Wehry Anna M, Beesdo-Baum Katja, Hennelly Meghann M, Connolly Sucheta D, Strawn Jeffrey R
College of Medicine, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, 45219, USA.
Curr Psychiatry Rep. 2015 Jul;17(7):52. doi: 10.1007/s11920-015-0591-z.
Recent advances in the developmental epidemiology, neurobiology, and treatment of pediatric anxiety disorders have increased our understanding of these conditions and herald improved outcomes for affected children and adolescents. This article reviews the current epidemiology, longitudinal trajectory, and neurobiology of anxiety disorders in youth. Additionally, we summarize the current evidence for both psychotherapeutic and psychopharmacologic treatments of fear-based anxiety disorders (e.g., generalized, social, and separation anxiety disorders) in children and adolescents. Current data suggest that these disorders begin in childhood and adolescence, exhibit homotypic continuity, and increase the risk of secondary anxiety and mood disorders. Psychopharmacologic trials involving selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SSNRIs) are effective in pediatric patients with anxiety disorders and have generally demonstrated moderate effect sizes. Additionally, current data support cognitive behavioral therapy (CBT) for the treatment of these conditions in youth and suggest that the combination of psychotherapy + an SSRI may be associated with greater improvement than would be expected with either treatment as monotherapy.
发育流行病学、神经生物学以及儿童焦虑症治疗方面的最新进展，增进了我们对这些病症的了解，并预示着受影响的儿童和青少年将有更好的治疗结果。本文回顾了青少年焦虑症的当前流行病学、纵向发展轨迹及神经生物学。此外，我们总结了目前关于儿童和青少年基于恐惧的焦虑症（如广泛性焦虑症、社交焦虑症和分离焦虑症）的心理治疗和药物治疗的证据。当前数据表明，这些病症始于儿童期和青少年期，呈现同型连续性，并增加继发焦虑症和情绪障碍的风险。涉及选择性5-羟色胺再摄取抑制剂（SSRI）和选择性5-羟色胺去甲肾上腺素再摄取抑制剂（SSNRI）的药物试验对患有焦虑症的儿科患者有效，且总体显示出中等效应量。此外，当前数据支持认知行为疗法（CBT）用于治疗青少年的这些病症，并表明心理治疗与SSRI联合使用可能比单一疗法的任何一种治疗效果更好。
