Featured Publications
Comparative efficacy, tolerability, and acceptability of pharmacological interventions for the treatment of children, adolescents, and young adults with Tourette's syndrome: a systematic review and network meta-analysis
Farhat L, Behling E, Landeros-Weisenberger A, Levine J, Macul Ferreira de Barros P, Wang Z, Bloch M. Comparative efficacy, tolerability, and acceptability of pharmacological interventions for the treatment of children, adolescents, and young adults with Tourette's syndrome: a systematic review and network meta-analysis. The Lancet Child & Adolescent Health 2022, 7: 112-126. PMID: 36528030, DOI: 10.1016/s2352-4642(22)00316-9.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdrenergic alpha-2 Receptor AgonistsAntipsychotic AgentsAripiprazoleChildClonidineFemaleHumansMaleNetwork Meta-AnalysisRandomized Controlled Trials as TopicRisperidoneTicsTourette SyndromeYoung AdultConceptsSecond-generation antipsychotic drugsMedication categoriesAntipsychotic drugsModerate certaintyIndividual medicationsTourette syndromePharmacological interventionsLow certaintyWHO International Clinical Trials Registry PlatformInternational Clinical Trials Registry PlatformSystematic reviewClinical Trials Registry PlatformChoice of medicationCochrane Central RegisterNetwork meta-analysis frameworkTrials Registry PlatformRandom-effects networkTerms of tolerabilityCertainty of evidenceClinical practice guidelinesComorbid attention deficit hyperactivity disorderStandardised mean differenceTreatment of childrenAttention deficit hyperactivity disorderWeb of ScienceMeta-analysis of the dose-response relationship of SSRI in obsessive-compulsive disorder
Bloch MH, McGuire J, Landeros-Weisenberger A, Leckman JF, Pittenger C. Meta-analysis of the dose-response relationship of SSRI in obsessive-compulsive disorder. Molecular Psychiatry 2009, 15: 850-855. PMID: 19468281, PMCID: PMC2888928, DOI: 10.1038/mp.2009.50.Peer-Reviewed Original ResearchMeSH KeywordsAnalysis of VarianceDose-Response Relationship, DrugDouble-Blind MethodFemaleHumansMaleObsessive-Compulsive DisorderOutcome Assessment, Health CareRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsConceptsSelective serotonin reuptake inhibitorsY-BOCS scoresSerotonin reuptake inhibitorsObsessive-compulsive disorderHigh dosesReuptake inhibitorsTreatment respondersDose of SSRIsTreatment efficacyDouble-blind placebo-controlled clinical trialGreater side effect burdenPlacebo-controlled clinical trialSide effect burdenAbsolute risk differenceTreatment of adultsGreater treatment efficacyMajor depressive disorderImproved treatment efficacyTreatment of OCDDose-response relationshipRevMan 4.2.8Clinical trialsDepressive disorderCause dropoutsMean changeMeta-Analysis: Treatment of Attention-Deficit/Hyperactivity Disorder in Children With Comorbid Tic Disorders
Bloch MH, Panza KE, Landeros-Weisenberger A, Leckman JF. Meta-Analysis: Treatment of Attention-Deficit/Hyperactivity Disorder in Children With Comorbid Tic Disorders. Journal Of The American Academy Of Child & Adolescent Psychiatry 2009, 48: 884-893. PMID: 19625978, PMCID: PMC3943246, DOI: 10.1097/chi.0b013e3181b26e9f.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic alpha-AgonistsAtomoxetine HydrochlorideAttention Deficit Disorder with HyperactivityChildComorbidityContraindicationsDose-Response Relationship, DrugDouble-Blind MethodHumansMethylphenidatePropylaminesPsychotropic DrugsRandomized Controlled Trials as TopicTic DisordersTourette SyndromeConceptsAlpha-2 agonistsAttention-deficit/hyperactivity disorderTic symptomsComorbid ticsSupratherapeutic dosesTic disordersADHD symptomsTreatment of ADHDHyperactivity disorderPlacebo-controlled trialEfficacy of medicationsStandardized mean differenceEvidence-based treatmentsHalf of childrenComorbid tic disordersPrimary outcomeDifferent medicationsPsychostimulant medicationPubMed searchTic severityTourette syndromePackage insertsDrug AdministrationAtomoxetineSymptomsA systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder
