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Evidence summaries

Behavioural and Cognitive Behavioural Therapy for Obsessive Compulsive Disorder in Children and Adolescents

Behavioural or cognitive-behaviour therapy alone appears to be an effective treatment for obsessive-compulsive disorder in children and adolescents. It is as effective as medication alone and may lead to better outcomes when combined with medication compared to medication alone. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 8 studies with a total of 343 subjects aged 18 years or younger with a diagnosis of obsessive-compulsive disorder (OCD). The review found evidence for lower post-treatment OCD severity and reduced risk of continuing with OCD for the behavioural or cognitive-behavioural therapy (BT/CBT) group compared to pill placebo or wait-list comparisons. There was no evidence found that the efficacy of BT/CBT alone and medication alone differ in terms of post treatment symptom severity or in the risk of having OCD. There was some evidence of a benefit for combined BT/CBT and medication compared to medication alone but not relative to BT/CBT alone. The low rates of drop out suggested BT/CBT is an acceptable treatment to child and adolescent patients and their families.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment).

    References

    • O'Kearney RT, Anstey KJ, von Sanden C. Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents. Cochrane Database Syst Rev 2006;(4):CD004856 [Review content assessed as up-to-date: 2 March 2009]. [PubMed]

Primary/Secondary Keywords