Family-based cognitive-behavioral therapy for pediatric obsessive-compulsive disorder: comparison of intensive and weekly approaches.

Full Abstract

OBJECTIVE:
To examine the relative efficacy of intensive versus weekly cognitive-behavioral therapy (CBT) for children and adolescents with obsessive-compulsive disorder (OCD).

METHOD:
Forty children and adolescents with OCD (range 7-17 years) were randomized to receive 14 sessions of weekly or intensive (daily psychotherapy sessions) family-based CBT. Assessments were conducted at three time points:
pretreatment, posttreatment, and 3-month follow-up. Raters were initially blind to randomization. Primary outcomes included scores on the Children's Yale-Brown Obsessive-Compulsive Scale, remission status, and ratings on the Clinical Global Impression-Severity and Clinical Global Improvement scales. Secondary outcomes included the Child Obsessive Compulsive Impact Scale-Parent Rated, Children's Depression Inventory, Multidimensional Anxiety Scale for Children, and Family Accommodation Scale. Adjunctive pharmacotherapy was not an exclusion criterion.

RESULTS:
Intensive CBT was as effective as weekly treatment with some advantages present immediately after treatment. No group differences were found at follow-up, with gains being largely maintained over time. Although no group x time interaction was found for the Children's Yale-Brown Obsessive-Compulsive Scale (F(1,38) = 2.2, p = .15), the intensive group was rated on the Clinical Global Impression-Severity as less ill relative to the weekly group (F(1,38) = 9.4, p < .005). At posttreatment, 75% (15/20) of youths in the intensive group and 50% (10/20) in the weekly group met remission status criteria. Ninety percent (18/20) of youths in the intensive group and 65% (13/20) in the weekly group were considered treatment responders on the Clinical Global Improvement (chi1(2) = 3.6, p = .06).

CONCLUSIONS:
Both intensive and weekly CBT are efficacious treatments for pediatric OCD. Intensive treatment may have slight immediate advantages over weekly CBT, although both modalities have similar outcomes at 3-month follow-up.

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Author information

Author/s: Storch, Eric A (EA); Geffken, Gary R (GR); Merlo, Lisa J (LJ); Mann, Giselle (G); Duke, Danny (D); Munson, Melissa (M); Adkins, Jennifer (J); Grabill, Kristen M (KM); Murphy, Tanya K (TK); Goodman, Wayne K (WK);

Affiliation: Department of Psychiatry, University of Florida, Gainesville, FL 32610, USA. estorch(-atsign-)psychiatry.ufl.edu

Journal and publication information

Publication Type: Comparative Study; Journal Article; Randomized Controlled Trial

Journal: Journal of the American Academy of Child and Adolescent Psychiatry (J Am Acad Child Adolesc Psychiatry), published in United States. (Language: eng)

Reference: 2007-Apr; vol 46 (issue 4) : pp 469-78

Dates: Created 2007/04/10; Completed 2007/05/14; Revised 2008/02/04;

PMID: 17420681, 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.

Comments and Corrections

CommentIn: Evid Based Ment Health. 2008 Feb;11(1):20. (PMID: 18223055)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Child
Cognitive Therapy - methods
Family Therapy
Female

Humans
Intensive Care
Male
Obsessive-Compulsive Disorder - therapy
Time Factors

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