Bloch MH, Landeros-Weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Molecular Psychiatry 2006, 11: 622-632. PMID: 16585942, DOI: 10.1038/sj.mp.4001823.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAntipsychotic AgentsBasal Ganglia DiseasesBenzodiazepinesComorbidityDepressive DisorderDibenzothiazepinesDouble-Blind MethodDrug ResistanceDrug Therapy, CombinationHaloperidolHumansMiddle AgedObsessive-Compulsive DisorderOlanzapinePatient DropoutsQuetiapine FumarateRandomized Controlled Trials as TopicRisperidoneSelective Serotonin Reuptake InhibitorsTic DisordersTreatment OutcomeConceptsSerotonin reuptake inhibitorsAntipsychotic augmentationAbsolute risk differenceObsessive-compulsive disorderComorbid ticsOCD patientsTreatment responseSystematic reviewTreatment-refractory obsessive-compulsive disorderTreatment-refractory OCD patientsRefractory obsessive-compulsive disorderDouble-blind trialEfficacy of quetiapineTreatment-refractory OCDCochrane Central RegisterMeaningful treatment responseProportion of subjectsEfficacy of haloperidolRandomized control trialObsessive-compulsive disorder patientsSRI monotherapyAdequate trialCentral RegisterControlled TrialsReuptake inhibitors
2023
Protocol description for a randomized controlled trial of fMRI neurofeedback for tics in adolescents with Tourette Syndrome
Awasthi J, Harris-Starling C, Kalvin C, Pittman B, Park H, Bloch M, Fernandez T, Sukhodolsky D, Hampson M. Protocol description for a randomized controlled trial of fMRI neurofeedback for tics in adolescents with Tourette Syndrome. Psychiatry Research Neuroimaging 2023, 336: 111692. PMID: 37673711, PMCID: PMC10722977, DOI: 10.1016/j.pscychresns.2023.111692.Peer-Reviewed Case Reports and Technical NotesMeSH KeywordsAdolescentHumansMagnetic Resonance ImagingNeurofeedbackRandomized Controlled Trials as TopicTic DisordersTicsTourette SyndromeConceptsTourette syndromeFunctional magnetic resonance imagingStudy protocolChronic tic disorderSupplementary motor areaLower functional connectivityMagnetic resonance imagingResearch study protocolLarge trialsClinical trialsTic disordersMotor areaBrain areasControl groupResonance imagingBrain regionsNew trialsFunctional connectivityNeurofeedback interventionFMRI neurofeedbackNF protocolTrialsNF studiesSyndromeIntervention
2020
Meta-analysis: Pharmacologic Treatment of Restricted and Repetitive Behaviors in Autism Spectrum Disorders
Zhou MS, Nasir M, Farhat LC, Kook M, Artukoglu BB, Bloch MH. Meta-analysis: Pharmacologic Treatment of Restricted and Repetitive Behaviors in Autism Spectrum Disorders. Journal Of The American Academy Of Child & Adolescent Psychiatry 2020, 60: 35-45. PMID: 32387445, DOI: 10.1016/j.jaac.2020.03.007.Peer-Reviewed Original ResearchMeSH KeywordsAntipsychotic AgentsAutism Spectrum DisorderDouble-Blind MethodHumansMethylphenidateRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsConceptsSelective serotonin reuptake inhibitorsPlacebo-controlled trialPharmacological treatmentPharmacological agentsAvailable pharmacological agentsAutism spectrum disorderSerotonin reuptake inhibitorsStandardized mean differenceStandardized study designsTreatment of ASDPharmacologic treatmentPrimary outcomeReuptake inhibitorsAntipsychotic medicationSpecific assessment toolsFolinic acidSpectrum disorderModest benefitRepetitive behaviorsMean differenceStudy designSmall effect sizesIndividual studiesTrialsPlacebo
