Clinicians' views on management of obsessive-compulsive disorders in children and adolescents

Research on obsessive-compulsive disorder (OCD) in children and adolescents has led to important developments with clinical implications as regards assessment and treatment. These developments have resulted in new guidelines and recommendations as to what is regarded to be an adequate treatment of the disorder. The objective of the present study was to examine if these developments have led to changes in the views on clinical management of childhood OCD among child psychiatry personnel in Norway. A national survey was conducted by means of a questionnaire addressing preferences and practices among clinicians in their assessment and management of OCD, the clinicians self-reported experienced treatment success, and need to develop clinical skills on assessing and treating childhood OCD. Seventy-nine clinicians (58.5%) responded. The results showed that cognitive/behavioural, family and medication approaches were preferred over psychodynamic and humanistic approaches in the management of OCD. The preferred cognitive/behavioural approach seems to be more cognitive than behavioural, and only one-third of clinicians reported frequent use of anxiety-provoking methods in treatment of childhood OCD. Clinicians that self-rated the Clinical Global Improvement Scale on their last treated OCD case indicated moderate treatment success. Because of low numbers of OCD cases in the clinics, the majority of clinicians are rated as inexperienced in the management of the disorder and results show a need for adequate training opportunities. It is concluded that clinicians have accommodated to recommended standards in the management of childhood OCD, but some results are contradictory and do not justify conclusive statements. The study needs to be supplemented by research focusing on more specific elements of the preferred treatments, thus narrowing the scope of the present study.