Pediatric social anxiety disorder: Predictors of response to pharmacological treatment

Gabriele Masi, Chiara Pfanner, Maria Mucci, Stefano Berloffa, Angela Magazù, Giulia Parolin, Giulio Perugi

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: Pediatric social anxiety disorder (SAD) is associated with an increased risk of comorbid mental disorders, with implications for prognosis and treatment strategy. The aim of this study is to explore predictors of treatment response, and the role of comorbidity in affecting refractoriness. Methods: One hundred and forty consecutive youths (81 males, 57.9%), ages 7-18 years (mean age 13.7±2.5 years, mean age at onset of SAD 10.6±2.7 years) met American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for SAD as primary diagnosis, according to a structured clinical interview (Kiddie Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version [K-SADS-PL]). All received a pharmacological treatment with serotonin reuptake inhibitors (SSRIs) targeted to SAD, associated with additional medications for comorbidities (mood stabilizers in 27.1%, antipsychotics in 12.8%) and 57.9% received an additional psychotherapy. Results: Eighty-nine patients (63.6%) responded to treatments after 3 months, namely 72.8% with psychotherapy plus medication and 50.8% with medication only. Nonresponders had more severe symptoms at baseline in terms of both clinical severity and functional impairment, and had more comorbid disruptive behavior disorders. The backward logistic regression indicated that clinical severity and functional impairment at baseline, comorbid disruptive behavior disorders, and bipolar disorders were predictors of nonresponse. Conclusion: Our data suggest that SSRIs can be effective in pediatric SAD, but that the more severe forms of the disorder and those with heavier comorbidity are associated with poorer prognosis.

Original languageEnglish
Pages (from-to)410-414
Number of pages5
JournalJournal of Child and Adolescent Psychopharmacology
Volume22
Issue number6
DOIs
Publication statusPublished - Dec 1 2012

Fingerprint

Pharmacology
Pediatrics
Attention Deficit and Disruptive Behavior Disorders
Comorbidity
Psychotherapy
Diagnostic and Statistical Manual of Mental Disorders
Therapeutics
Serotonin Uptake Inhibitors
Mood Disorders
Bipolar Disorder
Age of Onset
Mental Disorders
Antipsychotic Agents
Schizophrenia
Appointments and Schedules
Logistic Models
Social Phobia
Interviews

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health

Cite this

Pediatric social anxiety disorder : Predictors of response to pharmacological treatment. / Masi, Gabriele; Pfanner, Chiara; Mucci, Maria; Berloffa, Stefano; Magazù, Angela; Parolin, Giulia; Perugi, Giulio.

In: Journal of Child and Adolescent Psychopharmacology, Vol. 22, No. 6, 01.12.2012, p. 410-414.

Research output: Contribution to journalArticle

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abstract = "Objective: Pediatric social anxiety disorder (SAD) is associated with an increased risk of comorbid mental disorders, with implications for prognosis and treatment strategy. The aim of this study is to explore predictors of treatment response, and the role of comorbidity in affecting refractoriness. Methods: One hundred and forty consecutive youths (81 males, 57.9{\%}), ages 7-18 years (mean age 13.7±2.5 years, mean age at onset of SAD 10.6±2.7 years) met American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for SAD as primary diagnosis, according to a structured clinical interview (Kiddie Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version [K-SADS-PL]). All received a pharmacological treatment with serotonin reuptake inhibitors (SSRIs) targeted to SAD, associated with additional medications for comorbidities (mood stabilizers in 27.1{\%}, antipsychotics in 12.8{\%}) and 57.9{\%} received an additional psychotherapy. Results: Eighty-nine patients (63.6{\%}) responded to treatments after 3 months, namely 72.8{\%} with psychotherapy plus medication and 50.8{\%} with medication only. Nonresponders had more severe symptoms at baseline in terms of both clinical severity and functional impairment, and had more comorbid disruptive behavior disorders. The backward logistic regression indicated that clinical severity and functional impairment at baseline, comorbid disruptive behavior disorders, and bipolar disorders were predictors of nonresponse. Conclusion: Our data suggest that SSRIs can be effective in pediatric SAD, but that the more severe forms of the disorder and those with heavier comorbidity are associated with poorer prognosis.",
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