Promoting OCD WEllness and resilience (POWER) study: Rationale, design, and methods

Area of Science:

• Child and Adolescent Psychiatry
• Clinical Psychology
• Pharmacology

Background:

• Obsessive-compulsive disorder (OCD) impacts 1-2% of children, causing significant functional impairment and reduced quality of life.
• Effective treatments include cognitive behavioral therapy (CBT) with exposure and response prevention, and serotonin reuptake inhibitors (SRIs).
• Current practice often uses SRIs as first-line treatment or in combination with psychotherapy, despite limited data on discontinuing them in pediatric OCD.

Purpose of the Study:

• To address the gap in empirical data regarding the discontinuation of SRIs in youth with OCD.
• To evaluate if children with OCD, after successful CBT augmentation, can discontinue SRI medication and maintain wellness.
• To assess the efficacy of maintaining wellness for 24 weeks with maintenance CBT following SRI discontinuation.

Main Methods:

• The study employs a two-phase, double-blinded, placebo-controlled, randomized controlled non-inferiority trial design.
• Participants are youth diagnosed with OCD who are currently on SRI medication.
• The trial will assess the ability to discontinue SRIs after successful CBT augmentation while receiving maintenance CBT.

Main Results:

• This paper focuses on the rationale and methodological design of the POWER study.
• Specific results regarding treatment efficacy and SRI discontinuation rates will be reported upon study completion.

Conclusions:

• The POWER study is designed to provide crucial empirical data on SRI discontinuation in pediatric OCD.
• Findings are expected to inform clinical practice and treatment guidelines for managing OCD in children and adolescents.
• The study aims to support evidence-based decisions regarding medication management in conjunction with psychotherapy.