Moderators and predictors of response to cognitive behaviour therapy for pediatric obsessive-compulsive disorder : A systematic review

Journal article


Turner, Cynthia, O'Gorman, Beth, Nair, Archana and O'Kearney, Richard. (2018). Moderators and predictors of response to cognitive behaviour therapy for pediatric obsessive-compulsive disorder : A systematic review. Psychiatry Research. 261, pp. 50-60. https://doi.org/10.1016/j.psychres.2017.12.034
AuthorsTurner, Cynthia, O'Gorman, Beth, Nair, Archana and O'Kearney, Richard
Abstract

We report a systematic review of moderators of CBT efficacy for pediatric OCD relative to other treatments. CENTRAL, MEDLINE, EMBASE, CINAHL, and PsycINFO were searched for RCTs reporting on effect moderation for CBT outcomes. Five studies (N = 365) examined 17 variables with three significant moderators identified. Compared to pill-placebo, CBT monotherapy was not effective for children with a family history of OCD but was for those without a family history. For children with a family history, CBT plus sertraline efficacy was attenuated but remained significant. For children with tics, CBT but not sertraline remained superior to pill-placebo. For non-responders to initial treatment with CBT, continuing CBT was inferior to commencing sertraline for those with tics but was not different for those without tics. A supplementary review identified older age, symptom and impairment severity, co-morbidity and family accommodation as consistent predictors of a poorer outcome to CBT. Current evidence for moderation effects is post-hoc, from single RCTs, has small Ns and requires replication. The review identifies family history of OCD and the presence of tics as factors requiring further examination in properly conducted trials and about which clinicians need to show care in their treatment recommendations.

Keywordspediatric OCD; CBT; effect moderators; predictors
Year2018
JournalPsychiatry Research
Journal citation261, pp. 50-60
PublisherElsevier B.V.
ISSN0165-1781
Digital Object Identifier (DOI)https://doi.org/10.1016/j.psychres.2017.12.034
Scopus EID2-s2.0-85038913253
Open accessPublished as green open access
Page range50-60
Author's accepted manuscript
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Open
Publisher's version
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All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online20 Dec 2017
Publication process dates
Accepted13 Dec 2017
Deposited12 May 2021
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