceptability, and feasibility is lacking. Systematically searching five databases yielded four controlled and 36 uncontrolled studies (N=2707) involving youth with primary anxiety or obsessive-compulsive disorders, many of whom received prior treatments. Intensive treatments were acceptable and feasible, with low drop-out rates. Between-group analyses compared intensive treatment with standard treatment (k = 2) or waitlist (k = 2), revealing no significant post-treatment differences in symptom severity or remission. Uncontrolled within-group analyses of intensive treatments showed large improvements from pre- to post-treatment in symptoms (k = 47), remission (k = 17), impairment (k = 22), functioning (k = 5), and quality of life (k = 2), with larger effects at follow-ups. Intensive treatments show promise for youth with anxiety or obsessive-compulsive disorders by potentially offering high treatment completion rates and comparable outcomes to standard CBT, aiding earlier recovery and reducing overall suffering. This systematic review/meta-analysis provides a comprehensive overview of intensive treatments, their theoretical considerations, and empirical findings. Future RCTs should compare the effectiveness of standard and intensive treatments and identify optimal populations for their use.

Authors & Co-authors:  Ganzevoort Colin O W COW Wolters Lidewij H LH Hornstra Rianne R Grieve Caitlin M CM Højgaard Davíð R M A DRMA Skarphedinsson Gudmundur A GA Weidle Bernhard B Waite Polly P Bertie Lizél-Antoinette LA Tomlinson Mark M Nauta Maaike H MH

Study Outcome 

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Statistics
Citations : 
Authors :  11
Identifiers
Doi : 10.1016/j.janxdis.2024.102940
SSN : 1873-7897
Study Population
Male,Female
Mesh Terms
Other Terms
Adolescent development;Anxiety disorders;Obsessive compulsive disorder;Systematic review;Treatment
Study Design
Study Approach
Systemic Review
Country of Study
Publication Country
Netherlands