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Meta-Analysis
. 2006 Oct 18;2006(4):CD004856.
doi: 10.1002/14651858.CD004856.pub2.

Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents

R T O'Kearney  1 , K J Anstey, C von Sanden
Affiliations
Meta-Analysis

Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents

R T O'Kearney et al. Cochrane Database Syst Rev. .

Abstract

Background: While behavioural or cognitive-behavioural therapy (BT/CBT) is recommended as the psychotherapeutic treatment of choice for children and adolescents with obsessive-compulsive disorder (OCD), the application of BT/CBT to paediatric OCD may not be straightforward.

Objectives: This review examines the overall efficacy of BT/CBT for paediatric OCD, its relative efficacy against psychopharmacology and whether there are benefits in using BT/CBT combined with medication.

Search strategy: We searched CCDANCTR-Studies and CCDANCTR-References (searched on 5/8/2005), MEDLINE, EMBASE, PsycINFO, the reference lists of all selected studies and handsearched journals specifically related to behavioural treatment of OCD.

Selection criteria: Included studies were randomised controlled trials or quasi-randomised trials with participants who were 18 years of age or younger and had a diagnosis of OCD, established by clinical assessment or standardised diagnostic interview. Reviewed studies included the standard behavioural or cognitive-behavioural techniques, either alone or in combination, compared with wait-list or pill placebo.

Data collection and analysis: The quality of selected studies was assessed by two independent reviewers. The primary outcomes comprised of endpoint scores on the gold standard clinical outcome measure of OCD symptoms, distress and interference (CY-BOCS) and endpoint OCD status.

Main results: Four studies with 222 participants were considered eligible for inclusion and for data extraction. Two studies showed significantly better post-treatment functioning and reduced risk of continuing with OCD at post-treatment for the BT/CBT group compared to placebo or wait-list comparisons. We suggested that the POTS 2004 result, equal to a difference of about eight points on the CY-BOCS, represented the best available estimate for the efficacy of BT/CBT relative to no treatment. (WMD -7.50; 95% CI -11.55, -3.45). Pooled evidence from two trials indicated that the efficacy of BT/CBT and medication did not differ significantly (WMD -3.87; 95% CI -8.15, 0.41). There was evidence of the benefit of combined BT/CBT and medication compared to medication alone (WMD -4.55; 95% CI -7.40, -1.70), but not relative to BT/CBT alone (WMD -2.80; 95% CI -7.55, 1.95). The rates of drop out suggested BT/CBT is an acceptable treatment to child and adolescent patients and their families.

Authors' conclusions: Although only based on a small number of studies, behavioural or cognitive-behaviour therapy appears to be a promising treatment for OCD in children and adolescents. It can lead to better outcomes when combined with medication compared to medication alone. Additional trials are needed to confirm these findings. In the interim, consideration should be given to the ways in which BT/CBT might be made more widely available as a treatment for OCD in children and adolescents.

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Conflict of interest statement

None known.

Figures

1.1
1.1. Analysis
Comparison 1 BT/CBT versus waitlist or placebo, Outcome 1 CY‐BOCS at post treatment.
1.2
1.2. Analysis
Comparison 1 BT/CBT versus waitlist or placebo, Outcome 2 Number with OCD at post treatment.
1.3
1.3. Analysis
Comparison 1 BT/CBT versus waitlist or placebo, Outcome 3 NIMH‐GOCS at post treatment.
1.4
1.4. Analysis
Comparison 1 BT/CBT versus waitlist or placebo, Outcome 4 Clinical Global Impressions‐Improvement.
1.5
1.5. Analysis
Comparison 1 BT/CBT versus waitlist or placebo, Outcome 5 Change in CY‐BOCS prior to post.
2.1
2.1. Analysis
Comparison 2 BT/CBT versus medication, Outcome 1 CY‐BOCS score at post treatment.
2.2
2.2. Analysis
Comparison 2 BT/CBT versus medication, Outcome 2 Number with OCD at post treatment.
2.3
2.3. Analysis
Comparison 2 BT/CBT versus medication, Outcome 3 NIMH‐GOCS at post treatment.
3.1
3.1. Analysis
Comparison 3 BT/CBT combined with medication versus other, Outcome 1 CY‐BOCS score at post treatment.
3.2
3.2. Analysis
Comparison 3 BT/CBT combined with medication versus other, Outcome 2 Number with OCD at post treatment.
3.3
3.3. Analysis
Comparison 3 BT/CBT combined with medication versus other, Outcome 3 NIMH‐GOCS at post treatment.
3.4
3.4. Analysis
Comparison 3 BT/CBT combined with medication versus other, Outcome 4 CGIS at post treatment.
3.5
3.5. Analysis
Comparison 3 BT/CBT combined with medication versus other, Outcome 5 CGII at post treatment.
4.1
4.1. Analysis
Comparison 4 BT/CBT versus other ‐ secondary outcomes, Outcome 1 Self‐reported depression at post treatment.
4.2
4.2. Analysis
Comparison 4 BT/CBT versus other ‐ secondary outcomes, Outcome 2 Self‐reported anxiety at post treatment.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD004856