2019
Meta-analysis of placebo group dropout in adult antidepressant trials
Li F, Nasir M, Olten B, Bloch MH. Meta-analysis of placebo group dropout in adult antidepressant trials. Progress In Neuro-Psychopharmacology And Biological Psychiatry 2019, 98: 109777. PMID: 31697973, DOI: 10.1016/j.pnpbp.2019.109777.Peer-Reviewed Original ResearchMeSH KeywordsAdultAntidepressive AgentsAntidepressive Agents, Second-GenerationAnxietyClinical Trials as TopicDepressionHumansObsessive-Compulsive DisorderPlacebosRandomized Controlled Trials as TopicResearch DesignConceptsObsessive-compulsive disorderPlacebo leadAntidepressant trialsDiagnostic indicationsPlacebo-controlled trialStratified subgroup analysisBaseline illness severityMore study visitsDropout rateOverall dropout rateFreeman-Tukey transformationLonger trial durationEarlier publication yearPlacebo groupIllness severitySubgroup analysisDepressive disorderStudy visitMeta-AnalysisTrial durationAnxiety disordersTrialsEfficiency of trialsSubject burdenDisordersMeta-Analysis of Placebo Response in Adult Antidepressant Trials
Li F, Nasir M, Olten B, Bloch MH. Meta-Analysis of Placebo Response in Adult Antidepressant Trials. CNS Drugs 2019, 33: 971-980. PMID: 31573058, DOI: 10.1007/s40263-019-00662-y.Peer-Reviewed Original ResearchMeSH KeywordsAntidepressive Agents, Second-GenerationAnxietyClinical Trials as TopicDepressionHumansObsessive-Compulsive DisorderRandomized Controlled Trials as TopicConceptsPlacebo response ratesPlacebo improvementSymptom improvementObsessive-compulsive disorderResponse rateDiagnostic indicationsAntidepressant trialsRandomized placebo-controlled trialPlacebo-controlled trialStratified subgroup analysisSecond-generation antidepressantsPlacebo comparison groupFuture antidepressantsSubgroup analysisClinical trialsPlacebo responseTrial characteristicsGreater magnitudeDepression trialsMeta-AnalysisUS sitesTrial durationAntidepressantsLanguage limitsMean differenceThe Potential of Cannabinoid-Based Treatments in Tourette Syndrome
Artukoglu BB, Bloch MH. The Potential of Cannabinoid-Based Treatments in Tourette Syndrome. CNS Drugs 2019, 33: 417-430. PMID: 30977108, DOI: 10.1007/s40263-019-00627-1.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic alpha-2 Receptor AgonistsAntipsychotic AgentsBehavior TherapyCannabinoidsDeep Brain StimulationHumansRandomized Controlled Trials as TopicTourette SyndromeTreatment OutcomeConceptsTourette syndromeCannabinoid systemAdult populationPositive urine drug screenBiological rationaleCannabinoid-based treatmentsPotential of cannabinoidsTourette syndrome populationsPlacebo-controlled trialTreatment of ticsUrine drug screensNovel pharmacological treatmentsCannabis-derived compoundsStrong biological rationaleCurrent evidence baseComprehensive literature searchDevelopmental adverse effectsRefractory patientsSafety profilePharmacological treatmentClinical trialsTic disordersUncertain efficacyFurther trialsSyndrome population
2018
Meta-analysis: Second generation antidepressants and headache
Telang S, Walton C, Olten B, Bloch MH. Meta-analysis: Second generation antidepressants and headache. Journal Of Affective Disorders 2018, 236: 60-68. PMID: 29715610, DOI: 10.1016/j.jad.2018.04.047.Peer-Reviewed Original ResearchConceptsRisk of headacheSecond-generation antidepressantsAntidepressant medicationGeneration antidepressantsSide effectsTreatment-emergent side effectsPlacebo-controlled trialPooled risk ratioFixed-dose trialStratified subgroup analysisTreatment of adultsDosage of medicationReceptor affinity profileSignificant differencesMeta-analysis resultsOnly antidepressantsMedication classesMedication dosingMedication typeObsessive-compulsive disorderSubgroup analysisRisk ratioRelative riskHeadacheMedications
