Nadeau Joshua M, Jordan Cary, Selles Robert R, Wu Monica S, King Morgan A, Patel Priyal D, Hanks Camille E, Arnold Elysse B, Lewin Adam B, Murphy Tanya K, Storch Eric A
1 Department of Pediatrics, University of South Florida , St. Petersburg, Florida.
J Child Adolesc Psychopharmacol. 2015 May;25(4):337-43. doi: 10.1089/cap.2014.0149.
This study reports an open trial of family-based cognitive-behavioral therapy (CBT) in children and adolescents with obsessive-compulsive disorder (OCD) exhibiting an onset pattern consistent with pediatric acute-onset neuropsychiatric syndrome (PANS).
Eleven primarily Caucasian youth with PANS-related OCD (range=4-14 years; 6 boys) who were incomplete responders to antibiotic treatment, received family-based CBT delivered either face-to-face or via web camera.
All participants completing treatment (8 of 8) were considered improved at posttreatment, and average obsessive-compulsive symptom severity was reduced by 49%. Significant reductions in obsessive-compulsive symptom severity and in clinician- and parent-rated OCD-related impairment were noted. Reductions in parent- and child-rated anxiety, child-rated OCD-related impairment, and comorbid neuropsychiatric symptoms were not statistically significant.
Gains were maintained at follow-up, with 100% (6 of 6) of those assessed remaining improved. Implications for treatment and further research are discussed.
本研究报告了一项针对患有强迫症（OCD）且发病模式与儿童急性起病神经精神综合征（PANS）一致的儿童和青少年的基于家庭的认知行为疗法（CBT）的开放性试验。
11名主要为白人的患有与PANS相关的OCD的青少年（年龄范围=4至14岁；6名男孩），他们对抗生素治疗反应不完全，接受了面对面或通过网络摄像头提供的基于家庭的CBT。
所有完成治疗的参与者（8名中的8名）在治疗后被认为有所改善，强迫症症状严重程度平均降低了49%。强迫症症状严重程度以及临床医生和家长评定的与OCD相关的损害均有显著降低。家长和儿童评定的焦虑、儿童评定的与OCD相关的损害以及共病神经精神症状的降低无统计学意义。
随访时疗效得以维持，接受评估的患者中有100%（6名中的6名）仍有改善。讨论了对治疗和进一步研究的启示。