References

References to studies included in this review

Asbahr 2005 {published data only}
    1. Asbahr FR, Castillo AR, Ito LM, Latorre MR, Moreira MN, Lotufo‐Neto F. Group cognitive‐behavioral therapy versus sertraline for the treatment of children and adolescents with obsessive‐compulsive disorder. Journal of the Academy of Child and Adolescent Psychiatry 2005;44:1128‐1136. - PubMed
Barrett 2004 {published data only}
    1. Barrett P, Healy‐Farrell L, March JS. Cognitive‐behavioral family treatment of childhood obsessive‐compulsive disorder: A controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry 2004;43(1):46‐62. - PubMed
Bolton 2008 {published data only}
    1. Bolton D, Perrin S. Evaluation of exposure with response‐prevention for obsessive compulsive disorder in childhood and adolescence. Journal of Behavior Therapy and Experimental Psychiatry 2008;39:11‐22. - PubMed
de Haan 1998 {published data only}
    1. Haan E, Hoogduin KA, Buitelaar JK, Keijsers GP. Behavior Therapy versus clomipramine for the treatment of obsessive‐compulsive disorder in children and adolescents. Journal of Child and Adolescent Psychiatry 1998;37(10):1022‐9. - PubMed
Freeman 2008 {published data only}
    1. Freeman JB, Garcia AM, Coyne L, Ale C, Przeworski A, Himle M, et al. Early childhood OCD: Preliminary findings from a family‐based cognitive‐behavioral approach.. Journal of the American Academy of Child & Adolescent Psychiatry 2008;47:593‐602. - PMC - PubMed
Neziroglu 2000 {published data only}
    1. *Neziroglu F, Yaryur‐Tobias JA, Walk J, McKay D. The effect of fluvoxamine and behavior therapy on children and adolescents with obsessive‐compulsive disorder. Journal of Child and Adolescent Psychopharmacology 2000;10(4):295‐306. - PubMed
POTS 2004 {published data only}
    1. Franklin M, Foa E, March JS. The Pediatric Obsessive‐Compulsive Disorder Treatment Study: Rationale, design, and methods. Journal of Child and Adolescent Psychopharmacology 2003;13 Suppl 1:S39‐S51. - PubMed
    1. The Pediatric OCD Treatment Study (POTS) Team. Cognitive‐behavioral therapy, sertraline, and their combination for children and adolescents with obsessive‐compulsive disorder. JAMA 2004;292(16):1969‐76. - PubMed
Williams ND {unpublished data only}
    1. Williams TI, Salkovskis PM, Forrester L, Turner S, White H, Allsopp MA. A randomised controlled trial of cognitive behavioural treatment for obsessive compulsive disorder in children and adolescents. Author Unpublished. - PubMed

