Cognitive-Behavioral Therapy with Medication Enhances OCD Treatment

Since a person is multi-dimensional, doesn’t it make sense that treatment of a person’s illness could be enhanced when delivered using a multi-dimensional approach – particularly if the illness manifests on more than one level? That was the idea behind recent research that tested various methodologies for the treatment of pediatric obsessive compulsive disorder.

Obsessive compulsive disorder, commonly referred to as OCD, affects as many as 1 in 50 people in the United States. Around 1 percent of children in the U.S. suffer with the condition, which is characterized by rituals and obsessive thinking that may consume as much as one hour per day. It is more common than many childhood disorders or illnesses, but often goes unrecognized until somewhere between the ages of 7 and 12.

The most common treatment for OCD in young people is pharmacological. Children and teens are given serotonin uptake inhibitors called SRIs. Even though it is the standard, SRI treatment usually only provides a partial response.

Research conducted at three medical centers during 2004-2009 experimented with adding cognitive behavioral therapy to the medicinal regimen currently used to treat juvenile OCD. Cognitive behavioral therapy is psychotherapy grounded in the idea that a person’s thoughts cause their feelings and behaviors rather than anything external. Cognitive behavioral therapy (CBT) emphasizes the reality that people can change even when situations and other external factors do not. CBT is effective in treating a spectrum of mental disorders, including depression and anxiety, and is used in treatment of adult OCD.

The study, known as the Pediatric Obsessive-Compulsive Disorder Treatment Study, measured outcomes for 124 outpatients aged 7-17 who had received a primary OCD diagnosis. The trial used a 12-week randomized, controlled trial to check effects of adding CBT to medicinal treatment of OCD. Participants in the study were randomly designated to one of three groups: medication management alone; medication and full CBT; and medication with brief CBT (brief meaning instruction only). Those receiving CBT did so during their regular medication management sessions.

By the study’s end, outcomes were measured in terms of percentages of children with a minimum of a reduction of 30 percent in the Children’s Yale-Brown Obsessive Compulsive Scale baseline. Which group showed the most marked improvement? Here are the results:

  • 69 percent of those receiving full CBT
  • 34 percent of those receiving brief CBT
  • 30 percent of those receiving medication management only

Medication alone does not yield the best outcomes. The researchers expressed a desire to see CBT made more widely available as part of pediatric OCD treatment. The study was published in the September 2011 issue of the Journal of the American Medical Association.

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