Cognitive behavioral therapy for childhood anxiety disorders: What happens to comorbid mood and behavioral disorders? A systematic review

Background: High rates of comorbidity among children and adolescents with anxiety disorders are widely documented. To date the question of what happens to comorbid disorders upon treatment of the primary anxiety disorder has received little attention and the optimal treatment strategy for cases with comorbidity remains to be determined. Objectives: This review examines the literature on the impact of disorder-specific CBT on comorbid mood and behavioral disorders in young people with a primary anxiety disorder. Search methods: PsycINFO, EMBASE, MEDLINE and the Cochrane Library were systematically searched using predefined selection criteria. Two reviewers independently assessed the relevance of studies, obtained data using a data extraction form and undertook methodological quality analysis. Results: Ten studies (1647 children in total) were included in the review. All studies demonstrated positive outcomes for CBT focused on the primary anxiety disorder on untargeted comorbid mood and/or externalising disorders. Conclusions: Findings suggest CBT focused on the primary anxiety disorder successfully reduces comorbid mood and/or behavioral diagnoses and symptoms of these co-occurring clinical diagnoses. Therefore, the implementation of disorder-specific CBT for the primary disorder is a valid alternative to transdiagnostic interventions and is recommended in cases of comorbidity in children and adolescents with a primary anxiety disorder.