Cognitive behavioral therapy for obsessive-compulsive disorder in children and adolescents - preliminary results from a systematic review

Poster B53, Tuesday, October 9, 11:30 am - 1:00 pm, Essex Ballroom

Camilla Funch Staugaard1, Valdemar Uhre1, Nicole Lønfeldt1, Linea Pretzmann1, Signe Vangkilde1,2, Kerstin Plessen1,3, Katrine Pagsberg1; 1Child and Adolescent Mental Health Centre, Capital Region, Denmark, 2Department of Psychology, University of Copenhagen, Denmark, 3Lausanne University Hospital

Objective: To assess the effect of cognitive behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD). Methods: We systematically reviewed data from randomized trials with children and adolescents with OCD, comparing CBT with 1) no intervention (e.g., wait list); 2) treatment as usual (or similar terms); 3) pharmacological treatments; or 4) alternative psychotherapeutic approaches. On July 28th, 2017, we conducted a systematic literature search, which yielded 12 eligible trials. Data from the trials were grouped into three comparisons: CBT vs. no intervention (n=7), CBT vs. pharmacological intervention (n=3), CBT vs. relaxation therapy (n=3). We assessed the effect on symptom severity measured with the Children’s Yale-Brown Obsessive Compulsive Scale. To evaluate the quality of the trials, two independent investigators assessed risk of bias within seven domains, following the guidelines of The Cochrane Collaboration. For further details, see our protocol on PROSPERO (CRD42017079118). Results: The overall results indicate that in pediatric OCD, CBT is more favorable than no intervention (Z=5.29, p<0. 00001), and relaxation training (Z=7.22, p<0.00001), while no significant difference was found, comparing CBT to pharmacological treatment (Z=0.05, p=0.96). However, all included trials had a high risk of bias, not only owing to the nature of psychotherapeutic interventions, which makes blinding of participants and treatment providers effectively impossible. Conclusion: The systematic review indicates that CBT is more favorable than no intervention and relaxation training, and as effective as pharmacological treatment, for pediatric OCD. However, the quality of the evidence is low, and future trials with low risk of bias are needed.

Topic Area: Other

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