This study uses functional magnetic resonance imaging (fMRI) to learn how the brain functions in adolescents receiving fluoxetine (Prozac) or cognitive behavioral therapy (CBT) for anxiety or depression in children/adolescents. All participants will receive interviews to assess how they are doing in general, including his or her general mood, degree of nervousness and behavior. Each participant and one of his or her parents will be interviewed separately and together.
Age: 8 to 17
Consent: Can give consent/assent. (Parents will provide consent; minors will provide assent.)
IQ: All subjects will have IQ greater than 70 (Assessment relies on WASI)
SUBJECTS WITH AN ANXIETY DISORDER
Diagnosis: Current Diagnosis of Social Phobia, Separation Anxiety, or Generalized Anxiety Disorder (Based on K-SADS)
Symptom Severity: Score greater than 9 on PARS (This score was used to enroll subjects in previous trial demonstrating efficacy of an SSRI in pediatric anxiety.)
Clinical Impairment: CGAS less than 60
SUBJECTS WITH A MOOD DISORDER
Diagnosis: Current Diagnosis of Major Depression (Based on K-SADS (juveniles) or SCID (adults))
Clinical Impairment: CGAS less than 60 (juveniles) GAS less than 70 (adults)
Symptom Severity: CDRS Score greater than 39 (juveniles) (This score was used to enroll subjects in previous trials demonstrating efficacy of an SSRI in pediatric depression.)
Consent: Can give consent/assent.
IQ: All subjects will have IQ greater than 70. Assessment relies on WASI.
Any serious medical condition or condition that interferes with fMRI scanning, and for patients electing medication, any condition that increases risk of SSRI treatment. All patients will have complete physical examination. Healthy volunteer participants will be medication-free and have no current serious medical conditions, based on a review of their medical history.
Current use of any psychoactive substance; current suicidal ideation; current diagnosis of attention deficit hyperactivity disorder (ADHD) of sufficient severity to require pharmacotherapy. These factors could complicate treatment with an SSRI. No subject on medication will be accepted into the trial. Subjects will not be taken off of medications to enter the trial.
Current diagnoses: Tourette's, OCD, posttraumatic distress disorder, conduct disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression
Past or current history of mania, psychosis, or pervasive developmental disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression
Recent use of an SSRI: All subjects must have been free of any SSRI use for at least one month (fluoxetine six months) and must not have been treated with an SSRI for their current depressive episode. This is designed to exclude subjects who have failed a trial of an SSRI for their current episode of major depression.
HEALTHY ADULT SUBJECTS
Any current psychiatric diagnosis. Assessment relies on SCID.
SUBJECTS WITH AN ANXIETY DISORDER
Current Major Depressive Disorder
CE and CME credits are no longer available.
The Anxiety Disorders Association of America (ADAA) has partnered with MonkeySee.com to provide a series of seven free online educational videos on how to manage and overcome stress and anxiety.
Looking back, I recall first experiencing a panic attack in the sixth grade. I remember getting so nervous that I would have to leave class and go to the counselor’s office. Until I was 16, I was in and out of psychiatrists’ offices. It was a challenge to find a psychiatrist that I could connect with. Throughout junior high and high school, I still experienced anxiety and panic attacks. And when I started college, my anxiety and panic attacks intensified.Read
If you suspect that you might suffer from generalized anxiety disorder, also known as GAD, answer the questions below, print out the results and share them with your health care professional..
Are you troubled by the following?
My struggles with emotional and mental problems began at age 12, when I experienced my first nervous breakdown. At age 20 I was diagnosed with major depression. By the time I was 30 that diagnosis had changed to chronic major depression with generalized anxiety disorder (GAD). Later, ADHD and obsessive-compulsive disorder (OCD) were added to my diagnoses. At age 40, and after three suicide attempts within two years, my therapist began to suspect that I suffered from bipolar disorder.Read
Patients with GAD treated with venlafaxine hydrochloride extended release for 12 months have substantially lower relapse rates when they stop the medication than patients who stop the medication after 6 months. (Archives of General Psychiatry, 2010;67(12):1274-1281) Read more.
Like other anxiety disorders, GAD is treatable. Cognitive-behavioral therapy is effective for many people, helping them to identify, understand, and modify faulty thinking and behavior patterns. This enables people with GAD learn to control their worry. Some people with GAD also take medication.
Relaxation techniques, meditation, yoga, exercise, and other alternative treatments may also become part of a treatment plan.
Generalized anxiety disorder is characterized by persistent, excessive, and unrealistic worry about everyday things.