Management of phobias in childhood and adolescence
Keywords:
childhood phobias; Adolescence; cognitive-behavioral therapy; systematic review; Latin AmericaAbstract
Introduction: Phobias in childhood and adolescence represent a mental health issue of significant clinical and social importance, with an estimated global prevalence of between 5% to 15%. They are often underdiagnosed and tend to persist; there is little evidence in Latin America.
Objective: To analyze current evidence regarding the management of phobias in children and adolescents, identifying gaps, intervention strategies, and opportunities for improvement.
Material and Methods: A systematic review was conducted following PRISMA 2020 guidelines. Studies involving children and adolescents aged 4 to 18 years with the diagnosis of phobia, published between 2014 and 2024, were included. Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, PsycINFO, and the Cochrane Library. Screening was carried out by two independent reviewers.
Results: Forty-seven studies were included. Studies from Europe (43%) and North America (31%) predominated, while Latin America accounted for 8%. Cognitive-behavioral therapy with graded exposure is confirmed as the first-line intervention, achieving remission rates of 60% to 85% at 6–12 months; pharmacological treatments are recommended only as adjuncts. Virtual reality interventions showed an acceptability rate exceeding 70%. Only 42% of the studies used validated instruments, and long-term follow-up data were scarce.
Conclusions: Cognitive-behavioral therapy with graded exposure is the treatment of choice. Early detection, contextualized clinical guidelines, culturally sensitive instruments, and the expansion of evidence-based interventions involving the family, schools, and the community are required to reduce the disease burden and promote emotional well-being.
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