2017
Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment
Hirschtritt ME, Bloch MH, Mathews CA. Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment. JAMA 2017, 317: 1358-1367. PMID: 28384832, DOI: 10.1001/jama.2017.2200.Peer-Reviewed Original ResearchMeSH KeywordsAntipsychotic AgentsDeep Brain StimulationDiagnostic and Statistical Manual of Mental DisordersHumansMeta-Analysis as TopicObsessive-Compulsive DisorderRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsConceptsSelective serotonin reuptake inhibitorsSerotonin reuptake inhibitorsObsessive-compulsive disorderCognitive behavioral therapyTreatment of OCDReuptake inhibitorsBehavioral therapySystematic reviewFirst-line pharmacologic interventionPreferred initial treatment strategyTreatment-resistant obsessive-compulsive disorderInitial treatment strategyPrimary care settingTreatment-resistant casesDiagnosis of OCDFirst-line interventionEfficacy of neurolepticsDeep brain stimulationComputer-based cognitive behavioral therapyCase seriesPharmacologic interventionsAdjunctive useTreatment optionsTreatment advancesNeuromodulatory approaches
2016
Systematic Review and Meta-Analysis: Early Treatment Responses of Selective Serotonin Reuptake Inhibitors and Clomipramine in Pediatric Obsessive-Compulsive Disorder
Varigonda AL, Jakubovski E, Bloch MH. Systematic Review and Meta-Analysis: Early Treatment Responses of Selective Serotonin Reuptake Inhibitors and Clomipramine in Pediatric Obsessive-Compulsive Disorder. Journal Of The American Academy Of Child & Adolescent Psychiatry 2016, 55: 851-859.e2. PMID: 27663940, PMCID: PMC6944467, DOI: 10.1016/j.jaac.2016.07.768.Peer-Reviewed Original ResearchMeSH KeywordsChildClomipramineHumansObsessive-Compulsive DisorderRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsTreatment OutcomeConceptsSelective serotonin reuptake inhibitorsPediatric obsessive-compulsive disorderSerotonin reuptake inhibitorsObsessive-compulsive disorderYale-Brown ObsessiveReuptake inhibitorsTime courseEarly treatment responseTreatment effectsChildren's Yale-Brown ObsessiveSSRI agentsPlacebo groupSSRI treatmentAdult patientsTreatment responsePooled estimatesPharmacological responseHigh dosesMeta-AnalysisSystematic reviewClomipramineSymptom dataMagnitude of responseMean differenceCompulsive ScaleEarly onset of response with selective serotonin reuptake inhibitors in obsessive-compulsive disorder: a meta-analysis.
Issari Y, Jakubovski E, Bartley CA, Pittenger C, Bloch MH. Early onset of response with selective serotonin reuptake inhibitors in obsessive-compulsive disorder: a meta-analysis. The Journal Of Clinical Psychiatry 2016, 77: e605-11. PMID: 27249090, DOI: 10.4088/jcp.14r09758.Peer-Reviewed Original ResearchMeSH KeywordsAdultCognitive Behavioral TherapyCombined Modality TherapyDose-Response Relationship, DrugHumansObsessive-Compulsive DisorderRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsTreatment OutcomeConceptsSelective serotonin reuptake inhibitorsYale-Brown Obsessive Compulsive ScalePlacebo-controlled trialSerotonin reuptake inhibitorsTreatment of adultsObsessive-compulsive disorderSSRI responseSSRI treatmentReuptake inhibitorsSymptom improvementEfficacy of SSRIsTrials of SSRIsFirst-line pharmacologic treatmentCochrane Central RegisterStart of treatmentMajor depressive disorderEffect of doseObsessive Compulsive ScaleSSRI actionCentral RegisterPharmacologic treatmentPrimary outcomeControlled TrialsSSRI trialDepressive disorderSystematic Review of Pharmacological and Behavioral Treatments for Skin Picking Disorder
