Director’s Blog When the Mental Health Parity and Addiction Equity Act was signed into law in 2008, after decades of debate, advocates for mental health celebrated what was arguably their most important legislative achievement in 50 years. The new law, with the cumbersome acronym of MHPAEA, had a simple, ambitious goal: treatment for mental illness and substance abuse disorders would be on a par with treatment for all other medical disorders. If insurance companies covered treatments for depression and diabetes, they could not have different requirements or different deductibles or different reimbursement schedules for the two conditions.

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Importance There is debate about the effectiveness of psychiatric treatments and whether pharmacotherapy or psychotherapy should be primarily used. Objectives To perform a systematic overview on the efficacy of pharmacotherapies and psychotherapies for major psychiatric disorders and to compare the quality of pharmacotherapy and psychotherapy trials. Evidence Review We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Library (April 2012, with no time or language limit) for systematic reviews on pharmacotherapy or psychotherapy vs placebo, pharmacotherapy vs psychotherapy, and their combination vs either modality alone.

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Importance Pediatric anxiety disorders are highly prevalent and impairing and are considered gateway disorders in that they predict adult psychiatric problems. Although they can be effectively treated in the short term, data are limited on the long-term outcomes in treated children and adolescents, particularly those treated with medication.

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