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

Turner, Cynthia; O'Gorman, Beth; Nair, Archana; O'Kearney, Richard

Description

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,...[Show more]

dc.contributor.authorTurner, Cynthia
dc.contributor.authorO'Gorman, Beth
dc.contributor.authorNair, Archana
dc.contributor.authorO'Kearney, Richard
dc.date.accessioned2018-01-08T00:59:55Z
dc.identifier.issn0165-1781
dc.identifier.urihttp://hdl.handle.net/1885/139085
dc.description.abstractWe 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.
dc.format.mimetypeapplication/pdf
dc.publisherElsevier
dc.rights© 2017 Elsevier B.V.
dc.sourcePsychiatry research
dc.subjectcbt
dc.subjecteffect moderators
dc.subjectpediatric ocd
dc.subjectpredictors
dc.titleModerators and predictors of response to cognitive behaviour therapy for pediatric obsessive-compulsive disorder: A systematic review
dc.typeJournal article
local.identifier.citationvolume261
dc.date.issued2018-03
local.publisher.urlhttps://www.elsevier.com/
local.type.statusAccepted Version
local.contributor.affiliationNair, A., Research School of Psychology, The Australian National University
local.contributor.affiliationO'Kearney, R., Research School of Psychology, The Australian National University
local.identifier.essn1872-7123
local.bibliographicCitation.startpage50
local.bibliographicCitation.lastpage60
local.identifier.doi10.1016/j.psychres.2017.12.034
dcterms.accessRightsOpen Access
dc.provenancehttp://www.sherpa.ac.uk/romeo/issn/0165-1781/..."Author's post-print on open access repository after an embargo period of between 12 months and 48 months" from SHERPA/RoMEO site (as at 8/01/18).
CollectionsANU Research Publications

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