References to studies excluded from this review

Benazon 2002 {published data only}
    1. Benazon NR, Anger J, Rosenberg DT. Cognitive behavior therapy in treatment‐naive children and adolescents with obsessive‐compulsive disorder: an open trial. Behavior Research and Therapy 2002;40(5):529‐39. - PubMed
Bjorgvinsson 2008 {published data only}
    1. Bjorgvinsson T, Wetterneck CT, Powell DM, Chasson GS, Webb SA, Hart J, et al. Treatment outcomes for adolescent obsessive‐compulsive disorder in a specialized hospital setting. Journal of Psychiatric Practice 2008;14:137‐145. - PubMed
Bolton 1983 {published data only}
    1. Bolton D, Collins S, Steinberg D. The treatment of obsessive‐compulsive disorder in adolescence: A report of fifteen cases. British Journal of Psychiatry 1983;142:456‐64. - PubMed
Cannon 2003 {published data only}
    1. Cannon NA. The effectiveness of cognitive behavior therapy in a partial hospital setting with pediatric obsessive compulsive patients.. Dissertation Abstracts International 2003;64(6‐B):2909.
Dopfner 2007 {published data only}
    1. Dopfner M, Breuer U, Hastenrath B, Goletz H. Effectiveness and long‐term stability of cognitive behavior therapy in adolescents with obsessive‐compulsive disorder. Kindheit und Entwicklung 2007;16:129‐38.
Harris 1992 {published data only}
    1. Harris CV, Wiebe DJ. An analysis of response prevention and flooding procedures in the treatment of adolescent obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry 1992;23(2):107‐15. - PubMed
Himle 2003a {published data only}
    1. Himle JA, Fischer DJ, Etten ML, Janeck AS, Hanna GL. Group behavioral therapy for adolescents with tic‐related and non‐tic‐related obsessive‐compulsive disorder. Depression and Anxiety 2003;17(2):73‐7. - PubMed
Jaffa 1999 {published data only}
    1. Jaffa T, Tott C. Do inpatients on adolescent units recover? A study of outcome and acceptability of treatment. European Child and Adolescent Psychiatry 1999;8(4):292‐300. - PubMed
Kearney 1990 {published data only}
    1. Kearney CA, Silverman WK. Treatment of an adolescent with obsessive‐compulsive disorder by alternating response prevention and cognitive therapy: an empirical analysis. Journal of Behavior Therapy and Experimental Psychiatry 1990;21(1):39‐47. - PubMed
Knox 1996 {published data only}
    1. Knox LS, Albano AM, Barlow DH. Parental involvement in the treatment of childhood compulsive disorder: A multiple‐baseline examination incorporating parents. Behavior Therapy 1996;27(1):93‐114.
Lumpkin 2002 {published data only}
    1. Lumpkin PW, Silverman WK, Weems CF, Markham MR, Kurtines WM. Treating a heterogeneous set of anxiety disorders in youths with group cognitive therapy: A partially nonconcurrent multiple‐baseline evaluation.. Behavior Therapy 2002;33(1):163‐77.
March 1994 {published data only}
    1. March JS, Mulle K, Herbel B. Behavioral psychotherapy for children and adolescents with obsessive‐compulsive disorder: An open trial of new protocol‐driven treatment package. Journal of the American Academy of Child and Adolescent Psychiatry 1994;33(3):333‐41. - PubMed
March 1995a {published data only}
    1. March JS, Mulle K. Manualized cognitive‐behavioral psychotherapy for obsessive‐compulsive disorder in childhood: A preliminary single case study. Journal of Anxiety Disorders 1995;9(2):175‐84.
Martin 2005 {published data only}
    1. Martin JL, Thienemann M. Group Cognitive‐Behavior Therapy with Family Involvement for Middle‐School‐Age Children with Obsessive‐Compulsive Disorder: A Pilot Study. Child Psychiatry & Human Development 2005;36:113‐27. - PubMed
