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Published on: January 9, 2015
[A Review and Recommendations of Evidence-Based Treatments for Pediatric Obsessive-Compulsive Disorder]
Insights
Cognitive behavior therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) effectively treat pediatric obsessive-compulsive disorder (OCD). CBT is more effective than SSRIs alone, and combination therapy benefits SSRI-resistant cases.
Area of Science:
- Pediatric psychiatry
- Child and adolescent mental health
- Neuroscience
Background:
- Pediatric obsessive-compulsive disorder (OCD) involves obsessions and compulsions.
- Effective treatments are crucial for children and adolescents.
- Key treatments include cognitive behavior therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs).
Purpose of the Study:
- To review evidence-based treatments for pediatric OCD.
- To compare the efficacy of CBT and SSRIs.
- To evaluate treatments for resistant cases.
Main Methods:
- Systematic literature search of PubMed.
- Inclusion of randomized controlled trials, reviews, and expert guidelines.
- Analysis of treatment outcomes for pediatric OCD patients.
Main Results:
- CBT and SSRIs are effective for treatment-naïve pediatric OCD.
- CBT demonstrates superior efficacy compared to SSRIs in head-to-head trials.
- Combination therapy (CBT + SSRI) is most effective for SSRI-resistant patients.
Conclusions:
- CBT is a primary evidence-based treatment for pediatric OCD, especially with expert delivery.
- CBT is as effective as SSRIs for non-responders after 14 weeks.
- Combined CBT and SSRI treatment offers benefits for SSRI non-responders.
Unlabelled:
Pediatric obsessive-compulsive disorder (OCD) is characterized by recurrent obsessions and compulsions. In this review we depict evidence-based treatments for pediatric OCD patients. We searched PubMed for relevant publications including randomized controlled trials, reviews, and expert guidelines. Substantial evidence for cognitive behavior therapy (CBT) and specific serotonin reuptake inhibitors (SSRIs) among treatment-naïve patients shows that both treatments are effective. CBT is significantly more effective than SSRI based on head-to-head trials. The evidence for CBT- or SSRI-resistant patients is limited but indicates that CBT and SSRI are effective treatments for CBT non-responders while a combination of CBT and SSRI is the most effective treatment for SSRI non-responders with no prior exposure to CBT. The current data support clinical guidelines indicating that when CBT expertise is present, one can successfully treat patients with CBT. CBT is also as effective as SSRI in non-responders after 14 weeks of CBT. The results did not indicate that combined treatment of CBT and SSRI is more effective than CBT delivered by experts. However, combined treatment is more effective than SSRI in SSRI non-responders.
Key Words:
Obsessive-compulsive disorder, children and adolescents, treatment, Cognitive behavior therapy, selective serotonin reuptake inhibitors, atypical antipsychotics, treatment-resistant, treatment-refractory. Correspondence: Guðmundur Skarphedinsson, gudmundur.skarphedinsson@r-bup.no.
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