Children and adolescents with Obsessive Compulsive Disorder (OCD) respond best to a combination of both psychotherapy and an antidepressant, a major clinical trial has found. Supported by the National Institutes of Healths (NIH) National Institute of Mental Health, the study recommends that treatment begin with cognitive behavior therapy (CBT), either alone or with a serotonin reuptake inhibitor (SSRI) antidepressant. The research spotlights the need for improved access to CBT, since most young people with OCD currently receive only the antidepressant, often combined with an antipsychotic medication. John March, M.D., Duke University, Edna Foa, Ph.D., University of Pennsylvania, and colleagues report on the findings of the Pediatric OCD Treatment Study (POTS) in the October 27, 2004 Journal of the American Medical Association (JAMA).
Ninety-seven 7-17 year-olds with OCD completed 12 weeks of treatment with either CBT, the SSRI sertraline, the combination treatment, or a placebo. Independent evaluators, blind to their treatment status, assessed each patient every four weeks. Patients in the study were typical of patients seen in clinical practice. For example, while industry-sponsored trials commonly exclude patients with more than one condition, 80 percent of study participants had at least one additional psychiatric disorder.
Combining sertraline and CBT was more effective than treatment with just one or the other. CBT alone did prove superior to sertraline, which, in turn, was better than a placebo. By the end of the trial, the remission rates were 53.6 percent for combined treatment, 39.3 percent for CBT, 21.4 percent for sertraline, and 3.6 percent for placebo.
Jules Asher | EurekAlert!
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