Imipramine Plus Cognitive-Behavioral Therapy in the Treatment of School Refusal
Abstract
Objective To investigate the efficacy of 8 weeks of imipramine versus placebo in combination with cognitive-behavioral therapy (CBT) for the treatment of school-refusing adolescents with comorbid anxiety and major depressive disorders. Method This was a randomized, double-blind trial with 63 subjects entering the study and 47 completing. Outcome measures were weekly school attendance rates based on percentage of hours attended and anxiety and depression rating scales. Results Over the course of treatment, school attendance improved significantly for the imipramine group (z = 4.36, p Conclusions Imipramine plus CBT is significantly more efficacious than placebo plus CBT in improving school attendance and decreasing symptoms of depression in school-refusing adolescents with comorbid anxiety and depression.
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Very few studies have compared combined therapy to either treatment alone.
“Very few studies have compared combined therapy to either treatment alone [47–49].”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [47]
Cites
Variations in the pattern of pubertal changes in boys
Marshall, W. A., & Tanner, J. M. (1970) · Archives of Disease in Childhood · doi:10.1136/adc.45.239.13 · Cited by 5,147 · see citing works
Treating anxiety disorders in children: Results of a randomized clinical trial.
Kendall, P. C. (1994) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.62.1.100 · Cited by 1,376 · see citing works
Therapy for youths with anxiety disorders: A second randomized clincal trial.
Kendall, P. C., Flannery-Schroeder, E., Panichelli-Mindel, S. M., Southam-Gerow, M., Henin, A., & Warman, M. (1997) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.65.3.366 · Cited by 984 · see citing works
National Normative and Reliability Data for the Revised Children's Manifest Anxiety Scale
Reynolds, C. R., & Paget, K. D. (1983) · School Psychology Review · doi:10.1080/02796015.1983.12085047 · Cited by 275 · see citing works
School phobia: the overlap of affective and anxiety disorders
BERNSTEIN, G. A., & GARFINKEL, B. D. (1986) · Journal of the American Academy of Child Psychiatry · doi:10.1016/s0002-7138(09)60231-4 · Cited by 185 · see citing works
Self-citation
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Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-s1-s1 · Cited by 1,090 · see citing works
Connolly, S. D., & Bernstein, G. A. (2007) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000246070.23695.06 · Cited by 548 · see citing works
Self-citationDifferentiation between school attendance problems: why and how?
Heyne, D., Gren-Landell, M., Melvin, G., & Gentle-Genitty, C. (2019) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2018.03.006 · Cited by 339 · see citing works
School Refusal in Children and Adolescents: A Review of the Past 10 Years
KING, N. J., & BERNSTEIN, G. A. (2001) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200102000-00014 · Cited by 310 · see citing works
Self-citationKearney, C. A. (2008) · Educational Psychology Review · doi:10.1007/s10648-008-9078-3 · Cited by 280 · see citing works
A response to intervention model to promote school attendance and decrease school absenteeism
Kearney, C. A., & Graczyk, P. (2014) · Child & Youth Care Forum · doi:10.1007/s10566-013-9222-1 · Cited by 232 · see citing works
Seligman, L. D., Ollendick, T. H., Langley, A. K., & Baldacci, H. B. (2004) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3303_13 · Cited by 220 · see citing works
Evaluation of child therapy and caregiver training in the treatment of school refusal
HEYNE, D., KING, N. J., TONGE, B. J., ROLLINGS, S., YOUNG, D., PRITCHARD, M., & OLLENDICK, T. H. (2002) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200206000-00008 · Cited by 190 · see citing works
Practitioner Review: School refusal: developments in conceptualisation and treatment since 2000
Elliott, J. G., & Place, M. (2019) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12848 · Cited by 162 · see citing works
Kearney, C. A. (2003) · Professional Psychology: Research and Practice · doi:10.1037/0735-7028.34.1.57 · Cited by 142 · see citing works
Anxiety Disorders in Children and Adolescents
Rockhill, C., Kodish, I., DiBattisto, C., Macias, M., Varley, C., & Ryan, S. (2010) · Current Problems in Pediatric and Adolescent Health Care · doi:10.1016/j.cppeds.2010.02.002 · Cited by 110 · see citing works
Lyon, A. R., & Cotler, S. (2007) · Psychology in the Schools · doi:10.1002/pits.20247 · Cited by 91 · see citing works
DIETZ, L. J., BIRMAHER, B., WILLIAMSON, D. E., SILK, J. S., DAHL, R. E., AXELSON, D. A., EHMANN, M., & RYAN, N. D. (2008) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e3181676595 · Cited by 83 · see citing works
