Helping children with obsessive-compulsive disorder

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Schwartz, C., Barican, J., Yung, D., Gray-Grant, D., & Waddell, C. (2022). Helping children with obsessive-compulsive disorder. Children’s Mental Health Research Quarterly, 16(1), 1–20. Vancouver, BC: Children’s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University.

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Background: An estimated 0.3% of children meet diagnostic criteria for obsessive-compulsive disorder (OCD) at any given time and are in need of treatment. Our previous systematic review, conducted nearly a decade ago, identified cognitive-behavioural therapy (CBT), fluoxetine and sertraline as effective interventions. We set out to update our review to identify any additional interventions for treating childhood OCD.

Methods:  We used systematic review methods to find recently published randomized controlled trials (RCTs) evaluating treatments for childhood OCD. We accepted 12 new RCTs, assessing both psychosocial interventions and medications, including innovative ways of delivering CBT.

Results: There is strong evidence for using a variety of forms of CBT to treat childhood OCD, including in person with children alone and with their families as well as by phone or online. Positive Family Interaction Therapy also proved to be a helpful supplement to CBT among families with indicators predictive of a limited response to CBT alone. In contrast, the medications riluzole and d-cycloserine failed to produce benefits.

Conclusions: All children diagnosed with OCD need timely access to effective treatment. CBT should be a starting point for treatment, with fluoxetine and sertraline being considered with careful monitoring when CBT does not succeed.

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