Randomized, placebo-controlled trial of cognitive-behavioral therapy alone or combined with sertraline in the treatment of pediatric obsessive-compulsive disorder
- PMID: 24184429
- PMCID: PMC3908957
- DOI: 10.1016/j.brat.2013.09.007
Randomized, placebo-controlled trial of cognitive-behavioral therapy alone or combined with sertraline in the treatment of pediatric obsessive-compulsive disorder
Abstract
Background: To examine the efficacy of sequential sertraline and cognitive-behavioral therapy (CBT) treatment relative to CBT with pill placebo over 18 weeks in children and adolescents with obsessive-compulsive disorder (OCD).
Methods: Forty-seven children and adolescents with OCD (Range = 7-17 years) were randomized to 18-weeks of treatment in one of three arms: 1) sertraline at standard dosing + CBT (RegSert + CBT); 2) sertraline titrated slowly but achieving at least 8 weeks on the maximally tolerated daily dose + CBT (SloSert + CBT); or 3) pill placebo + CBT (PBO + CBT). Assessments were conducted at screening, baseline, weeks 1-9, 13, and 17, and post-treatment. Raters and clinicians were blinded to sertraline (but not CBT) randomization status. Primary outcomes included the Children's Yale-Brown Obsessive-Compulsive Scale, and response and remission status. Secondary outcomes included the Child Obsessive Compulsive Impact Scale-Parent/Child, Children's Depression Rating Scale-Revised, Multidimensional Anxiety Scale for Children, and Clinical-Global Impressions-Severity.
Results: All groups exhibited large within-group effects across outcomes. There was no group by time interaction across all outcomes suggesting that group changes over time were comparable.
Conclusions: Among youth with OCD, there was no evidence that sequentially provided sertraline with CBT differed from those receiving placebo with CBT.
Clinicaltrialsgov identifier: NCT00382291.
Keywords: Children; Cognitive-behavioral therapy; Obsessive–compulsive disorder; Sertraline; Treatment.
Copyright © 2013 Elsevier Ltd. All rights reserved.
References
-
- AACAP Practice Parameters for the Assessment and Treatment of Pediatric Obsessive-Compulsive Disorder. Journal of the American Academy of Child and Adolescent Psychiatry. 2012
-
- Cottraux J, Mollard E, Bouvard M, Marks I, Sluys M, Nury AM, et al. A controlled study of fluvoxamine and exposure in obsessive-compulsive disorder. International Clinical Psychopharmacology, 1990;5(1):17–30. - PubMed
-
- Foa EB, Liebowitz MR, Kozak MJ, Davies S, Campeas R, Franklin ME, et al. Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder. American Journal Psychiatry. 2005;162:151–161. - PubMed
-
- Geller DA, Biederman J, Stewart SE, Mullin B, Farrell C, Wagner KD, et al. Impact of comorbidity on treatment response to paroxetine in pediatric obsessive-compulsive disorder: is the use of exclusion criteria empirically supported in randomized clinical trials? Journal of Child and Adolescent Psychopharmacology. 2003;13(1):S19–S29. - PubMed
Publication types
MeSH terms
Substances
Associated data
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical