***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Various studies find relationships among anxiety and depressive disorders of adolescence and adulthood . This study prospect ively examines the magnitude of longitudinal associations between adolescent and adult anxiety or depressive disorders . METHODS An epidemiologically selected sample of 776 young people living in upstate New York received DSM-based psychiatric assessment s in 1983 , 1985 , and 1992 using structured interviews .  The magnitude of the association between adolescent and adult anxiety or depressive disorders was quantified using odds ratios generated from logistic regression analyses and from a set of latent Markov analyses . We focus on longitudinal associations among narrowly defined DSM anxiety or depressive disorders . RESULTS In simple logistic models , adolescent anxiety or depressive disorders predicted an approximate 2- to 3-fold increased risk for adulthood anxiety or depressive disorders . There was evidence of specificity in the course of simple and social phobia but less specificity in the course of other disorders . Results from the analyses using latent variables suggested that while most adolescent disorders were no longer present in young adulthood , most adult disorders were preceded by adolescent disorders . CONCLUSIONS An anxiety or depressive disorder during adolescence confers a strong risk for recurrent anxiety or depressive disorders during early adulthood . Most anxiety and depressive disorders in young adults may be preceded by anxiety or depression in adolescence OBJECTIVE The goal of this study was to examine the associations between specific anxiety disorders and the risk of major depressive disorder  and to explore the role of various clinical characteristics of anxiety disorders in these relationships using a prospect i ve , longitudinal design . METHOD The data are from a 4-year prospect i ve ,  longitudinal community study  , which included both baseline and follow-up survey data on 2548 adolescents and young adults aged 14 to 24 years at baseline . DSM-IV diagnoses were made using the Munich-Composite International Diagnostic Interview . RESULTS The presence at baseline of any anxiety disorder ( odds ratio [ OR ] = 2.2 [ 95 % CI = 1.6 to 3.2 ] ) and each of the anxiety disorders ( specific phobia , OR = 1.9 [ 95 % CI = 1.3 to 2.8 ] ; social phobia , OR = 2.9 [ 95 % CI = 1.7 to 4.8 ] ; agoraphobia , OR = 3.1 [ 95 % CI = 1.4 to 6.7 ] ; panic disorder , OR = 3.4 [ 95 % CI = 1.2 to 9.0 ] ; generalized anxiety disorder , OR = 4.5 [ 95 % CI = 1.9 to 10.3 ] ) was associated with a significantly ( p < .05 ) increased risk of first onset of major depressive disorder . These associations remained significant after we adjusted for mental disorders occurring prior to the onset of the anxiety disorder , with the exception of the panic disorder association . The following clinical characteristics of anxiety disorders were associated with a significantly ( p < .05 ) increased risk of developing major depressive disorder : more than 1 anxiety disorder , severe impairment due to the anxiety disorder , and comorbid panic attacks . In the final model , which included all clinical characteristics , severe impairment remained the only clinical characteristic that was an independent predictor of the development of major depressive disorder ( OR = 2.2 [ 95 % CI = 1.0 to 4.4 ] ) . CONCLUSION Our findings suggest that anxiety disorders are risk factors for the first onset of major depressive disorder . Although a number of clinical characteristics of anxiety disorders appear to play a role in the association between anxiety disorders and depression , severe impairment is the strongest predictor of major depressive disorder OBJECTIVE This study evaluated follow-up outcomes associated with cognitive behavioral therapy ( CBT ) for childhood anxiety by comparing successfully and unsuccessfully treated participants 6.72 to 19.17 years after treatment . METHOD Participants were a sample of 66 youths ( ages 7 - 14 years at time of treatment , ages 18 - 32 years at present follow-up ) who had been diagnosed with an anxiety disorder and r and omized to treatment in a r and omized clinical trial on average 16.24 ( SD = 3.56 , range = 6.72 - 19.17 ) years prior . The present follow-up included  self-report measures and a diagnostic interview  to assess anxiety , depression , and substance misuse . RESULTS Compared with those who responded successfully to CBT for an anxiety disorder in childhood , those who were less responsive had higher rates of panic disorder , alcohol dependence , and drug abuse in adulthood . Relative to a normative comparison group , those who were less responsive to CBT in childhood had higher rates of several anxiety disorders and substance misuse problems in adulthood . Participants remained at particularly increased risk , relative to the normative group , for generalized anxiety disorder and nicotine dependence regardless of initial treatment outcome . CONCLUSIONS The present study is the first to assess the long-term follow-up effects of CBT treatment for an anxiety disorder in youth on anxiety , depression , and substance abuse through the period of young adulthood when these disorders are often seen . Results support the presence of important long-term benefits of successful early CBT for anxiety OBJECTIVE We report active treatment group differences on response and remission rates and changes in anxiety severity at weeks 24 and 36 for the Child/Adolescent Anxiety Multimodal Study ( CAMS ) . METHOD CAMS youth ( N = 488 ; 74 % ≤ 12 years of age ) with DSM-IV separation , generalized , or social anxiety disorder were r and omized to 12 weeks of cognitive-behavioral therapy ( CBT ) , sertraline ( SRT ) , CBT+SRT ( COMB ) , or medication management/pill placebo ( PBO ) . Responders attended 6 monthly