Mehta 1990 {published data only}
    1. Mehta M. A comparative study of family‐based and patient‐based behavioral management in obsessive‐compulsive disorder. British Journal of Psychiatry 1990;157:133‐5. - PubMed
Piacentini 2002 {published data only}
    1. Piacentini J, Bergman R, Jacobs C, McCracken JT, Kretchman J. Open trial of cognitive behavior for childhood obsessive‐compulsive disorder. Journal of Anxiety Disorders 2002;16(2):207‐19. - PubMed
Sallinen 2004 {published data only}
    1. Sallinen BJ, Nangle DW, O'Grady A. Case study: Successful medication withdrawal using cognitive‐behavioral therapy for a preadolescent with OCD. Journal of the American Academy of Child and Adolescent Psychiatry 2004;43:1441‐1444. - PubMed
Scahill 1996 {published data only}
    1. Scahill L, Vitulano LA, Brenner EM, Lynch KA, King RA. Behavioral therapy in children and adolescents with obsessive‐compulsive disorder: A pilot study. Journal of Child and Adolescent Psychopharmacology 1996;6(3):191‐202. - PubMed
Simeon 1994 {published data only}
    1. Simeon JG, Knott VJ, Dubois C, Wiggins D, Geraets I, Thatte S, et al. Buspirone therapy of mixed anxiety disorders in childhood and adolescence: A pilot study. Journal of Child and Adolescent Psychopharmacology 1994;4(3):159‐70.
Storch 2007a {published data only}
    1. Storch EA, Bagner DM, Geffken GR, Adkins JW, Murphy TK, Goodman WK, et al. Sequential cognitive‐behavioral therapy for children with obsessive‐compulsive disorder with an inadequate medication response: a case series of five patients. Depression & Anxiety 2007;24:375‐381. - PubMed
Storch 2007b {published data only}
    1. Storch EA, Geffken GR, Merlo LJ, Mann G, Duke D, Munson M, et al. Family‐based cognitive‐behavioral therapy for pediatric obsessive‐compulsive disorder: Comparison of intensive and weekly approaches. Journal of the American Academy of Child & Adolescent Psychiatry 2007;46:469‐478. - PubMed
Thienemann 2001 {published data only}
    1. Thienemann M, Martin J, Cregger B, Thompson HB, Dyer‐Friedman J. Manual‐driven group cognitive‐behavioral therapy for adolescents with obsessive‐compulsive disorder: a pilot study. Journal of the American Academy of Child and Adolescent Psychiatry 2001;40(11):1254‐60. - PubMed
Thornicroft 1991 {published data only}
    1. Thornicroft G, Colson L, Marks I. An in‐patient behavioral psychotherapy unit. Description and audit. British Journal of Psychiatry 1991;158:363‐7. - PubMed
Van Noppen 1997 {published data only}
    1. Noppen B, Steketee G, McCorkle BH, Pato M. Group and multifamily behavioral treatment for obsessive compulsive disorder: A pilot study. Journal of Anxiety Disorders 1997;11(4):431‐46. - PubMed
Waters 2001 {published data only}
    1. Waters TL, Barrett PM, March JS. Cognitive‐behavioral family treatment of childhood obsessive‐compulsive disorder: preliminary findings. American Journal of Psychotherapy 2001;55(3):372‐87. - PubMed
Wever 1997 {published data only}
    1. Wever C, Rey JM. Juvenile obsessive‐compulsive disorder. Australian and New Zealand Journal of Psychiatry 1997;31(1):105‐13. - PubMed
Whiteside 2008 {published data only}
    1. Whiteside SP, Brown AM, Abramowitz J. Five‐day intensive treatment for adolescent OCD: a case series. Journal of Anxiety Disorders 2008;22:495‐504. - PubMed
Willmuth 1988 {published data only}
    1. Willmuth ME. Cognitive‐behavioral and insight‐orientated psychotherapy of an eleven‐year‐old boy with obsessive‐compulsive disorder. American Journal of Psychotherapy 1998;42(3):472‐8. - PubMed

