Keynote 13 - How Far Have We Really Come in the Treatment of Pediatric Anxiety: An Overview of Successes and Failures

Anxiety disorders affect 10-15% of children and adolescents and there are some indications that prevalence may be increasing across generations. These disorders are important for two primary reasons: first, they are associated with significant life impairment across family, relationships, and achievements; and second, most lifetime anxiety disorders have their origins during the child or adolescent developmental periods. Therefore, successful intervention during these stages can reduce serious developmental impairment and can potentially prevent a lifetime of cascading impacts. Across the past 50+ years, research into the management of paediatric anxiety disorders and the development of new treatments have exploded, from a small handful of studies in the 1970's and 1980's to many 10's of studies every year currently. But has this explosion of research really led us to be able to fully help the anxious young person? In this address I will start with a short walk down memory lane about the evolution of evidence into the management of paediatric anxiety, culminating in a summary of our current success. I will then explore a series of "big buts" - a wide range of limitations to our current evidence base that might make us pause in our self-congratulations. Of course it's always nice to finish a talk on a positive note - we'll have to see whether I can manage that.