Selles Robert R, Naqqash Zainab, Best John R, Franco-Yamin Diana, Qiu Serene T, Ferreira Jessica S, Deng Xiaolei, Hannesdottir Dagmar Kr, Oberth Carla, Belschner Laura, Negreiros Juliana, Farrell Lara J, Stewart S Evelyn
British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Front Psychiatry. 2021 May 17;12:669494. doi: 10.3389/fpsyt.2021.669494. eCollection 2021.
Optimizing individual outcomes of cognitive-behavioral therapy (CBT) remains a priority. Youth were randomized to receive intensive CBT at a hospital clinic ( = 14) or within their home ( = 12). Youth completed 3 × 3 h sessions (Phase I) and up to four additional 3-h sessions as desired/needed (Phase II). An independent evaluator assessed youth after Phase I, Phase II (when applicable), and at 1- and 6-months post-treatment. A range of OCD-related (e.g., severity, impairment) and secondary (e.g., quality of life, comorbid symptoms) outcomes were assessed. Families' satisfaction with the treatment program was high. Of study completers ( = 22), five youth (23%) utilized no Phase II sessions and 9 (41%) utilized all four (Median Phase II sessions: 2.5). Large improvements in OCD-related outcomes and small-to-moderate benefits across secondary domains were observed. Statistically-significant differences in primary outcomes were not observed between settings; however, minor benefits for home-based treatment were observed (e.g., maintenance of gains, youth comfort with treatment). Intensive CBT is an efficacious treatment for pediatric OCD. Families opted for differing doses based on their needs. Home-based treatment, while not substantially superior to hospital care, may offer some value, particularly when desired/relevant. www.ClinicalTrials.gov; https://clinicaltrials.gov/ct2/show/NCT03672565, identifier: NCT03672565.
优化认知行为疗法（CBT）的个体治疗效果仍是首要任务。青少年被随机分为两组，一组在医院诊所接受强化CBT治疗（n = 14），另一组在自己家中接受治疗（n = 12）。青少年完成了3次每次3小时的治疗课程（第一阶段），并根据需要/意愿最多再接受4次每次3小时的治疗课程（第二阶段）。一名独立评估人员在第一阶段、第二阶段（如适用）以及治疗后1个月和6个月时对青少年进行评估。评估了一系列与强迫症相关的结果（如严重程度、功能损害）和次要结果（如生活质量、共病症状）。家庭对治疗方案的满意度很高。在完成研究的参与者（n = 22）中，5名青少年（23%）未使用第二阶段的治疗课程，9名（41%）使用了全部4次（第二阶段治疗课程的中位数：2.5次）。观察到与强迫症相关的结果有大幅改善，在次要领域有小到中等程度的益处。在不同治疗环境之间未观察到主要结果的统计学显著差异；然而，观察到家庭治疗有一些微小益处（如治疗效果的维持、青少年对治疗的舒适度）。强化CBT是治疗儿童强迫症的有效方法。家庭根据自身需求选择了不同剂量的治疗。家庭治疗虽然在本质上并不优于医院治疗，但可能具有一定价值，特别是在有需求/相关的情况下。www.ClinicalTrials.gov；https://clinicaltrials.gov/ct2/show/NCT03672565，标识符：NCT03672565。