References to studies awaiting assessment

Himle 2003b {published data only}
    1. Himle JA. Group cognitive behavioral therapyversus group anxiety management for adolescent OCD: A randomized, controlled pilot study. cited in Watson 2008 2003.

References to ongoing studies

Bolton ongoing {unpublished data only}
    1. Bolton D, Williams TI, Perrin S, Salkovskis P, Atkinson L, Gallop CG, Waite P. A randomised controlled trial comparison of brief cognitive behaviour therapy, standard cognitive behaviour therapy and wait list. author unpublished. - PubMed
Ivarsson ongoing {unpublished data only}
    1. Ivarsson T. Nordic Long‐term Obsessive compulsive disorder (OCD) Treatment Study. SRCTN66385119 Ongoing.
Murphy ongoing {unpublished data only}
    1. Murphy TK. SSRI‐Induced Activation Syndrome in Pediatric Obsessive Compulsive Disorder. NIH trials register NCT00382291.
O'Neil ongoing {unpublished data only}
    1. O'Neil JO, Piacentini JC. Cognitive‐Behavioral Therapy & Glutametergic Neurometabolites in Pediatric OCD. NIH trials register NCT00748761.
POTS II ongoing {unpublished data only}
    1. Freeman J, Choate‐Summers M, Garcia A, Moore P, Sapyta J, Khanna M, March J, Foa E, Franklin M. The pediatric obsessive‐compulsive disorder treatment study II: rationale,design, and methods.. Child and adolescent psychiatry and mental health 2009;3:doi:10.1186/1753‐2000‐3‐4. - PMC - PubMed
Turner ongoing {unpublished data only}
    1. Turner C, Heyman I, Mataix‐Cols D, Lovell K, Byford S. Evaluation and dissemination of a telephone‐administered cognitive behaviour therapy (CBT) program for children and young people with obsessive‐compulsive disorder (OCD).. ISRCTN Register.

