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Intensive Cognitive Behavioural Treatment Has Slight Edge as OCD Treatment: Presented at ADAA

By Jill Stein

ST. LOUIS, MO -- April 4, 2007 -- While both intensive and weekly cognitive-behavioural treatment (CBT) eventually provide similar extent of improvement for obsessive-compulsive disorder (OCD), intensive treatment may be "somewhat more expedient," researchers reported here at the 27^th Annual Meeting of the Anxiety Disorders Association of America (ADAA).

Eric A. Storch, PhD, assistant professor, departments of psychiatry and paediatrics, University of Florida, Gainesville, Florida, United States, and associates randomised 40 children and adolescents with OCD to weekly or intensive CBT.

"Cognitive-behavioural treatment with exposure and response prevention alone or with concurrent pharmacotherapy is the first-line therapy for OCD," Dr. Storch said in his presentation on March 31^st. "However, a primary limitation remains access to practitioners since most research on CBT has been done in specialised academic centres rather than in routine clinical settings. Thus, patient access to treatment is limited by the availability of trained therapists, and most patients receive no treatment, medication alone, and/or non-CBT psychotherapy."

A potential solution, he added, is intensive CBT.

In the trial, participants randomised to intensive CBT received individual CBT sessions each weekday for 3 weeks for a total of 14 sessions. Treatment included psychoeducation, cognitive training, and exposure with response prevention. Sessions were conducted in a family-based format by teams of therapists.

Participants randomised to weekly CBT received 14 weekly CBT sessions. Sessions were conducted in a family-based format by an individual therapist.

Patients were assessed prior to treatment, after treatment was completed, and at 3-month follow up.

At post-treatment follow up, patients in both intensive and weekly treatment protocols showed marked improvements, with effect sizes of 2.62 and 1.73, respectively, on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOS).

In addition, 90% of the 20 children in the intensive group and 65% of the 20 in the weekly group were considered treatment responders according to the Clinical Global Improvement (CGI) measure.

At the 3-month follow up, 75% of children in the intensive group and 50% in the weekly group were classified as responders. The differences between the 2 groups were not significant at this time point.

Dr. Storch said that intensive treatment may be well suited for children with severe symptoms or functional impairment (e.g., not going to school) with a view towards minimising the duration of illness or impact of illness.

Obsessive-compulsive disorder affects 1% to 4% of the general population.


[Presentation title: Cognitive Behavioral Treatment for Pediatric Obsessive-Compulsive Disorder: Comparison of Intensive Versus Weekly Treatment. Abstract 48]

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