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

the ages of 7 and 17 with a primary diagnosis of OCD into a randomized, controlled clinical trial conducted at three centers in the U.S. Patients were randomly assigned to receive either CBT plus sertraline, CBT alone, sertraline alone or pill placebo for a period of 12 weeks.

Those in the active medication and placebo groups received standard care from a child and adolescent psychiatrist who monitored the effects of the medication (or placebo) and who offered general support and encouragement in resisting OCD. The participants in both groups and their care providers did not know if they were receiving or administering the active pill or placebo. They were seen once a week for medication adjustments during the first six weeks of the study, and then were seen every other week for the next six weeks. The dosage ranged from 25 to 200 milligrams over the first six weeks, depending on the response of the individual. Over the following six weeks, dosage was adjusted for side-effects only.

Those in the CBT groups had 14 visits with a therapist over 12 weeks twice a week for the first two weeks and then once weekly for the remainder of the study period. Each visit lasted approximately one hour. Participants in the CBT-only group were aware they were not receiving medication. Participants in the CBT combination group were aware they were receiving active medication, as opposed to placebo.

The team found that 53.6 percent of the participants in the combination group (CBT plus sertraline) showed no signs of the disorder by the end of their treatment. For the CBT-only group, 39.3 percent of participants became nearly asymptomatic for OCD; with sertraline alone, 21.4 percent of the group became asymptomatic, and of those receiving the placebo, only 3.6 percent responded with greatly reduced symptoms of OCD.

"The take home message from this study is that kids with OCD should receive cognitive behavioral therapy - either a
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Contact: Tracey Koepke
Koepk002@mc.duke.edu
919-660-1301
Duke University Medical Center
26-Oct-2004


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