Research shows behavioural and cognitive behavioural therapy work just as well as medication to treat obsessive compulsive disorder
O’Kearney RT, Anstey KJ, von Sanden C
The Bottom Line:
This review of four good quality studies found that behavioural and cognitive behavioural therapy (BT/CBT) is at least as effective as medication in treating the symptoms of obsessive compulsive disorder (OCD). A combination of BT/CBT and medication works better than medication alone to relieve the symptoms, but not better than BT/CBT alone. There is no evidence to determine if medication or BT/CBT should be offered first. |
What problem is being addressed?
Children and teenagers can suffer from a condition called obsessive compulsive disorder (OCD) in which they have persistent, unwanted thoughts and impulses to do or say inappropriate things. These behaviours and thoughts can cause anxiety and disrupt daily life for these young people and their families.
Although medication has been found to be effective in adults with OCD, and there is some good evidence that they work in young patients, some parents and practitioners do not wish to use them in children or teenagers. In other disorders such as depression or anxiety, CBT has been found to be effective for this age group. If this is also true for OCD, it could provide an attractive alternative for parents who wish to avoid medication.
What intervention is being tested?
This systematic review assessed the results for 222 children and teens who had participated in 4 different studies of behavior therapy (BT) and/or cognitive behavioural therapy (CBT), medication, or combinations of each.
What is the real scientific evidence?
The studies assessed in this review looked at whether or not BT/CBT singly or in combination with medication worked, and whether either treatment worked better than the other to produce good outcomes in children and adolescents with OCD.
The results showed that:
- BT/CBT worked better than a placebo
- neither BT/CBT nor medication, when used alone, is superior to the other
- BT/CBT combined with medication works better than medication alone
- medication combined with BT/CBT does not produce better outcomes than BT/CBT alone
The preceding is a summary of:
Geller DA, Biederman J, Stewart SE, Mullin B, Martin A, Spencer T, Faraone SV. Which SSRI? A Meta-Analysis of Pharmacotherapy Trials in Pediatric Obsessive-Compulsive Disorder. American Journal of Psychiatry 2003, 160(11): 1919-1928.
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