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Comorbidity in childhood anxiety disorders and treatment outcome.

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  • 1Child and Adolescent Anxiety Disorders Clinic, Department of Psychology, Temple University, Philadelphia, PA 19122, USA.



Psychiatric comorbidity is common in anxious children. The purpose of this study was to investigate the impact of comorbidity on treatment outcome in anxious children.


Participants were 173 children between the ages of 8 and 13 years who met primary DSM-III-R/DSM-IV diagnoses of separation anxiety disorder, overanxious disorder/generalized anxiety disorder, or avoidant disorder/social phobia assessed by the Anxiety Disorders Interview Schedule for Children (ADIS-C). The majority (79%) had at least one comorbid diagnosis. Participants were randomly assigned to cognitive-behavioral therapy or waitlist. Group differences in ADIS-C diagnoses were compared after treatment. Multiple parent and child self-report measures were used to measure symptoms as well.


Pretreatment comorbidity was not associated with differences in treatment outcome: 68.4% of noncomorbid participants and 70.6% of comorbid participants were free of their primary diagnosis after treatment. Regarding parent and child self-report symptoms, multivariate analyses of variance revealed significant time (treatment) main effects, but no significant main effect for group (comorbid status) or time/group interaction.


The cognitive-behavioral treatment program was similarly effective in anxious children with and without comorbid disorders; both groups showed clinically significant reductions in pretreatment diagnoses and symptoms.

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