Combination therapy, not medication alone, most effective for treating children with OCD

Treating children and adolescents with obsessive-compulsive disorder (OCD) with a combination of cognitive-behavior therapy (CBT) and the medication sertraline is more effective than CBT or sertraline alone, according to a study in the October 27 issue of JAMA.

Epidemiologic data suggest that approximately 1 in 200 young people suffers from OCD, which in many cases severely disrupts academic, social, and vocational functioning, according to background information in the article. Among adults with OCD, one-third to one-half develop the disorder during childhood or adolescence, which suggests that early intervention in childhood may prevent long-term illness in adulthood. Previous research has shown the effectiveness of short-term CBT or medical management with a selective serotonin reuptake inhibitor (such as sertraline, an antidepressant). However, little is known about their relative and combined efficacy. CBT is a form of psychotherapy that helps patients change their thought patterns and behaviors related to obsessive thoughts and compulsions.

OCD is characterized by recurrent obsessions and/or compulsions that are intense enough to cause severe discomfort. Obsessions are recurrent and persistent thoughts, impulses, or images that are unwanted and cause marked anxiety or distress. Compulsions are repetitive behaviors or rituals (such as hand washing, hoarding, checking something over and over) or mental acts (such as counting, repeating words silently).

John S. March, M.D., M.P.H., of the Duke University Medical Center, Durham, N.C., and members of the Pediatric OCD Treatment Study (POTS) team, evaluated the efficacy of CBT alone, medication management with the SSRI sertraline alone, or combined treatment consisting of CBT and sertraline as initial treatment for children and adolescents with OCD. POTS, a randomized controlled trial, was conducted at three academic centers in the U.S. and included 112 patients aged 7 through 17

Contact: Tracey Koepke
JAMA and Archives Journals

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