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Vol. LX, No. 23
November 14, 2008
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Digest

  Treatment that combines a certain type of psychotherapy with an antidepressant medication is most likely to help children with anxiety disorders, but each of the treatments alone is also effective, an NIMH study found.  
  Treatment that combines a certain type of psychotherapy with an antidepressant medication is most likely to help children with anxiety disorders, but each of the treatments alone is also effective, an NIMH study found.  

Effective Treatments for Childhood Anxiety Disorders

Treatment that combines a certain type of psychotherapy with an antidepressant medication is most likely to help children with anxiety disorders, but each of the treatments alone is also effective, according to a new study funded by the National Institute of Mental Health. The study was published online Oct. 30 in the New England Journal of Medicine. The Child/Adolescent Anxiety Multimodal Study (CAMS) randomly assigned 488 children ages 7 years to 17 years to one of four treatment options for a 12-week period: cognitive behavioral therapy (CBT); the antidepressant sertraline; CBT combined with sertraline; and placebo. Sixty percent in the CBT-only group improved, and 55 percent in the sertraline-only group improved. Among those on placebo, 24 percent improved. A second phase of the study will monitor the children for an additional 6 months. “CAMS clearly showed that combination treatment is the most effective for these children,” said a study investigator. “But sertraline alone or CBT alone showed a good response rate as well. This suggests that clinicians and families have three good options to consider for young people with anxiety disorders, depending on treatment availability and costs.”

Mechanism, Possible Treatment for Growth of Nerve Tumors Found

Researchers studying neurofibromatosis type 1—a rare disease in which tumors grow within nerves—have found that the tumors are triggered by crosstalk between cells in the nerves and cells in the blood. The researchers—funded by NINDS, NCI and the Department of Defense—also found that a drug on the market for treating certain kinds of blood cancer (Gleevec) curbs tumor growth in a mouse model of neurofibromatosis type 1. A clinical trial of the drug is under way in people with the disease. The results of the study on mice were published in the Oct. 31 issue of Cell. Neurofibromatosis type 1 is a genetic disease that affects about 1 in 3,500 Americans. The researchers say that the complex origin of tumors in neurofibromatosis— which has thwarted therapeutic development until now—could be the chink in the disease’s armor.

Earlier Jaundice Treatment Decreases Brain Injury in Preemies

A study from an NIH research network found that an early treatment to prevent severe newborn jaundice in extremely early preterm infants reduced the infants’ rate of brain injury, a serious complication of severe jaundice. The study also found that the smallest, most frail infants in the study were more likely to die than were the larger infants, regardless of whether they received the early or the conventional treatment. Moreover, the study found a trend toward a higher proportion of deaths among the smaller infants in the early treatment group, when compared to the smaller infants receiving the conventional treatment. However, this trend was within the statistical margin of error. The study appeared in the Oct. 30 New England Journal of Medicine and was conducted by researchers in NICHD’s Neonatal Research Network. Based on the results, the authors concluded that the early treatment should be considered for the larger infants—those at birth weighing from 751 to 1,000 grams (about 1.65 pounds to about 2.2 pounds). The researchers did not rule out the treatment for smaller infants. However, they said the study findings merited caution before offering the early treatment to this group of infants.

Study Shows No Benefit for Use of Selenium, Vitamin E in Prostate Cancer

Initial, independent review of study data from the Selenium and Vitamin E Cancer Prevention Trial (SELECT), funded by NCI and other institutes shows that selenium and vitamin E supplements, taken either alone or together, did not prevent prostate cancer. The data also showed two concerning trends: a small but not statistically significant increase in the number of prostate cancer cases among the over 35,000 men age 50 and older in the trial taking only vitamin E, and a small but not statistically significant increase in the number of cases of adult onset diabetes in men taking only selenium. Because this is an early analysis of the data from the study, neither of these findings proves an increased risk from the supplements and both may be due to chance. SELECT involves more than 400 clinical sites in the U.S., Puerto Rico and Canada. Participants are receiving letters explaining the study review and telling them to stop taking their study supplements.

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