Schumer MC, Bartley CA, Bloch MH. Systematic Review of Pharmacological and Behavioral Treatments for Skin Picking Disorder. Journal Of Clinical Psychopharmacology 2016, 36: 147-152. PMID: 26872117, PMCID: PMC4930073, DOI: 10.1097/jcp.0000000000000462.Peer-Reviewed Original ResearchMeSH KeywordsBehavior TherapyDisruptive, Impulse Control, and Conduct DisordersHumansMental DisordersRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsSelf-Injurious BehaviorSkin DiseasesTreatment OutcomeConceptsInactive control conditionsUncontrolled trialsBehavioral treatmentSystematic reviewLarger placebo-controlled RCTsSelective serotonin reuptake inhibitorsShort-term clinical trialsBehavioral interventionsPlacebo-controlled RCTsSerotonin reuptake inhibitorsSkin picking disorderEfficacy of treatmentNovel pharmacological agentsShort-term trialsReuptake inhibitorsTreatment armsControl conditionClinical trialsDemonstrated efficacyPsychiatric disordersPharmacological agentsSignificant improvementElectronic databasesRCTsMeta-Analysis
2015
Meta-Analysis: Reduced Risk of Anxiety with Psychostimulant Treatment in Children with Attention-Deficit/Hyperactivity Disorder
Coughlin CG, Cohen SC, Mulqueen JM, Ferracioli-Oda E, Stuckelman ZD, Bloch MH. Meta-Analysis: Reduced Risk of Anxiety with Psychostimulant Treatment in Children with Attention-Deficit/Hyperactivity Disorder. Journal Of Child And Adolescent Psychopharmacology 2015, 25: 611-617. PMID: 26402485, PMCID: PMC4617411, DOI: 10.1089/cap.2015.0075.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAnxietyAttention Deficit Disorder with HyperactivityCentral Nervous System StimulantsChildChild, PreschoolDose-Response Relationship, DrugHumansRandomized Controlled Trials as TopicConceptsRisk of anxietyAttention-deficit/hyperactivity disorderPsychostimulant treatmentSide effectsHyperactivity disorderPlacebo-controlled trialStratified subgroup analysisTreatment of childrenDuration of useRisk ratioSubgroup analysisPsychostimulant medicationPlaceboPubMed searchTrial designNumber of childrenHigh dosesStimulant typePsychostimulantsAnxiety symptomsTreatmentChildrenRiskSymptomsAnxietyMeta-Analysis: Risk of Tics Associated With Psychostimulant Use in Randomized, Placebo-Controlled Trials
Cohen SC, Mulqueen JM, Ferracioli-Oda E, Stuckelman ZD, Coughlin CG, Leckman JF, Bloch MH. Meta-Analysis: Risk of Tics Associated With Psychostimulant Use in Randomized, Placebo-Controlled Trials. Journal Of The American Academy Of Child & Adolescent Psychiatry 2015, 54: 728-736. PMID: 26299294, DOI: 10.1016/j.jaac.2015.06.011.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAmphetamineAttention Deficit Disorder with HyperactivityCentral Nervous System StimulantsChildHumansMethylphenidateOdds RatioRandomized Controlled Trials as TopicSeverity of Illness IndexTicsConceptsWorsening of ticsRisk of ticsAttention-deficit/hyperactivity disorderPlacebo-controlled trialNew onsetDuration of treatmentPsychostimulant usePsychostimulant medicationNew-onset ticsType of psychostimulantsParallel-group trialStratified subgroup analysisSide effect dataTreatment of childrenAge of participantsPlacebo groupAdverse eventsCrossover studyPsychostimulant treatmentTic symptomsRisk ratioSubgroup analysisFamily historyGroup trialsPubMed searchSystematic Review and Meta-Analysis: Early Treatment Responses of Selective Serotonin Reuptake Inhibitors in Pediatric Major Depressive Disorder
