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Sleep problems and cognitive behavior therapy in pediatric obsessive-compulsive disorder have bidirectional effects

Tord Ivarsson1, Gudmundur Skarphedinsson1

  • 1The Center for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Norway.

Journal of Anxiety Disorders
|January 16, 2015
PubMed

Insights

Sleep problems are common in pediatric obsessive-compulsive disorder (OCD) and negatively impact cognitive behavioral therapy (CBT) outcomes. Addressing these sleep issues is crucial for improving CBT efficacy in children with OCD.

Area of Science:

  • Pediatric Psychiatry
  • Sleep Medicine
  • Child Psychology

Background:

  • Sleep problems are frequently observed in children and adolescents diagnosed with obsessive-compulsive disorder (OCD).
  • The impact of these sleep disturbances on treatment outcomes for pediatric OCD is not fully understood.
  • Cognitive Behavioral Therapy (CBT) is a primary treatment for pediatric OCD, but its effectiveness may be influenced by co-occurring sleep issues.

Purpose of the Study:

  • To determine the prevalence of sleep problems in pediatric OCD patients.
  • To examine the effect of CBT on sleep problems in this population.
  • To investigate whether baseline sleep problems predict the efficacy of CBT for OCD symptoms.

Main Methods:

  • A cohort of 269 children and adolescents (aged 7-17) with primary DSM-IV OCD participated.
  • Sleep problems and a sleep composite score (SCS) were assessed using the Child Behavior Checklist (CBCL).
  • OCD symptom severity was measured using the Children Yale-Brown Obsessive Compulsive Scale (CY-BOCS).

Main Results:

  • Elevated symptoms of sleep deprivation and nightmares were present before treatment.
  • CBT significantly reduced most sleep problems, including nightmares, insufficient sleep, and parasomnias.
  • Higher baseline levels of sleep problems, indicated by the SCS and individual issues, predicted a poorer response to CBT for OCD symptoms.

Conclusions:

  • Sleep problems are prevalent in pediatric OCD and significantly interfere with CBT treatment outcomes.
  • The study highlights the need for improved assessment methods for sleep problems in future pediatric OCD trials.
  • Failure to resolve sleep problems during or after CBT may diminish its overall effectiveness in treating pediatric OCD.
Abstract

Keywords:
Cognitive behavior therapyInsomniaObsessive-compulsive disorderOutcomeParasomniaSleep

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