4 - (SYM 78) Predictors of Relapse After Successful CBT in Anxiety Disorders in Children and Young People

Abstract Body
Around 50% of children and young people (CYP) with anxiety disorders initially respond to cognitive behavioral therapy (CBT). A substantial proportion, however, relapses after initial response and little is known about those at risk. Anxiety disorder relapse rates of youth from prior studies are often either highly varied and incongruently operationalized, or unmentioned. Using a combined international sample, this presentation is about (1) what the anxiety disorder relapse rates in CYP after initial response to CBT are, and (2) what characteristics of the child or parent predict these relapse rates.

CYP who initially met criteria for an anxiety disorder and were in full remission after CBT (N = 535 across eight global sites), were followed for 3-12 months after treatment. Relapse was operationalized as re-diagnosis of any anxiety disorder during any available follow-ups, after full remission post-treatment. Examined predictive factors were child characteristics including demographics (age, sex), pre-treatment anxiety disorder type and comorbidity, pre-treatment and post-treatment symptomatology of anxiety and depression, and maternal and paternal psychopathology.

Roughly one quarter (23.6%) of participants relapsed into any anxiety disorder during the 3-12 months post-treatment (ranging between 0 and 63.3% across trials). Relapse was significantly predicted only by depressive symptomatology at post-treatment (OR = 1.54).

The substantial relapse rate within 12 months suggests relapse prevention strategies need further development. Such strategies are likely needed for, and could be tailored to, CYP with post-treatment symptoms of depression. In view of the high variance in relapse rates between trials, a more a standardized mean of reporting anxiety relapse rates in studies is warranted.