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 ritual prevention far pediatric obsessive-compulsive disorder (OCD). Method: Children and adolescents with diagnosed OCD (N = 14) received cognitive-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 received cognitive-behavioral treatment alone. Outcome was assessed via interviewer 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 treatment was effective in ameliorating OCD symptoms. Twelve of the 14 patients 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 follow-up = 9 months). Conclusions: Results suggest that cognitive-behavioral treatment by exposure and ritual prevention is effective for pediatric OCD. Controlled studies with random assignment to conditions are warranted to evaluate the relative efficacy of cognitive behavioral, pharmacological, and combined treatments.