CBT augmentation of pharmacotherapy in pediatric OCD

January 01, 0001

CBT augmentation of pharmacotherapy in pediatric OCD

These US researchers studies augmenting serotonin reuptake inhibitors (SRIs) with cognitive behavioral therapy (CBT), brief CBT, or instructions in CBT. They performed a randomized controlled trial of pediatric outpatients with OCD that only partially responded to SRIs (n=124). The enrollees were followed over a 12 week period.

The researchers found: "The medication management plus CBT strategy was superior to the other 2 strategies on all outcome measures. In the primary intention-to-treat analysis, 68.6% in the plus CBT group were considered responders, which was significantly better than the 34.0% in the plus instructions in CBT group, and 30.0% in the medication management only group. The results were similar in pairwise comparisons with the plus CBT strategy being superior to the other 2 strategies. The plus instructions in CBT strategy was not statistically superior to medication management only. The number needed-to-treat analysis with the plus CBT vs medication management only in order to see 1 additional patient at week 12, on average, was estimated as 3. For the plus CBT vs the plus instructions in CBT strategy, the number needed to treat was also estimated as 3. For the plus instructions in CBT vs medication management only the number needed to treat was estimated as 25."

The researchers concluded: "Among patients aged 7 to 17 years with OCD and partial response to SRI use, the addition of CBT to medication management compared with medication management alone resulted in a significantly greater response rate, whereas augmentation of medication management with the addition of instructions in CBT did not."

Cognitive behavioral therapy is an excellent augmenting strategy in pediatric patient with OCD only partially responding to first line pharmacotherapy

For the full abstract, click here.

JAMA 306(11):1224-1232, 21 September 2011 © 2011 American Medical Association
Cognitive Behavior Therapy Augmentation of Pharmacotherapy in Pediatric Obsessive-Compulsive Disorder. Martin E. Franklin, Jeffrey Sapyta, Jennifer B. Freeman, et al.

Category: P. Psychological. Keywords: cognitive behavioral therapy, obsessive-compulsive disorder, serotonin, pediatrics, augmentation, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 4 October 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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