de Haan E, Hoogduin K A, Buitelaar J K, Keijsers G P
Outpatient Department, Reinier de GraafGasthuis, Delft, The Netherlands.
J Am Acad Child Adolesc Psychiatry. 1998 Oct;37(10):1022-9. doi: 10.1097/00004583-199810000-00011.
To compare, via a pilot study, the effectiveness of behavior therapy and of drug treatment in children and adolescents with obsessive-compulsive disorder.
Twenty-two children aged between 8 and 18 years were randomly assigned to behavior therapy (n = 12) or open clomipramine (n = 10) in a parallel design lasting 12 weeks. Behavior therapy included exposure and response prevention administered in weekly sessions. The mean dosage of clomipramine was 2.5 mg/kg (range = 1.4-3.3 mg/kg). The main outcome variables were the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) and the Leyton Obsessional Inventory-Child Version (LOI-CV).
Significant improvement was obtained in both treatment conditions. Behavior therapy produced stronger therapeutic changes than clomipramine on the CY-BOCS (p < .05), whereas on the LOI-CV no significant differences between the results of the two treatments were found. Five of the nine initial nonresponders showed significant changes after extension of treatment for another 12 weeks.
Behavior therapy is shown to be a good alternative for drug treatment and deserves further study in larger samples of children with obsessive-compulsive disorder.
通过一项初步研究，比较行为疗法与药物治疗对患有强迫症的儿童和青少年的有效性。
22名年龄在8至18岁之间的儿童被随机分配至行为疗法组（n = 12）或开放性氯米帕明组（n = 10），采用平行设计，为期12周。行为疗法包括每周进行的暴露与反应预防。氯米帕明的平均剂量为2.5毫克/千克（范围 = 1.4 - 3.3毫克/千克）。主要结局变量为儿童耶鲁-布朗强迫症量表（CY - BOCS）和莱顿强迫观念量表儿童版（LOI - CV）。
两种治疗条件下均取得了显著改善。在CY - BOCS上，行为疗法比氯米帕明产生了更强的治疗变化（p <.05），而在LOI - CV上，两种治疗结果之间未发现显著差异。9名初始无反应者中有5名在再延长治疗12周后出现了显著变化。
行为疗法被证明是药物治疗的一个良好替代方案，值得在更大样本的强迫症儿童中进行进一步研究。
