Tics moderate treatment outcome with sertraline but not cognitive-behavior therapy in pediatric obsessive-compulsive disorder.

Full Abstract

BACKGROUND:
The presence of a comorbid tic disorder may predict a poorer outcome in the acute treatment of pediatric obsessive-compulsive disorder (OCD).

METHODS:
Using data from the National Institute of Mental Health (NIMH)-funded Pediatric OCD Treatment Study (POTS) that compared cognitive-behavior therapy (CBT), medical management with sertraline (SER), and the combination of CBT and SER (COMB), to pill placebo (PBO) in children and adolescents with OCD, we asked whether the presence of a comorbid tic disorder influenced symptom reduction on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) after 12 weeks of treatment.

RESULTS:
Fifteen percent (17 of 112) of patients exhibited a comorbid tic disorder. In patients without tics, results replicated previously published intent-to-treat outcomes:
COMB > CBT > SER > PBO. In patients with a comorbid tic disorder, SER did not differ from PBO, while COMB remained superior to CBT and CBT remained superior to PBO.

CONCLUSIONS:
In contrast to CBT outcomes, which are not differentially impacted, tic disorders appear to adversely impact the outcome of medication management of pediatric OCD. Children and adolescents with obsessive-compulsive disorder and a comorbid tic disorder should begin treatment with cognitive-behavior therapy alone or the combination of cognitive-behavior therapy plus a serotonin reuptake inhibitor.

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Author information

Author/s: March, John S (JS); Franklin, Martin E (ME); Leonard, Henrietta (H); Garcia, Abbe (A); Moore, Phoebe (P); Freeman, Jennifer (J); Foa, Edna (E);

Affiliation: Department of Psychiatry, Duke University Medical Center, Durham, North Carolina 27710, USA. jsmarch(-atsign-)duke.edu

Grants: 1 R10 MH55121 (Agency:NIMH NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: Biological psychiatry (Biol Psychiatry), published in United States. (Language: eng)

Reference: 2007-Feb; vol 61 (issue 3) : pp 344-7

Dates: Created 2007/01/23; Completed 2007/03/20; Revised 2007/12/03;

PMID: 17241830, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Male
Obsessive-Compulsive Disorder - drug therapy; psychology
Psychiatric Status Rating Scales
Serotonin Uptake Inhibitors - therapeutic use
Sertraline - therapeutic use
Tic Disorders - drug therapy; psychology; therapy
Tourette Syndrome - drug therapy; psychology

Associated Chemicals: Serotonin Uptake Inhibitors (0) ; Sertraline (79617-96-2)

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