Comorbidity in childhood anxiety disorders and treatment outcome

Objective: Psychiatric comorbidity is common in anxious children. The purpo se of this study was to investigate the impact of comorbidity on treatment outcome in anxious children. Method: Participants were 173 children between the ages of 8 and 13 years who met primary DSM-III-R/DSM-IV diagnoses of s eparation anxiety disorder, overanxious disorder/generalized anxiety disord er. or avoidant disorder/social phobia assessed by the Anxiety Disorders in terview Schedule for Children (ADIS-C). The majority (79%) had at least one comorbid diagnosis. Participants were randomly assigned to cognitive-behav ioral therapy or waitlist. Group differences in ADIS-C diagnoses were compa red after treatment. Multiple parent and child self-report measures were us ed to measure symptoms as well. Results: Pretreatment comorbidity was not a ssociated with differences in treatment outcome: 68.4% of noncomorbid parti cipants and 70.6% of comorbid participants were free of their primary diagn osis after treatment. Regarding parent and child self-report symptoms, mult ivariate analyses of variance revealed significant time (treatment) main ef fects. but no significant main effect for group (comorbid status) or time/g roup interaction. Conclusions: The cognitive-behavioral treatment program w as similarly effective in anxious children with and without comorbid disord ers; both groups showed clinically significant reductions in pretreatment d iagnoses and symptoms.