Varigonda AL, Jakubovski E, Taylor MJ, Freemantle N, Coughlin C, Bloch MH. Systematic Review and Meta-Analysis: Early Treatment Responses of Selective Serotonin Reuptake Inhibitors in Pediatric Major Depressive Disorder. Journal Of The American Academy Of Child & Adolescent Psychiatry 2015, 54: 557-564. PMID: 26088660, DOI: 10.1016/j.jaac.2015.05.004.Peer-Reviewed Original ResearchMeSH KeywordsChildDepressive Disorder, MajorEarly Medical InterventionHumansPediatricsRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsConceptsSelective serotonin reuptake inhibitorsPediatric major depressive disorderMajor depressive disorderSerotonin reuptake inhibitorsSSRI agentsReuptake inhibitorsPediatric depressionDepressive disorderAdult major depressive disorderFirst-line pharmacological treatmentEarly treatment responseIndividual patient dataStandardized mean differenceMDD trialsSSRI doseSSRI pharmacotherapyPlacebo groupAdult patientsSSRI responsePharmacological treatmentPharmacological trialsTreatment responsePooled estimatesPharmacological responseHigh dosesAssessment and Management of Treatment-Refractory Obsessive-Compulsive Disorder in Children
Bloch MH, Storch EA. Assessment and Management of Treatment-Refractory Obsessive-Compulsive Disorder in Children. Journal Of The American Academy Of Child & Adolescent Psychiatry 2015, 54: 251-262. PMID: 25791142, PMCID: PMC4460245, DOI: 10.1016/j.jaac.2015.01.011.Peer-Reviewed Original ResearchConceptsTreatment-refractory obsessive-compulsive disorderPediatric obsessive-compulsive disorderSelective serotonin reuptake inhibitorsObsessive-compulsive disorderCognitive behavioral therapyTreatment-Refractory ObsessivePharmacological treatment optionsSide effect profileSerotonin reuptake inhibitorsTreatment of adultsGlutamate-modulating agentsLittle evidence-based dataEvidence of efficacyEvidence-based dataPediatric OCD patientsOCD symptomsAntipsychotic augmentationSSRI dosagesPediatric patientsReuptake inhibitorsEffect profilePediatric populationTreatment optionsPractice guidelinesEffective treatment
2014
Meta-analysis: hoarding symptoms associated with poor treatment outcome in obsessive–compulsive disorder
Bloch MH, Bartley CA, Zipperer L, Jakubovski E, Landeros-Weisenberger A, Pittenger C, Leckman JF. Meta-analysis: hoarding symptoms associated with poor treatment outcome in obsessive–compulsive disorder. Molecular Psychiatry 2014, 19: 1025-1030. PMID: 24912494, PMCID: PMC4169729, DOI: 10.1038/mp.2014.50.Peer-Reviewed Original ResearchMeSH KeywordsAdultBehavior TherapyChildHoarding DisorderHumansPsychotropic DrugsRandomized Controlled Trials as TopicTreatment OutcomeConceptsObsessive-compulsive disorderTreatment responseOCD patientsOdds ratioFurther treatment researchCase-control studyPoor treatment outcomesDifferential treatment responseSymptoms of OCDPrimary outcomeTreatment modalitiesEligible studiesTreatment outcomesPatientsElectronic searchSymptomsTotal participantsBehavioral therapyOCD treatmentDisordersSymptom dimensionsTreatment researchDSM-5Hoarding symptomsTreatment
2013
Cognitive-Behavioral Therapy for Anxiety in Children With High-Functioning Autism: A Meta-analysis
Sukhodolsky DG, Bloch MH, Panza KE, Reichow B. Cognitive-Behavioral Therapy for Anxiety in Children With High-Functioning Autism: A Meta-analysis. Pediatrics 2013, 132: e1341-e1350. PMID: 24167175, PMCID: PMC3813396, DOI: 10.1542/peds.2013-1193.Peer-Reviewed Original ResearchMeSH KeywordsAnxietyAutistic DisorderChildCognitive Behavioral TherapyHumansRandomized Controlled Trials as TopicConceptsCognitive behavioral therapyAutism spectrum disorderCo-occurring anxiety symptomsControl conditionSelf-reported anxietyAttention control conditionSample of childrenUsual control conditionFunctioning autismParent ratingsASD diagnosisBehavioral therapySpectrum disorderWaitlist controlAnxiety symptomsOverall effect sizeAnxietyClinician ratingsEffect sizeTreatment controlAdolescentsChildrenRatingsAutismTreatment changes