Cox, G. R., Callahan, P., Churchill, R., Hunot, V., Merry, S. N., Parker, A. G., & Hetrick, S. E. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008324.pub2 · Cited by 70 · see citing works
Predictors of treatment response in anxious-depressed adolescents with school refusal
LAYNE, A. E., BERNSTEIN, G. A., EGAN, E. A., & KUSHNER, M. G. (2003) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200303000-00012 · Cited by 73 · see citing works
Self-citationHochadel, J., Frölich, J., Wiater, A., Lehmkuhl, G., & Fricke-Oerkermann, L. (2014) · Psychopathology · doi:10.1159/000345403 · Cited by 71 · see citing works
Cognitive mediation of cognitive-behavioural therapy outcomes for anxiety-based school refusal
Maric, M., Heyne, D. A., MacKinnon, D. P., van Widenfelt, B. M., & Westenberg, P. M. (2013) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465812000756 · Cited by 67 · see citing works
The pharmacological management of childhood anxiety disorders: a review
Reinblatt, S. P., & Riddle, M. A. (2007) · Psychopharmacology · doi:10.1007/s00213-006-0644-4 · Cited by 67 · see citing works
Pharmacotherapy for anxiety disorders in children and adolescents
Kodish, I., Rockhill, C., & Varley, C. (2011) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2011.13.4/ikodish · Cited by 62 · see citing works
Intensive (daily) behavior therapy for school refusal: a multiple baseline case series
Tolin, D. F., Whiting, S., Maltby, N., Diefenbach, G. J., Lothstein, M. A., Hardcastle, S., Catalano, A., & Gray, K. (2009) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2009.02.003 · Cited by 62 · see citing works
Melvin, G. A., Dudley, A. L., Gordon, M. S., Klimkeit, E., Gullone, E., Taffe, J., & Tonge, B. J. (2017) · Child Psychiatry & Human Development · doi:10.1007/s10578-016-0675-y · Cited by 52 · see citing works
Anxiety in the school setting: a framework for evidence-based practice
Jones, A. M., West, K. B., & Suveg, C. (2019) · School Mental Health · doi:10.1007/s12310-017-9235-2 · Cited by 48 · see citing works
Wu, X., Liu, F., Cai, H., Huang, L., Li, Y., Mo, Z., & Lin, J. (2013) · International Journal of Pharmacology · doi:10.3923/ijp.2013.197.203 · Cited by 33 · see citing works
A systematic review of intervention programs for school attendance problems.
Pérez-Marco, M., Gonzálvez, C., Fuster, A., & Vicent, M. (2025) · Children and Youth Services Review · doi:10.1016/j.childyouth.2024.108091 · Cited by 32 · see citing works
da Costa, C. Z. G., de Morais, R. M. C. B., Zanetta, D. M. T., Turkiewicz, G., Neto, F. L., Morikawa, M., Rodrigues, C. L., Labbadia, E. M., & Asbahr, F. R. (2013) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2012.0110 · Cited by 31 · see citing works
School refusal: categorical diagnoses, functional analysis and treatment planning
King, N. J., Heyne, D., Tonge, B., Gullone, E., & Ollendick, T. H. (2001) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.313 · Cited by 25 · see citing works
A Systematic Review of Pharmacologic Treatments for School Refusal Behavior
Londono Tobon, A., Reed, M. O., Taylor, J. H., & Bloch, M. H. (2018) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2017.0160 · Cited by 22 · see citing works
Cochrane review: Cognitive behavioural therapy for anxiety disorders in children and adolescents
James, A., Soler, A., & Weatherall, R. (2007) · Evidence-Based Child Health: A Cochrane Review Journal · doi:10.1002/ebch.206 · Cited by 20 · see citing works
An open trial of intensive cognitive-behavioral therapy for school refusal
Hannan, S., Davis, E., Morrison, S., Gueorguieva, R., & Tolin, D. F. (2019) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2019.1575706 · Cited by 21 · see citing works
Psychopharmacology Interventions for Pediatric Anxiety Disorders: A Research Update
Waslick, B. (2006) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2005.08.009 · Cited by 17 · see citing works
Advances in Pharmacotherapy for Pediatric Anxiety Disorders
Nicotra, C. M., & Strawn, J. R. (2023) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2023.02.006 · Cited by 16 · see citing works
Peterson, B. S., West, A. E., Weisz, J. R., Mack, W. J., Kipke, M. D., Findling, R. L., Mittman, B. S., Bansal, R., Piantadosi, S., Takata, G., et al. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03314-y · Cited by 13 · see citing works
- Authors
- BERNSTEIN, G. A., BORCHARDT, C. M., PERWIEN, A. R., CROSBY, R. D., KUSHNER, M. G., THURAS, P. D., & LAST, C. G.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2000-03
- Volume
- 39
- Issue
- 3
- Pages
- 276-283
- ISSN
- 0890-8567
- Cited by
- 169
- References
- 5
- Language
- en
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