Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents

O’Kearney, Richard; Anstey, Kaarin J.; Sanden, Chwee Chwee Von; Hunt, Aliza

doi:10.1002/14651858.cd004856.pub2

Cited by 79 publications

(49 citation statements)

References 71 publications

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“…[74] It found significantly improved OCD symptoms (assessed by the children' . Individual or group CBT described in both RCTs involved 14 sessions (each duration 1-1.5 hours) and included the following components: psycho education, anxiety management, cognitive therapy, exposure and response prevention, resiliency building, generalisation training, and relapse prevention.…”

Section: Benefitsmentioning

confidence: 93%

“…The review reported that the description of randomisation in the first RCT suggested quasi-randomisation. [74] CBT versus SRIs:…”

Section: Benefitsmentioning

confidence: 99%

“…The SRIs used were clomipramine (titrated from 25 mg/day to either 3 mg/kg/day or 200 mg/day over 3-4 weeks) in one RCT and sertraline (titrated from 25 mg/day to 200 mg/day over 6 weeks, followed by adjustment [not defined] for adverse effects) in the other RCT. [74] We found one subsequent RCT (40 children and adolescents aged 9-17 years with DSM-IV OCD) comparing group CBT versus sertraline (titrated from 25 mg/day [every fourth day] to a max of 200 mg/day or as tolerated [not defined]). [75] It found that both groups had a significant reduction in OCD symptoms (assessed by children's YBOCS) after 12 weeks' treatment, but it did not compare groups (data presented graphically; significance between groups not assessed).…”

Section: Benefitsmentioning

confidence: 99%

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Obsessive Compulsive Disorder

2017

Encyclopedia of Feeding and Eating Disorders

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INTRODUCTION: Obsessions or compulsions that cause personal distress or social dysfunction affect about 1% of adult men and 1.5% of adult women. About half of adults with obsessive compulsive disorder (OCD) have an episodic course, whereas the other half have continuous problems. Prevalence in children and adolescents is 2.7%. The disorder persists in about 40% of children and adolescents at mean follow-up of 5.7 years. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of initial treatments for obsessive compulsive disorder in adults? What are the effects of initial treatments for obsessive compulsive disorder in children and adolescents? What are the effects of maintenance treatment for obsessive compulsive disorder in adults? What are the effects of maintenance treatment for obsessive compulsive disorder in children and adolescents? What are the effects of treatments for obsessive compulsive disorder in adults who have not responded to initial treatment with serotonin reuptake inhibitors (SRIs)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2007 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 70 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: addition of antipsychotics to serotonin reuptake inhibitors; behavioural therapy alone or with serotonin reuptake inhibitors; cognitive therapy or cognitive behavioural therapy (CBT) (alone or with serotonin reuptake inhibitors); electroconvulsive therapy; serotonin reuptake inhibitors (citalopram, clomipramine, fluoxetine, fluvoxamine, paroxetine, or sertraline); and optimum duration of maintenance treatment. QUESTIONS Key points• Obsessions or compulsions that cause personal distress or social dysfunction affect about 1% of adult men and 1.5% of adult women. Prevalence in children and adolescents is 2.7%.About half of adults with obsessive compulsive disorder (OCD) have an episodic course, whereas the other half have continuous problems. Up to half of adults show improvement of symptoms over time. The disorder persists in about 40% of children and adolescents at mean follow-up of 5.7 years.• In adults,CBT and behavioural therapy improve symptoms of OCD compared with a waiting list control.Behavioural therapy may be as effective at improving symptoms as CBT, but we don't know how they compare with SRIs (SSRIs and clomipramine). Behavioural therapy may be more effective than relaxation.• SRIs improve symptoms of OCD in adults ...

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Section: Benefitsmentioning

confidence: 93%

“…The review reported that the description of randomisation in the first RCT suggested quasi-randomisation. [74] CBT versus SRIs:…”

Section: Benefitsmentioning

confidence: 99%

Section: Benefitsmentioning

confidence: 99%

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Obsessive Compulsive Disorder

2017

Encyclopedia of Feeding and Eating Disorders

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“…CBT is the approach with stronger evidence of effectiveness as compared to waiting lists or attention control interventions for both OCD [163][164][165] and non-OCD pediatric anxiety disorders. [164][165][166] The overall effect size of CBT for pediatric anxiety in a meta-analysis involving 48 studies (n=3,740) was 0.66 (compared to passive control 0.77 and to active control 0.39; both significant), demonstrating a key role of non-specific factors.…”

Section: Psychotherapymentioning

confidence: 99%

Pediatric anxiety disorders: from neuroscience to evidence-based clinical practice

Salum

DeSousa

Rosário

et al. 2013

Rev. Bras. Psiquiatr.

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The objective of this narrative review of the literature is to describe the epidemiology, etiology, pathophysiology, diagnosis, and treatment of pediatric anxiety disorders. We aim to guide clinicians in understanding the biology of anxiety disorders and to provide general guidelines for the proper diagnoses and treatment of these conditions early in life. Anxiety disorders are prevalent, associated with a number of negative life outcomes, and currently under-recognized and under-treated. The etiology involves both genes and environmental influences modifying the neural substrate in a complex interplay. Research on pathophysiology is still in its infancy, but some brain regions, such as the amygdala and the prefrontal cortex, have been implicated in fear and anxiety. Current practice is to establish diagnosis based purely on clinical features, derived from clinical interviews with the child, parents, and teachers. Treatment is effective using medication, cognitive behavioral therapy, or a combination of both. An introduction to the neuroscience behind anxiety disorders combined with an evidence-based approach may help clinicians to understand these disorders and treat them properly in childhood.

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“…Recent expert consensus guidelines suggest that cognitive behavioural treatments are the first choice treatments for children and adolescents with OCD [21,26] although a Cochrane review concluded only that ''behavioural or cognitive behaviour therapy (CBT) appears to be a promising treatment for OCD in children and adolescents'' [27]. Until recently, there have been few trials which examine the effectiveness of cognitive behavioural therapy for young people, based on the assumption that adult-based research would generalise.…”

Section: Introductionmentioning

confidence: 99%

A randomised controlled trial of cognitive behavioural treatment for obsessive compulsive disorder in children and adolescents

Williams

Šalkovskis

Forrester

et al. 2009

Eur Child Adolesc Psychiatry

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Cognitive behaviour therapy (CBT) for young people with obsessive compulsive disorder (OCD) has become the treatment of first choice. However, the literature is largely based on studies emphasising exposure and response prevention. In this study, we report on a randomised controlled trial of CBT for young people carried out in typical outpatient clinic conditions which focused on cognitions. A randomised controlled trial compares 10 sessions of manualised cognitive behavioural treatment with a 12-week waiting list for adolescents and children with OCD. Assessors were blind to treatment allocation. 21 consecutive patients with OCD aged between 9 and 18 years were recruited. The group who received treatment improved more than a comparison group who waited for 3 months. The second group was treated subsequently using the same protocol and made similar gains. In conclusion, CBT can be delivered effectively to young people with OCD in typical outpatient settings.

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Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents

Cited by 79 publications

References 71 publications

Obsessive Compulsive Disorder

Obsessive Compulsive Disorder

Pediatric anxiety disorders: from neuroscience to evidence-based clinical practice

A randomised controlled trial of cognitive behavioural treatment for obsessive compulsive disorder in children and adolescents

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