BEHAVIORAL-THERAPY IN CHILDREN AND ADOLESCENTS WITH OBSESSIVE-COMPULSIVE DISORDER - A PILOT-STUDY

Despite advances in pharmacotherapy for obsessive-compulsive disorder (OCD), medication treatments are not always effective. This pilot proj ect examined the feasibility of a structured behavioral therapy progra m in the treatment of children and adolescents with OCD. Ten subjects with a primary diagnosis of OCD were invited to participate in the tre atment program. Seven youngsters, 5 boys and 2 girls (age range 10.8-1 5.8, mean 13.0 years), participated and were treated for a mean of 14 sessions. These 7 subjects showed a broad range of OCD severity, as me asured by the Children's Yale-Brown Obsessive Compulsive Scale (CYBOCS score range 12-29). Five subjects were also receiving antiobsessional medication (dose was not changed during the trial), and 2 subjects we re treated without medication. All 7 youngsters showed a clinically si gnificant reduction in the CYBOCS score at treatment endpoint (mean ch ange 61%, range 30%-90%, effect size 2.04, p < 0.05), and the therapeu tic gains were stable for at least 3 months after treatment. One of 5 children who had been receiving concurrent antiobsessional medication was able to tolerate a dose reduction following behavioral treatment. Two to three booster sessions within 6 months posttreatment were effec tive in preventing relapse in 4 of 6 subjects. The 3 children who decl ined behavioral treatment showed no improvement at 3-month and 6-month follow-up. Behavioral treatment appeared to be a useful adjunct to me dication in children and adolescents with OCD. Further research could evaluate whether behavioral treatment would lower the dose requirement s for children receiving antiobsessional medications. Randomized clini cal trials are also needed to confirm the effectiveness of behavioral therapy alone or in combination with medication.