Additional references

AACAP 1998
    1. American Academy of Child, Adolescent Psychiatry. Summary of the practice parameters for the assessment and treatment of children and adolescents with obsessive‐compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry 1998;37(10):1110‐6. - PubMed
Abramowitz 2005
    1. Abramowitz JS, Whiteside SP, Deacon BJ. The effectiveness of treatment for pediatric obsessive‐compulsive disorder: a meta‐analysis. Behavior Therapy 2005;36:55‐63.
Alderson 2004
    1. Alderson P, Green S, Higgins JP, editors. Cochrane Reviewers' Handbook 4.2.2. In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd, Issue 1 2004.
Anthony 1998
    1. Anthony, Barlow D. Anxiety Disorders Interview Schedule for DSM ‐IV for Children. London: Oxford University Press, 1998.
Asbahr 2009
    1. Asbahr FR. Personal communication. Personal communication 2009.
Barrett 2002
    1. Barrett P, Shortt A, Healy L. Do parent and child behaviours differentiate families whose children have obsessive‐compulsive disorder from other clinic and non‐clinic families?. Journal of Clinical Psychology and Psychiatry 2002;43(5):597‐607. - PubMed
Barrett 2008
    1. Barrett PM, Farrell L, Pina TS, Perris TS, Piacentini J. EVidence‐based psychosocial treatments for child and adolescent obsessive‐compulsive disorder. Journal of Clinical Child and Adolescent Psychology 2008;37:131‐155. - PubMed
Bridge 2007
    1. Bridge, J. A, Iyengar, S, Salary C, B, Barbe, R, P, Birmaher, B, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: A meta‐analysis of randomized controlled trials. JAMA 2007;297:1683‐96. - PubMed
Compton 2002
    1. Compton SN, Burns BJ, Robertson E, Egger HL. Review of the evidence base for treatment of childhood psychopathology: internalising disorders. Journal of Consulting and Clinical Psychology 2002;70(6):1240‐66. - PubMed
de Haan 2005
    1. Haan E, Huyser C, Boer F. Obsessive‐compulsive disorder in children and adolescents. Tijdschrift voor Psychiatrie 2005;47:229‐238.
de Haan 2006
    1. Haan E. Personal Communication 2006.
Douglass 1995
    1. Douglass H, Moffitt T, Dar R, McGee R, Silva P. Obsessive compulsive disorder in a birth cohort of 18 year olds: Prevalence and predictors. Journal of the American Academy of Child and Adolescent Psychiatry 1995;34(11):1424‐31. - PubMed
Flament 1988
    1. Flament MF, Whitaker A, Rapoport JL, Davies M, Berg CZ, Kalikow K, et al. Obsessive compulsive disorder in adolescence: An epidemiological study. Journal of the American Academy of Child and Adolescent Psychiatry 1988;27(6):764‐71. - PubMed
Franklin 2003
    1. Franklin M, Foa E, March JS. The PEdiatric Obessive ‐Compulsive Treatment Study: Rationale, design and methods. Journal of Child and Adolescent Psychopharmacology 2003;13 Suppl 1:S39‐S51. - PubMed
Freeman 2007
    1. Freeman JB, Choate‐Summers ML, Moore PS, Garcia AM, Sapyta JJ, Leonard HL, et al. Cognitive behavioral treatment for young children with obsessive‐compulsive disorder. Biological Psychiatry 2007;61:337‐343. - PMC - PubMed
Freeman 2009
    1. Freeman JB, Choate‐Summers ML, Garcia AM, Moore PS, Sapyta JJ, Khanna MS, et al. The pediatric obsessive‐compulsive disorder treatment study II: rationale, design and methods. Child and Adolescent Psychiatry and Mental Health 2009;3:4:doi:10.1186/1753‐2000‐3‐4. - PMC - PubMed
Geller 1996
    1. Geller DA, Biederman J, Griffin S, Jones J, Lefkowitz TR. Comorbidity of juvenile obsessive‐compulsive disorder with disruptive behavior disorder. Journal of the Academy of Child and Adolescent Psychiatry 1996;35(12):1637‐46. - PubMed
Geller 1998
    1. Geller DA, Biederman J, Jones J, Shapiro S, Schwatrz S, Park KS. Obsessive‐compulsive disorder in children and adolescents: a review. Harvard Review of Psychiatry 1998;5(5):260‐73. - PubMed
Geller 2001
    1. Geller DA, Biederman J, Faraone S, Agranat A, Cradock K, Hagermoser L, et al. Developmental aspects of obsessive compulsive disorder: findings in children, adolescents and adults. Journal of Nervous and Mental Diseases 2001;189(7):471‐7. - PubMed
Geller 2003a
    1. Geller DA. Recent advances in Pediatric OCD Research. Journal of Child and Adolescent Psychopharmocology 2003;13 Suppl 1:1‐6. - PubMed
Geller 2003b
    1. Geller DA, Biederman J, Stewart SE, Mullin B, Martin A, Spencer T, Faraone SV. Which SSRI? A meta‐analysis of pharmacotherapy trials in pediatric obsessive‐compulsive disorder. American Journal of Psychiatry 2003;160(11):1919‐28. - PubMed
Harvard 2002
    1. Harvard Mental Health Letter. Obsession and compulsions in children. Harvard Health Online, Harvard Medical School 2002;19(1):4‐7. - PubMed
Higgins 2008a
    1. Higgins JPT, Altman DG. 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors) editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0 [updated February 2008] Available from www.cochrane‐handbook.org. The Cochrane Collaboration,, 2008.
Higgins 2008b
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0 [updated February 2008]. The Cochrane Collaboration, 2008. Available from www.cochrane‐handbook.org, 2008.
