Treating childhood obsessive-compulsive disorder

Background: Approximately 0.4% of children meet diagnostic criteria for OCD. These young people need effective treatment in order to reach their full potential. Methods: We used systematic review methods to identify studies evaluating OCD treatments. Applying our inclusion criteria, we accepted one systematic review which included 13 randomized controlled trials (RCTs). We also identified three RCTs published since the systematic review that met inclusion criteria.Results: Our review found strong evidence supporting a form of Cognitive-Behavioural Therapy (CBT) — Exposure and Response Prevention — for treating OCD. This therapy produced large treatment effects which persisted months after treatment ended. There was also evidence supporting the effectiveness of the medications clomipramine, fluoxetine, fluvoxamine, paroxetine and sertraline. While all medications were associated with side effects, clomipramine all resulted in serious adverse events.Conclusions: Treatment for childhood OCD should begin with CBT. Then, if needed, fluoxetine or sertraline should be considered. If medications are used, they should be carefully monitoring for both benefits and side effects.