Psychological Treatment for Obsessive-Compulsive Disorder in People with Autism Spectrum Disorders - A Pilot Study

Department of Psychology, Institute of Psychiatry, Kings College London, London, UK.
Psychotherapy and Psychosomatics (Impact Factor: 9.37). 12/2008; 78(1):59-61. DOI: 10.1159/000172622
Source: PubMed

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Available from: David Mataix-Cols, Oct 14, 2014
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    • "orted " significant progress in terms of reducing ( the participants ' ) frequency of checking " ( p . 15 ) following CBT based on the March and Mulle ( 1998 ) manual , although the authors reported no data . Three experiments used group designs , although Wood et al . ( 2009 ) did not report the effects of treatment specifically on OCD symptoms . Russell et al . ( 2008 ) investigated CBT and exposure and response prevention for treatment of OCD in 24 high - functioning adults with ASD using a nonrandomized between - groups design . To help distinguish OCD from ASD symptoms , OCD symptoms were only included for treatment if they caused some degree of distress and interfered with the individual ' s dail"
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    ABSTRACT: The purpose of this paper is to systematically review empirical evidence for the assessment and treatment of obsessive–compulsive disorder (OCD) among individuals with autism spectrum disorders (ASD). Systematic searches were conducted in electronic databases, reference lists, and journals. Fifty-five studies met inclusion criteria: 21 studies investigating prevalence, symptom presentation, and assessment, as well as 34 intervention studies investigating 14 different interventions. Based on the Chambless criteria for treatment efficacy, four treatments (behavior analysis and behavior modification, risperidone, fluoxetine, and fluvoxamine for adults) met criteria for possible efficacious interventions for OCD among individuals with ASD. Positive intervention outcomes were reported in the majority of studies, but there was not enough research to make firm conclusions regarding efficacy of other treatments.
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    ABSTRACT: Cognitive behaviour therapy (CBT) and selective serotonin reuptake inhibitors have both been established as effective interventions for paediatric obsessive-compulsive disorder (OCD), with CBT being the recommended first-line treatment in most cases. While the majority of young people respond well to these treatments, a significant proportion remain symptomatic. Although the research on treatment-resistant OCD remains limited, increasing empirical attention is being paid to predictors of treatment outcome in young people with OCD, and efforts are being made to identify the factors that hinder recovery. This article outlines potential barriers in treatment and highlights strategies for optimising outcome, with particular focus on cognitive behavioural techniques.
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    ABSTRACT: High rates of anxiety disorders, particularly obsessive compulsive disorder (OCD) are reported in people with Autism spectrum disorders (ASD). Group cognitive behavioral treatment (CBT) has been found effective for anxiety in young people with ASD but not been OCD specific. One uncontrolled pilot study of individual CBT for OCD for adults with ASD showed good treatment efficacy. Forty-six adolescents and adults (mean age 26.9 years, 35 Males) with ASD and comorbid OCD were randomized to CBT for OCD or anxiety management (AM), a plausible control treatment. Treatments were matched in duration (mean of 17.4 sessions CBT; 14.4 sessions AM), the Yale–Brown Obsessive Compulsive Severity Scale (YBOCS) as primary outcome measure and evaluations blind to treatment group. Treatment response was defined as > 25% reduction in YBOCS total severity scores. Both treatments produced a significant reduction in OCD symptoms, within-group effect sizes of 1.01 CBT group and 0.6 for the AM group. There were no statistically significant differences between the two groups at end of treatment, although more responders in the CBT group (45 versus 20%). Effect sizes for self-rated improvement were small (0.33 CBT group; –0.05 AM group). Mild symptom severity was associated with improvement in the AM but not the CBT group. Family/carer factors were important for both groups, in that increased family accommodation was associated with poorer outcome. Evidence-based psychological interventions, both AM and CBT, were effective in treating comorbid OCD in young people and adults with ASD.
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