booster sessions in their assigned treatment arm ; youth in COMB and SRT continued on their medication throughout this period . Efficacy of COMB , SRT , and CBT ( n = 412 ) was assessed at 24 and 36 weeks postr and omization . Youth r and omized to PBO ( n = 76 ) were offered active CAMS treatment if nonresponsive at week 12 or over follow-up and were not included here . Independent evaluators blind to study condition assessed anxiety severity , functioning , and treatment response . Concomitant treatments were allowed but monitored over follow-up . RESULTS The majority ( > 80 % ) of acute responders maintained positive response at both weeks 24 and 36 . Consistent with acute outcomes , COMB maintained advantage over CBT and SRT , which did not differ , on dimensional outcomes ; the 3 treatments did not differ on most categorical outcomes over follow-up . Compared to COMB and CBT , youth in SRT obtained more concomitant psychosocial treatments , whereas those in SRT and CBT obtained more concomitant combined ( medication plus psychosocial ) treatment . CONCLUSIONS COMB maintained advantage over CBT and SRT on some measures over follow-up , whereas the 2 monotherapies remained indistinguishable . The observed convergence of COMB and monotherapy may be related to greater use of concomitant treatment during follow-up among youth receiving the monotherapies , although other explanations are possible . Although outcomes were variable , most CAMS-treated youth experienced sustained treatment benefit . Clinical trial registration information-Child and Adolescent Anxiety Disorders ( CAMS ) ; URL : http:// clinical trials.gov . Unique identifier : NCT00052078 BACKGROUND Anxiety disorders are common psychiatric conditions affecting children and adolescents . Although cognitive behavioral therapy and selective serotonin-reuptake inhibitors have shown efficacy in treating these disorders , little is known about their relative or combined efficacy . METHODS In this r and omized , controlled trial , we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis of separation anxiety disorder , generalized anxiety disorder , or social phobia to receive 14 sessions of cognitive behavioral therapy , sertraline ( at a dose of up to 200 mg per day ) , a combination of sertraline and cognitive behavioral therapy , or a placebo drug for 12 weeks in a 2:2:2:1 ratio . We administered categorical and dimensional ratings of anxiety severity and impairment at baseline and at weeks 4 , 8 , and 12 . RESULTS The percentages of children who were rated as very much or much improved on the Clinician Global Impression-Improvement scale were 80.7 % for combination therapy ( P<0.001 ) , 59.7 % for cognitive behavioral therapy ( P<0.001 ) , and 54.9 % for sertraline ( P<0.001 ) ; all therapies were superior to placebo ( 23.7 % ) . Combination therapy was superior to both monotherapies ( P<0.001 ) . Results on the Pediatric Anxiety Rating Scale documented a similar magnitude and pattern of response ; combination therapy had a greater response than cognitive behavioral therapy , which was equivalent to sertraline , and all therapies were superior to placebo .  Adverse events , including suicidal and homicidal ideation , were no more frequent in the sertraline group than in the placebo group . No child attempted suicide . There was less insomnia , fatigue , sedation , and restlessness associated with cognitive behavioral therapy than with sertraline . CONCLUSIONS Both cognitive behavioral therapy and sertraline reduced the severity of anxiety in children with anxiety disorders ; a combination of the two therapies had a superior response rate . ( Clinical Trials.gov number , NCT00052078 . BACKGROUND If most adults with mental disorders are found to have a juvenile psychiatric history , this would shift etiologic research and prevention policy to focus more on childhood mental disorders . METHOD Our prospect i ve longitudinal study followed up a representative birth cohort ( N = 1037 ) . We made psychiatric diagnoses according to DSM criteria at 11 , 13 , 15 , 18 , 21 , and 26 years of age . Adult disorders were defined in the following 3 ways : ( 1 ) cases diagnosed using a st and ardized diagnostic interview  , ( 2 ) the subset using treatment , and ( 3 ) the subset receiving intensive mental health services .  Follow-back analyses ascertained the proportion of adult cases who had juvenile diagnoses and the types of juvenile diagnoses they had . RESULTS Among adult cases defined via the Diagnostic Interview Schedule , 73.9 % had received a diagnosis before 18 years of age and 50.0 % before 15 years of age . Among treatment-using cases , 76.5 % received a diagnosis before 18 years of age and 57.5 % before 15 years of age . Among cases receiving intensive mental health services , 77.9 % received a diagnosis before 18 years of age and 60.3 % before 15 years of age . Adult disorders were generally preceded by their juvenile counterparts ( eg , adult anxiety was preceded by juvenile anxiety ) , but also by different disorders . Specifically , adult anxiety and schizophreniform disorders were preceded by a broad array of juvenile disorders . For all adult disorders , 25 % to 60 % of cases had a history of conduct and /or oppositional defiant disorder . CONCLUSIONS Most adult disorders should be reframed as extensions of juvenile disorders . In particular , juvenile conduct disorder is a priority prevention target for reducing psychiatric disorder in the adult population 
    Output:
    
CBT effects compared to active controls were mixed ( EQ1 ) .
SSRI/SNRI were more effective than placebo ( EQ1 ) but comparative effectiveness remains uncertain .
RCTs of web/computer-based interventions showed mixed results ( EQ1 ) .
CBM/ABM was not more efficacious than active controls ( EQ1 ) .
High quality RCTs support treatment with CBT and medication  .