COGNITIVE-BEHAVIORAL TREATMENT OF PEDIATRIC OBSESSIVE-COMPULSIVE DISORDER - AN OPEN CLINICAL-TRIAL

Objective: The purpose of this open clinical trial was to examine the efficacy of cognitive-behavioral treatment involving exposure and ritu al prevention far pediatric obsessive-compulsive disorder (OCD). Metho d: Children and adolescents with diagnosed OCD (N = 14) received cogni tive-behavioral treatment; seven patients received intensive treatment (mean = 18 sessions over 1 month) and seven received weekly treatment (mean = 16 sessions over 4 months). Eight of these patients received concurrent treatment with serotonin reuptake inhibitors and six receiv ed cognitive-behavioral treatment alone. Outcome was assessed via inte rviewer ratings on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Obsessive Compulsive Rating Scales for Main Fear and Main Ritual, and Hamilton Depression Rating Scale. Results: cognitive-behavioral treat ment was effective in ameliorating OCD symptoms. Twelve of the 14 pati ents were at least 50% improved over pretreatment Y-BOCS severity, and the Vast majority remained improved at follow-up; mean reduction in Y -BOCS was 67% at posttreatment and 62% at follow-up (mean time to foll ow-up = 9 months). Conclusions: Results suggest that cognitive-behavio ral treatment by exposure and ritual prevention is effective for pedia tric OCD. Controlled studies with random assignment to conditions are warranted to evaluate the relative efficacy of cognitive behavioral, p harmacological, and combined treatments.