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Cognitive Behavior Therapy, SRIs Improve OCD Treatment

Better response in pediatric obsessive compulsive disorder than medication management alone

TUESDAY, Sept. 20 (HealthDay News) -- Cognitive behavior therapy (CBT) together with serotonin reuptake inhibitors (SRIs) is a better treatment for pediatric obsessive-compulsive disorder (OCD) than medication management alone, according to a study published in the Sept. 21 issue of the Journal of the American Medical Association.

Martin E. Franklin, Ph.D., from the University of Pennsylvania School of Medicine in Philadelphia, and colleagues investigated the effects of augmenting SRIs with CBT. A total of 124 outpatients between the ages of 7 and 17 years with OCD were enrolled from 2004 to 2009 and assigned to one of three treatment strategies of seven sessions over 12 weeks: medication only, medication plus CBT instruction, or medication plus CBT (including 14 concurrent sessions). An improvement in the obsessive-compulsive scale score by 30 percent or more and change in continuous score over 12 weeks were the outcome measures.

The investigators found that medication management plus CBT was superior on all outcome measures. Primary intention-to-treat analysis revealed 68.6 responders in the plus CBT group, significantly more than the 34 and 30 percent responders in the plus CBT instructions and medication management only groups, respectively. Pairwise comparisons showed the plus CBT strategy was significantly superior to the other strategies. The plus CBT instruction strategy was not significantly better than medication management alone.

"Augmentation of maintenance SRI medication with CBT was efficacious, indicating that the combination of CBT and medication is superior to medication monotherapy," the authors write.

One of the study authors disclosed financial ties to the pharmaceutical industry, including AstraZeneca, Pfizer, and Wyeth.

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