6/6-Child/Adolescent Anxiety Multimodal Extended Long-Term Study (CAMELS)

描述（由申请人提供）：焦虑症是青少年最常见的精神疾病，患病率平均为5-20%。这些障碍与学业、家庭、社会和心理功能的显著短期和长期损害有关。虽然药物治疗和认知行为疗法（CBT）在短期内是有效的，但关于治疗效果的持久性和干预对长期功能的相对影响的问题仍然存在。这项竞争性的延续申请（响应PAR- 09-153）将继续儿童/青少年焦虑多模式研究（CAMS）组成功的多站点合作，对参加CAMS试验的青少年焦虑症样本进行为期5年的随访。这六个地点是：纽约州精神病学研究所；杜克大学医学中心；约翰霍普金斯大学；天普大学;加州大学洛杉矶分校；以及西方精神病学研究所和诊所。这项名为“儿童/青少年焦虑多模式延长长期研究”（CAMELS）的拟议研究的核心问题是检查患有焦虑症的青少年的长期精神、身体和功能结果，这些患者被随机分配到四种治疗条件之一（即CBT、舍曲林[SRT]、药丸安慰剂或CBT + SRT联合治疗）。CAMS成功地随机抽取了488名儿童/青少年。鉴于需要更多关于成功治疗对焦虑症状及其后遗症的影响的信息，以及NIMH优先考虑了解精神疾病的发展轨迹，骆驼项目至关重要（美国国土卫生和公众服务部，2008年）。camel将招募最大的样本，仔细描述患有焦虑症的年轻人，并将告知该领域：1)成功治疗（心理社会；药物）对后期精神病理学发展的预防作用，2)治疗持久性，3)潜在的长期不良影响（例如，长期使用药物），以及4)复发或长期维持的预测因素。研究结果还将用于改进当前的治疗方法，阐明现有的干预措施可能需要如何增强或个性化，以针对特定儿童的特定远端精神病理和/或功能结果。

DESCRIPTION (provided by applicant): Anxiety disorders are the most common psychiatric illnesses in youth with prevalence rates averaging 5-20%. These disorders are associated with significant short- and long-term impairment in academic, familial, social, and psychological functioning. Although medication and cognitive-behavioral therapy (CBT) have been found to be effective in the short term, questions remain regarding the durability of treatment effects and the relative impact of intervention on long-term functioning. This competing continuation application (in response to PAR- 09-153) will continue the successful multi-site collaboration of the Child/Adolescent Anxiety Multi-modal Study (CAMS) group to conduct a 5-year follow-up of the sample of youth with anxiety disorders that participated in the CAMS trial. The six sites are: New York State Psychiatric Institute; Duke University Medical Center; Johns Hopkins University; Temple University; University of California at Los Angeles; and Western Psychiatric Institute and Clinic. The central questions of the proposed study, entitled the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), are to examine the long-term psychiatric, physical, and functional outcomes of youth with anxiety disorders who were randomized to one of four treatment conditions (i.e., CBT, sertraline [SRT], pill placebo, or combined CBT + SRT). CAMS succeeded in randomizing 488 children/adolescents. The CAMELS is critical in light of the need for additional information about the effects of successful treatment on the course of anxiety symptoms and their sequelae and the NIMH priority to understand the developmental trajectories of mental illness (US DHHS, 2008). CAMELS will enroll the largest sample of carefully characterized youth with anxiety disorders and will inform the field about: 1) the preventive effects of successful treatment (psychosocial; medication) on the development of later psychopathology, 2) treatment durability, 3) potential long-term adverse effects (e.g., from chronic use of medication), and 4) predictors of relapse or long-term maintenance. Findings will also be used to refine current treatments, shedding light on how existing interventions may need to be augmented or personalized to target specific distal psychopathology and/or functional outcomes for specific children. PUBLIC HEALTH RELEVANCE: This five-year study, entitled the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), proposes to follow up the sample of children and adolescents (N=488) with anxiety disorders that participated in the successful multi-site collaboration of the Child/Adolescent Anxiety Multi-modal Study (CAMS; U01MH64089). The central question of the proposed study is to examine the long-term psychiatric, physical, and functional outcomes of youth with anxiety disorders who were randomized to one of four treatment conditions (i.e., cognitive behavioral therapy (CBT), sertraline (SRT), pill placebo, or combined CBT + SRT. Key findings will inform the field about the preventive effects of successful treatment (both psychosocial and medication) on the development of later psychopathology and treatment durability.