Insel 1983
    1. Insel, T.R, Murphy, D.D, Cohen, R.M, Alterman, J, KIts, C, et al. Obsessive‐compulsive Disorder: a double blind trial of clomipramine and clorgyline. Archives of General Psychiatry 1983;40:605‐612. - PubMed
Kobak 1998
    1. Kobak KA, Griest JH, Jefferson JW, Katzelnick DJ, Henk HJ. Behavioral versus pharmacological treatments of obsessive compulsive disorder: a meta‐analysis. Psychopharmacology 1998;136(3):205‐16. - PubMed
Kovacs 1992
    1. Kovacs, M. Children's Depression Inventory (CDI). Children's Depression Inventory (CDI). Tonawanda, NY.: Multi‐Health Systems, 1992.
Liebowitz 2002
    1. Liebowitz M, Turner S, Piacentini J, Beidel D, Clarvit S, Davies S, et al. Fluoxetine in children and adolescents with OCD: a placebo‐controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry 2002;41(12):1431‐8. - PubMed
March 1997
    1. March JS, Francis A, Kahn DA, Carpenter D. The expert consensus guidelines series: Treatment of Obsessive‐compulsive disorder. Journal of Clinical Psychiatry 1997;58 Suppl 4:No Pagination.
March 1998
    1. March JS, Mulle K. OCD in children and adolescents: A cognitive‐behavioural treatment manual. New York: The Guildford Press, 1998.
Moncrieff 2001
    1. Moncrieff J, Churchill R, Drummond C, McGuire H. Development of a quality assessment instrument for trials of treatments for depression and neurosis. International Journal of Methods in Psychiatric Research 2001;10(3):126‐33.
Murphy 2002
    1. Murphy M, Pichichero ME. Prospective identification and treatment of children with pediatric autoimmune neuropsychiatric disorders associated with Group A streptococci infection (PANDAS). Archives of Pediatrics and Adolescent Medicine 2002;156(4):356‐61. - PubMed
NIMH 1985
    1. National Institute of Mental Health. Special feature: rating scales and assessment instruments for use in pediatric psychopharmacological research. Psychopharmacology Bulletin 1985;21:839–44. - PubMed
O'Kearney 2007
    1. O'Kearney R. Benefits of cognitive‐behavioural therapy for children and youth with obsessive‐compulsive disorder: re‐examination of the evidence. Australian and New Zealand Journal of Psychiatry 2007;41:199‐212. - PubMed
Piacentini 2003
    1. Piacentini J, Bergman L, Keller, McCracken J. Functional impairment in children and adolescents with obsessive‐compulsive disorder. Journal of Child and Adolescent Psychopharmacology 2003;13 Suppl 1:61‐9. - PubMed
Rapoport 2000
    1. Rapoport J, Inoff‐Germian G, Weissman M, Greenwald S, Narrow WE, Jensen PS, et al. Childhood obsessive‐compulsive disorder in the NIMH MECA Study: parent versus child identification of cases. Methods for the Epidemiology of Child and Adolescent Mental Disorders. Journal of Anxiety Disorders 2000;14(6):535‐48. - PubMed
Reynolds 1989
    1. Reynolds WM, Graves A. Reliability of childrens' reports of depressive symptoms. Journal of Abnormal Child Psychology 1989;17:647‐655. - PubMed
Shafran 1998
    1. Shafran R, Somers J. Treating adolescent obsessive‐compulsive disorder: applications of the cognitive theory. Behaviour Research and Therapy 1998;36(1):93‐7. - PubMed
Silverman 1996
    1. Silverman W, Albano A. The Anxiety Disorders Interview Schedule for DSM‐IV: Child and Parent Version. San Antonio, TX: Psychological Corp., 1996.
Stegge 2007
    1. Stegge, H, & Meerum Terwogt, M. Awareness and regulation of emotion in typical and atypical development. In: James J Gross editor(s). Handbook of emotion regulation. New York: The Guilford Press, 2007:269‐286.
Stewart 2004
    1. Stewart, S.E, Geller, D. A, Jenike, M, Pauls, D, Shaw, D, Mullin, B, & Faraone, S. V. Long‐term outcome of pediatric obsessive‐compulsive disorder: a meta‐analysis and qualitative review of the literature. Acta Psychiatria Scandinavia 2004;10:4‐13. - PubMed
Storch 2004
    1. Stroch EA, Murphy TK, Geffken GR, Soto O, Sajid M, et al. Psychometric evaluation of the Children's Yale‐Brown Obsessive‐Compulsive Scale. Psychiatric Research 2004;129:91‐98. - PubMed
Swedo 1992
    1. Swedo S, Leonard H, Rapoport J. Child‐onset obsessive compulsive disorder. Psychiatric Clinics of North America 1992;15(4):767‐75. - PubMed
Turner 2006
    1. Turner CM. Cognitive‐behavioural theory and therapy for obsessive‐compulsive disorder in children and adolescents: current status and future directions. Clinical Psychology Review 2006;26:912‐938. - PubMed
Watson 2008
    1. Watson HJ, Rees CS. Meta‐analysis of randomized, controlled treatment trials for pediatric obsessive‐compulsive disorder. Journal of Child Psychology and Psychiatry 2008;49:489‐498. - PubMed
Williams 2009
    1. Willilams TI. Personal communciation. Personal communication 2009.

References to other published versions of this review

O'Kearney 2006
    1. O'Kearney RT, Anstey KJ, Sanden C. Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents. Cochrane Database of Systematic Reviews 2006, Issue 4. [DOI: ] - PMC - PubMed

Publication types