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Randomized Controlled Trial
. 2019 Jun:276:115-123.
doi: 10.1016/j.psychres.2019.04.021. Epub 2019 Apr 19.

Improvement in anxiety and depression symptoms following cognitive behavior therapy for pediatric obsessive compulsive disorder

Michelle Rozenman  1 , John Piacentini  2 , Joseph O'Neill  2 , R Lindsey Bergman  2 , Susanna Chang  2 , Tara S Peris  2
Affiliations
Randomized Controlled Trial

Improvement in anxiety and depression symptoms following cognitive behavior therapy for pediatric obsessive compulsive disorder

Michelle Rozenman et al. Psychiatry Res. 2019 Jun.

Abstract

Pediatric obsessive-compulsive disorder (OCD) co-occurs frequently with other mental health conditions, adding to the burden of disease and complexity of treatment. Cognitive behavioral therapy (CBT) is efficacious for both OCD and two of its most common comorbid conditions, anxiety and depression. Therefore, treating OCD may yield secondary benefits for anxiety and depressive symptomatology. This study examined whether anxiety and/or depression symptoms declined over the course of OCD treatment and, if so, whether improvements were secondary to reductions in OCD severity, impairment, and/or global treatment response. The sample consisted of 137 youths who received 12 sessions of manualized CBT and were assessed by independent evaluators. Mixed models analysis indicated that youth-reported anxiety and depression symptoms decreased in a linear fashion over the course of CBT, however these changes were not linked to specific improvements in OCD severity or impairment but to global ratings of treatment response. Results indicate that for youth with OCD, CBT may offer benefit for secondary anxiety and depression symptoms distinct from changes in primary symptoms. Understanding the mechanisms underlying carryover in CBT techniques is important for furthering transdiagnostic and/or treatment-sequencing strategies to address co-occurring anxiety and depression symptoms in pediatric OCD.

Keywords: Adolescent; Anxiety; Child; Depression; Obsessive-compulsive disorder.

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Figures

Figure 1.
Figure 1.
Anxiety and Depression Symptom Trajectories during CBT for Pediatric OCD* * The slope of symptom change was significant for both anxiety and depression symptoms. CBT = Cognitive Behavioral Therapy; MASC = Multidimensional Anxiety Scale for Children; CDI = Children’s Depression Inventory
Figure 2.
Figure 2.
Anxiety and Depression Symptom Trajectories by Responder Status during CBT for Pediatric OCD CBT = Cognitive Behavioral Therapy; MASC = Multidimensional Anxiety Scale for Children; CDI = Children’s Depression Inventory; Responders = Post-Treatment CGI-I ≤ 2; Non-Responders = Post-Treatment CGI-I >2 * indicates significant group differences in estimated marginal means by time point
See this image and copyright information in PMC

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