TY - JOUR
T1 - Novel mechanism-based treatments for pediatric anxiety and depressive disorders
AU - Sylvester, Chad M.
AU - Luby, Joan L.
AU - Pine, Daniel S.
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to American College of Neuropsychopharmacology.
PY - 2024/1
Y1 - 2024/1
N2 - Pediatric anxiety and depressive disorders are common, can be highly impairing, and can persist despite the best available treatments. Here, we review research into novel treatments for childhood anxiety and depressive disorders designed to target underlying cognitive, emotional, and neural circuit mechanisms. We highlight three novel treatments lying along a continuum relating to clinical impact of the disorder and the intensity of clinical management required. We review cognitive training, which involves the lowest risk and may be applicable for problems with mild to moderate impact; psychotherapy, which includes a higher level of clinical involvement and may be sufficient for problems with moderate impact; and brain stimulation, which has the highest potential risks and is therefore most appropriate for problems with high impact. For each treatment, we review the specific underlying cognitive, emotional, and brain circuit mechanisms that are being targeted, whether treatments modify those underlying mechanisms, and efficacy in reducing symptoms. We conclude by highlighting future directions, including the importance of work that leverages developmental windows of high brain plasticity to time interventions to the specific epochs in childhood that have the largest and most enduring life-long impact.
AB - Pediatric anxiety and depressive disorders are common, can be highly impairing, and can persist despite the best available treatments. Here, we review research into novel treatments for childhood anxiety and depressive disorders designed to target underlying cognitive, emotional, and neural circuit mechanisms. We highlight three novel treatments lying along a continuum relating to clinical impact of the disorder and the intensity of clinical management required. We review cognitive training, which involves the lowest risk and may be applicable for problems with mild to moderate impact; psychotherapy, which includes a higher level of clinical involvement and may be sufficient for problems with moderate impact; and brain stimulation, which has the highest potential risks and is therefore most appropriate for problems with high impact. For each treatment, we review the specific underlying cognitive, emotional, and brain circuit mechanisms that are being targeted, whether treatments modify those underlying mechanisms, and efficacy in reducing symptoms. We conclude by highlighting future directions, including the importance of work that leverages developmental windows of high brain plasticity to time interventions to the specific epochs in childhood that have the largest and most enduring life-long impact.
UR - http://www.scopus.com/inward/record.url?scp=85168595691&partnerID=8YFLogxK
U2 - 10.1038/s41386-023-01709-x
DO - 10.1038/s41386-023-01709-x
M3 - Review article
C2 - 37608220
AN - SCOPUS:85168595691
SN - 0893-133X
VL - 49
SP - 262
EP - 275
JO - Neuropsychopharmacology
JF - Neuropsychopharmacology
IS - 1
ER -