Evidence-Based Treatments in Treatment-Naïve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder

Gudmundur Skarphedinsson; Tord Ivarsson

doi:10.1007/s40473-015-0047-0

Evidence-Based Treatments in Treatment-Naïve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder

Gudmundur Skarphedinsson
, Tord Ivarsson

Faculty of Psychology

University of Iceland

Research output: Contribution to journal › Article › peer-review

Abstract

Pediatric obsessive-compulsive disorder (OCD) is a chronic, disabling, and common disorder. In this paper, we describe evidence-based treatments in treatment-naïve and treatment-refractory pediatric OCD patients. We conducted a PubMed search to identify randomized controlled trials, reviews, and expert guidelines. The evidence for cognitive behavior therapy (CBT) and specific serotonin reuptake inhibitors (SSRIs) among treatment-naïve patients is substantial and shows that both treatments are effective. Head-to-head trials in pediatric OCD only show that CBT is significantly more effective than SSRI. The evidence among CBT and SSRI non-responders is limited. One trial among CBT non-responders showed that both continued CBT and switching to an SSRI are effective strategies. Likewise, one trial among SSRI non-responders showed that augmenting with CBT is necessary. Evidence of treatments for treatment-refractory pediatric OCD is lacking. We describe the treatments available and evidence from studies of adult OCD. Evidence for emerging treatments such as modifying CBT and glutamatergic drugs is also described.

Original language	English
Pages (from-to)	127-136
Number of pages	10
Journal	Current Behavioral Neuroscience Reports
Volume	2
Issue number	3
DOIs	https://doi.org/10.1007/s40473-015-0047-0
Publication status	Published - 1 Sept 2015

Bibliographical note

Funding Information: The Center for Child and Adolescent Mental Health, Eastern and Southern Norway gave the main authors the support to perform this work. ? Dr. Ivarsson is consultant and Speaker?s bureau for Shire, Sweden. Dr. Skarphedinsson has no declaration of interest to report. Gudmundur Skarphedinsson has no disclosures relevant to this work. Tord Ivarsson received payment for an educational presentation/speaking engagement. This article does not contain any studies with human or animal subjects performed by any of the authors. Publisher Copyright: © 2015, Springer International Publishing AG.

Other keywords

Atypical antipsychotics
Children and adolescents
Cognitive behavior therapy
Obsessive-compulsive disorder
Selective serotonin reuptake inhibitors
Treatment
Treatment-refractory
Treatment-resistant

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10.1007/s40473-015-0047-0

Cite this

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title = "Evidence-Based Treatments in Treatment-Na{\"i}ve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder",

abstract = "Pediatric obsessive-compulsive disorder (OCD) is a chronic, disabling, and common disorder. In this paper, we describe evidence-based treatments in treatment-na{\"i}ve and treatment-refractory pediatric OCD patients. We conducted a PubMed search to identify randomized controlled trials, reviews, and expert guidelines. The evidence for cognitive behavior therapy (CBT) and specific serotonin reuptake inhibitors (SSRIs) among treatment-na{\"i}ve patients is substantial and shows that both treatments are effective. Head-to-head trials in pediatric OCD only show that CBT is significantly more effective than SSRI. The evidence among CBT and SSRI non-responders is limited. One trial among CBT non-responders showed that both continued CBT and switching to an SSRI are effective strategies. Likewise, one trial among SSRI non-responders showed that augmenting with CBT is necessary. Evidence of treatments for treatment-refractory pediatric OCD is lacking. We describe the treatments available and evidence from studies of adult OCD. Evidence for emerging treatments such as modifying CBT and glutamatergic drugs is also described.",

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note = "Funding Information: The Center for Child and Adolescent Mental Health, Eastern and Southern Norway gave the main authors the support to perform this work. ? Dr. Ivarsson is consultant and Speaker?s bureau for Shire, Sweden. Dr. Skarphedinsson has no declaration of interest to report. Gudmundur Skarphedinsson has no disclosures relevant to this work. Tord Ivarsson received payment for an educational presentation/speaking engagement. This article does not contain any studies with human or animal subjects performed by any of the authors. Publisher Copyright: {\textcopyright} 2015, Springer International Publishing AG.",

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N2 - Pediatric obsessive-compulsive disorder (OCD) is a chronic, disabling, and common disorder. In this paper, we describe evidence-based treatments in treatment-naïve and treatment-refractory pediatric OCD patients. We conducted a PubMed search to identify randomized controlled trials, reviews, and expert guidelines. The evidence for cognitive behavior therapy (CBT) and specific serotonin reuptake inhibitors (SSRIs) among treatment-naïve patients is substantial and shows that both treatments are effective. Head-to-head trials in pediatric OCD only show that CBT is significantly more effective than SSRI. The evidence among CBT and SSRI non-responders is limited. One trial among CBT non-responders showed that both continued CBT and switching to an SSRI are effective strategies. Likewise, one trial among SSRI non-responders showed that augmenting with CBT is necessary. Evidence of treatments for treatment-refractory pediatric OCD is lacking. We describe the treatments available and evidence from studies of adult OCD. Evidence for emerging treatments such as modifying CBT and glutamatergic drugs is also described.

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KW - Treatment-resistant

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Evidence-Based Treatments in Treatment-Naïve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder

Abstract

Bibliographical note

Other keywords

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