Torp Nor Christian, Dahl Kitty, Skarphedinsson Gudmundur, Thomsen Per Hove, Valderhaug Robert, Weidle Bernhard, Melin Karin Holmgren, Hybel Katja, Nissen Judit Becker, Lenhard Fabian, Wentzel-Larsen Tore, Franklin Martin E, Ivarsson Tord
Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway; Department of Child and Adolescent Psychiatry, Division of Mental Health and Addiction, Vestre Viken Hospital, Drammen, Norway.
Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
Behav Res Ther. 2015 Jan;64:15-23. doi: 10.1016/j.brat.2014.11.005. Epub 2014 Nov 21.
The purpose of this study was to examine the acute effectiveness of manualized exposure-based CBT with a family-based treatment, as an initial treatment for pediatric OCD delivered in regular community child and adolescents outpatient clinics. The report summarizes outcome of the first treatment step in the NordLOTS, which was conducted in Denmark, Sweden and Norway.
269 participants, age 7-17, with OCD, received treatment for 14 weekly sessions. Treatment response was defined as CY-BOCS score of ≤15 at post treatment.
241 participants (89.6%) completed all 14 weeks of treatment. Treatment response among the completers was 72.6% (95% CI 66.7%-77.9%). Mixed effects model revealed a statistically significant effect of time F(1,479) = 130.434. Mean symptom reduction on the CY-BOCS was 52.9% (SD = 30.9). The estimated within-group effect size between baseline and post treatment was 1.58 (95% CI: 1.37-1.80).
This study found that manualized CBT can be applied effectively in community mental health clinics. These findings underscore the feasibility of implementing exposure-based CBT for pediatric OCD in a regular child and adolescent mental health setting.
This study was registered in Current Controlled Trials; Nordic Long-term Obsessive-compulsive disorder (OCD) Treatment Study (www.controlled-trials.com ISRCTN66385119).
本研究旨在探讨以家庭治疗为基础的手动暴露认知行为疗法（CBT）作为常规社区儿童和青少年门诊治疗小儿强迫症的初始治疗方法的急性疗效。本报告总结了在丹麦、瑞典和挪威进行的NordLOTS研究中第一步治疗的结果。
269名年龄在7至17岁之间的强迫症患者接受了为期14周的每周一次治疗。治疗反应定义为治疗后儿童耶鲁布朗强迫症量表（CY - BOCS）评分为≤15分。
241名参与者（89.6%）完成了全部14周的治疗。完成治疗者的治疗反应率为72.6%（95%可信区间66.7% - 77.9%）。混合效应模型显示时间具有统计学显著效应F(1,479) = 130.434。CY - BOCS症状平均减轻52.9%（标准差 = 30.9）。基线与治疗后组内效应量估计值为1.58（95%可信区间：1.37 - 1.80）。
本研究发现手动CBT可在社区心理健康诊所有效应用。这些发现强调了在常规儿童和青少年心理健康环境中实施小儿强迫症暴露认知行为疗法的可行性。
本研究已在“当前对照试验”注册；北欧长期强迫症（OCD）治疗研究（www.controlled-trials.com ISRCTN66385119）。
