Therapy, medication combination superior for children with obsessive-compulsive disorder

DURHAM, N.C. Children with obsessive-compulsive disorder (OCD) fare best when treated with a combination of cognitive behavioral therapy (CBT) and sertraline (trade name Zoloft), researchers at Duke University Medical Center and their colleagues at two other research institutions have determined. The team's research findings appear in the October 27, 2004 issue of the Journal of the American Medical Association.

Despite knowing that OCD is illogical, children and adolescents with OCD dwell or "obsess" on unwanted thoughts and perform repetitious actions or rituals in a compulsive manner as a way of dealing with those thoughts. Compulsive hand washing or cleaning, counting to certain numbers or the repetitious checking of household items or belongings are examples of symptoms that might manifest in children and adults with this disorder.

Until now, the researchers said, little was known about the relative efficacy of CBT and medication, either alone or in combination, to treat pediatric OCD. The CBT used in this study is an OCD-specific psychotherapeutic treatment designed to create and reinforce new thought patterns and behaviors in children and adolescents with the disorder, said the researchers. The drug sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly used in the treatment of depression and OCD.

"The results are so robust decision makers at all levels of the health care system simply have no reason not to recommend CBT as the starting place for treatment of OCD in children and adolescents," said John March, M.D., chief of child and adolescent psychiatry at Duke and co-principal investigator on the study. "Starting with medication has no clear benefit for the patient. Our research team feels very strongly that we now have conclusive evidence that CBT -- alone or in combination with medication -- works exceptionally well for this patient population."

The research team enrolled 112 patients between

Contact: Tracey Koepke
Duke University Medical Center

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