Partners in Caring for Anxious Youth

Running, not enrolling · Phase 3

Conditions studied: Anxiety, Separation, Anxiety, Generalized, Anxiety, Social

In brief

Pediatric onset anxiety disorders (generalized anxiety, social anxiety, separation anxiety) are highly prevalent, and if untreated, are impairing into adolescence and adulthood. In the largest comparative efficacy study remission occurred in about 65% of children and adolescents treated with a combination of a selective serotonin reuptake inhibitors (SSRI) and cognitive behavioral therapy (CBT). In contrast, CBT without an SSRI achieved remission in 35% of children at 3 months and 45% at 6 months-a 30% and 20% difference, respectively. Despite the difference in remission rates, CBT alone is the preferred treatment of most patients and families. Lack of awareness of the significant difference in remission rates and concerns about medication side effects may drive patient and family preference even though SSRIs have a positive safety profile. Critiques of CBT in the above study suggest that CBT was not as effective as it could be due to short treatment duration, restricted family involvement and limited exposure sessions. Would the combination of CBT and an SSRI still be superior to CBT only, if CBT was of longer duration, and included more family involvement and exposure sessions? In the Partners in Care for Anxious Youth (PCAY) study, children and adolescents with an anxiety disorder ages 7-17 years followed in pediatric primary care clinics affiliated with three institution: Lurie Children's Hospital of Chicago, University of California Los Angeles and University of Cincinnati will be randomized to one of two treatment arms; either CBT only or CBT combined with an SSRI (either fluoxetine, sertraline, or escitalopram). CBT in PCAY will be 6 months in duration and include more family involvement, and more exposure opportunities than past trials. The 6-month acute treatment phase will be followed by 6 months of followup. The primary outcome will be anxiety symptom remission and reduction in impairment over 6 and 12-months.

Key facts

Study ID: NCT04598230
Run by: Ann & Robert H Lurie Children's Hospital of Chicago
People needed: 468
Starts: 2021-02-09
Expected to finish: 2026-12-01
Last updated by the study team: 2026-07-01

Who can join

Age: 7 and older, up to 17. Sex: any. Healthy volunteers: accepted.

You may qualify if…

Ages 7-17 years (inclusive at time of consent/assent)
Primary Diagnostic and Statistical Manual, 5th Edition (DSM-5) diagnosis of separation anxiety disorder (SAD), and/or generalized anxiety disorder (GAD), and/or social anxiety disorder (SocAD) as determined by self-reported structured interview (MINI-KID) and confirmation by a study clinician.
Stable/treated Attention Deficit Hyperactivity Disorder (ADHD), combined or hyperactive impulsive subtypes
An available primary caretaker with ongoing patient contact who is legally able to provide consent
Medically cleared by a pediatric clinician including a negative urine pregnancy test for females of child-bearing age. Furthermore, female patients must agree to abstain from sexual activity or to use a reliable method of birth control as determined by pediatric clinician during the study.

You may not qualify if…

Patients with the following lifetime psychiatric disorders: moderate to severe autism, bipolar disorder, schizophrenia, or schizoaffective disorder, history of intellectual disability
Primary Attention Deficit Hyperactivity Disorder (ADHD), combined or hyperactive impulsive subtypes
Major depressive disorder with greater severity than anxiety disorder requiring treatment not provided in PCAY
Obsessive Compulsive Disorder (OCD) only (no co-occurring SAD, SocAD or GAD)
Patients with a major medical illness that would interfere with participation in the study (e.g., complex, and evolving medical treatments, or require frequent hospitalizations).
Patients who are pregnant as indicated by a positive pregnancy test or are sexually active and not using effective birth control.
Patients who pose a significant and imminent risk to self or to others.
Patients who experienced minimal or no change an adequate dose of evidenced-based medication treatment or CBT for their anxiety disorder.
(See medication and CBT exclusions below)
Patients or caregiver(s) who do not speak English or Spanish. All materials and treatments will be available in Spanish and English.
Children and adolescents with complex psychiatric needs that cannot be managed in primary care and community settings as determined by study local Principal Investigator (PI) and provider teams.
Medication Exclusions
Fluoxetine
20 mg for at least 6 of 10 weeks in children <12 year
40 mg for at least 6 of 10 weeks in adolescents >12 years
Sertraline
100 for at least 6 of 10 weeks in children <12 years
150 for at least 6 of 10 weeks in adolescents >12 years
Citalopram
20 mg for at least 6 of 10 weeks in children >12 years
30 mg for at least 6 of 10 weeks adolescent > 12 years
Escitalopram
10 mg for at least 6 of 10 weeks in children <12 years
20 mg for at least 6 of 10 weeks in adolescent >12 years
Fluvoxamine

Where it is running

UCLA Semel Institute for Neuroscience and Human Behavior — Los Angeles, California, United States
Lurie Children's Hospital and Affiliated Pediatric Practices — Chicago, Illinois, United States
University of Cincinnati — Cincinnati, Ohio, United States

Full record on ClinicalTrials.gov

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