Cognitive Behavioral Therapy for the Treatment of Child and Adolescent OCD
Cognitive behavioral therapy reduces the severity of obsessive compulsive disorder in children and adolescents, according to a new review. This form of treatment helps relieve the overall distress and reduces the interference that OCD symptoms can cause in young people's lives.
Further, the evidence indicates that cognitive behavioral therapy (CBT) and medication are equally effective in treating pediatric OCD, say lead researcher Richard O'Kearney and colleagues.
"When CBT is combined with medication, treatment is more effective than medication alone. Health professionals need to consider this therapy - particularly in view of the controversy about prescribing psychotropic medications to children and teens," said O'Kearney, director of clinical training for psychology at the Australian National University, in Canberra.
This review appears in the October 18 issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
OCD can start at a very early age - review participants were as young as 7 years old. The disorder affects an estimated 0.5 percent to 4 percent of children and adolescents.
Carol A. Mathews, M.D., with the department of psychiatry at the University of California, San Francisco, called the systematic review "excellent" and said it represents an important step forward in the understanding of the effectiveness of various types of treatment for pediatric OCD. Pediatric OCD is frequently under diagnosed and under treated, she said, and this could be because of limited treatment options parents have for their children.
"This study shows convincingly that CBT is superior to placebo, not only in reducing the number of OCD symptoms, but also in effecting remission in many cases. The study also shows that CBT plus medication is more effective than medication alone in children - an important confirmation of what has been believed clinically, but never proven," said Mathews, who was not involved with the study.
"The results of this paper provide clinicians and parents with an additional effective treatment option - CBT or CBT plus medication - a treatment that involves only about 14 to 21 hours, in general," Mathews said.
"Probably the most important issue related to our findings is that while the evidence suggests that CBT is as effective as medication, relatively few children and adolescents get CBT treatment," O'Kearney said. "Part of this is because of access and part is because primary care doctors often prescribe medicine before they refer patients to CBT. Hopefully this review will make them think more about this practice."
O'Kearney said that although attempts have been made to use telephone and computer-assisted delivery to increase access, "overall, there need to be more trained CBT therapists skilled in treating pediatric OCD."
O'Kearney RT, Anstey KJ, von Sanden C. Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents (Review). The Cochrane Database of Systematic Reviews 2006, Issue 4. No abstract
Further, the evidence indicates that cognitive behavioral therapy (CBT) and medication are equally effective in treating pediatric OCD, say lead researcher Richard O'Kearney and colleagues.
"When CBT is combined with medication, treatment is more effective than medication alone. Health professionals need to consider this therapy - particularly in view of the controversy about prescribing psychotropic medications to children and teens," said O'Kearney, director of clinical training for psychology at the Australian National University, in Canberra.
This review appears in the October 18 issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
OCD can start at a very early age - review participants were as young as 7 years old. The disorder affects an estimated 0.5 percent to 4 percent of children and adolescents.
Carol A. Mathews, M.D., with the department of psychiatry at the University of California, San Francisco, called the systematic review "excellent" and said it represents an important step forward in the understanding of the effectiveness of various types of treatment for pediatric OCD. Pediatric OCD is frequently under diagnosed and under treated, she said, and this could be because of limited treatment options parents have for their children.
"This study shows convincingly that CBT is superior to placebo, not only in reducing the number of OCD symptoms, but also in effecting remission in many cases. The study also shows that CBT plus medication is more effective than medication alone in children - an important confirmation of what has been believed clinically, but never proven," said Mathews, who was not involved with the study.
"The results of this paper provide clinicians and parents with an additional effective treatment option - CBT or CBT plus medication - a treatment that involves only about 14 to 21 hours, in general," Mathews said.
"Probably the most important issue related to our findings is that while the evidence suggests that CBT is as effective as medication, relatively few children and adolescents get CBT treatment," O'Kearney said. "Part of this is because of access and part is because primary care doctors often prescribe medicine before they refer patients to CBT. Hopefully this review will make them think more about this practice."
O'Kearney said that although attempts have been made to use telephone and computer-assisted delivery to increase access, "overall, there need to be more trained CBT therapists skilled in treating pediatric OCD."
O'Kearney RT, Anstey KJ, von Sanden C. Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents (Review). The Cochrane Database of Systematic Reviews 2006, Issue 4. No abstract
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