Obsessive-compulsive disorder in children

Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of Medicine, USA.
Psychiatric Clinics of North America (Impact Factor: 2.13). 10/2000; 23(3):519-33.
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Childhood OCD is a chronic and commonly disabling disorder with a lifetime prevalence of 2% to 3%. Traditionally OCD was a neglected diagnosis, but renewed research interest over the past decade has led to significant advances in the understanding of the disorder in young people. OCD is relatively consistent across the age span in terms of prevalence, phenomenology, etiology, and response to treatment. Comorbidity, especially depression and other anxiety disorders, is common in children with OCD and may exert a negative influence on treatment response and long-term outcome. Nevertheless, CBT and SSRI therapy have been shown to be effective and well-tolerated therapies for children with OCD.

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    • "The Anxiety Disorders Interview Schedule for Children-Parent version (ADIS-P) (Silverman and Albano, 1996) was developed specifically to diagnose anxiety disorders in children and to differentiate these from other internalizing and externalizing disorders (Silverman and Eisen, 1992). Studies that have examined the reliability of the child and parent versions of the ADIS (ADIS-C/P) have shown good interrater and retest reliability, with results suggesting that this measure has the best psychometric properties for the diagnostic assessment of childhood anxiety disorders of the available measures (Piacentini and Bergman, 2000). The ADIS-C/P has demonstrated good sensitivity to treatment effects in both childhood anxiety research (Barrett et al., 1996; Kendall, 1994) and childhood OCD research (Knox et al., 1996; Waters et al., 2001). "
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    ABSTRACT: To evaluate the relative efficacy of (1) individual cognitive-behavioral family-based therapy (CBFT); (2) group CBFT; and (3) a waitlist control group in the treatment of childhood obsessive-compulsive disorder (OCD). This study, conducted at a university clinic in Brisbane, Australia, involved 77 children and adolescents with OCD who were randomized to individual CBFT, group CBFT, or a 4- to 6-week waitlist control condition. Children were assessed before and after treatment and at 3 months and 6 months following the completion of treatment using diagnostic interviews, symptom severity interviews, and self-report measures. Parental distress, family functioning, sibling distress, and levels of accommodation to OCD demands were also assessed. Active treatment involved a manualized 14-week cognitive-behavioral protocol, with parental and sibling components. By an evaluable patient analysis, statistically and clinically significant pretreatment-to-posttreatment change occurred in OCD diagnostic status and severity across both individual and group CBFT, with no significant differences in improvement ratings between these conditions. There were no significant changes across measures for the waitlist condition. Treatment gains were maintained up to 6 months of follow-up. Contrary to previous findings and expectations, group CBFT is as effective in reducing OCD symptoms for children and adolescents as individual treatment. Findings support the efficacy and durability of CBFT in treating childhood OCD.
    Full-text · Article · Feb 2004 · Journal of the American Academy of Child & Adolescent Psychiatry
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