Evidence Base Update of Psychosocial Treatments for Pediatric Obsessive-Compulsive Disorder: Evaluating, Improving,...

Area of Science:

• Child and Adolescent Psychiatry
• Psychology
• Behavioral Science

Background:

• Pediatric obsessive-compulsive disorder (OCD) is a persistent and disabling condition often continuing into adulthood.
• Previous reviews have assessed psychosocial treatments, with this update evaluating advancements since 2014.

Purpose of the Study:

• To review and evaluate psychosocial treatments for pediatric OCD, assessing literature improvements.
• To propose a new framework for study categorization based on research questions.
• To identify predictors and moderators of treatment efficacy.

Main Methods:

• Systematic review of psychosocial treatment studies for pediatric OCD published since the last update.
• Evaluation of studies based on methodological rigor and evidence-based criteria (Journal of Clinical Child and Adolescent Psychology criteria).
• Analysis of demographic, clinical, family, and neurocognitive factors as predictors of treatment outcomes.

Main Results:

• Cognitive-behavioral therapy (CBT) is strongly supported as a first-line treatment for youth with OCD.
• Family-focused CBT is well-established; CBT combined with D-Cycloserine, Sertraline, positive family interaction therapy, and technology-based CBT are probably efficacious.
• Demographic, clinical, and family factors consistently predict CBT outcomes, while neurocognitive predictors show mixed results.

Conclusions:

• The field has advanced significantly, reinforcing CBT's efficacy for pediatric OCD.
• Further research is needed to understand the mechanisms of treatment efficacy beyond simply identifying which treatments work.
• Refined evaluation criteria and a focus on 'how and why' treatments work are crucial for future research directions.