Universität zu Köln

Adam, Julia, Goletz, Hildegard, Dengs, Stefanie, Klingenberger, Nora, Koennecke, Sonja, Vonderbank, Christina, Hautmann, Christopher, Hellmich, Martin, Plueck, Julia and Doepfner, Manfred (2022). Extended treatment of multimodal cognitive behavioral therapy in children and adolescents with obsessive-compulsive disorder improves symptom reduction: a within-subject design. Child Adolesc. Psychiatry Ment. Health, 16 (1). LONDON: BMC. ISSN 1753-2000

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Abstract

Background: Based on the current state of research regarding the treatment in pediatric obsessive-compulsive disorder (OCD), cognitive behavioral therapy (CBT) (in severe cases with additional pharmacotherapy) is considered as the first-line treatment according to internationally recognized guidelines. Research is mostly based on randomized controlled trials (RCTs; efficacy research). Thus, examined treatment conditions, especially the treatment duration, and patients' characteristics do not necessarily correspond to those found within routine care. Studies showed CBT packages as a whole to be efficacious, but less is known about the effects of individual CBT components. Furthermore, effects on comorbid symptoms or psychosocial impairment have been often neglected and different rater perspectives have been hardly considered in previous research. Methods: This effectiveness study aimed to examine the effects of multimodal CBT in children, adolescents, and young adults (age 6-20 years) with OCD (n = 38) within routine care. Effects on obsessive-compulsive and co-existing symptoms were evaluated in a within-subject design by comparing changes during the assessment phase with 12-week standard treatment and with individually tailored extended treatment. Additionally, within the standard treatment, non-exposure treatment was compared to exposure treatment. Multi-informant assessment was applied, and the analyses included multilevel modeling and t-tests for pre-post comparisons. Results: During the standard treatment and extended treatment, obsessive-compulsive symptoms, strain, and functional impairment significantly decreased. Moreover, a significant reduction of overall comorbid symptoms emerged, particularly regarding internalizing symptoms, including anxiety and depression. Comparisons of treatment components indicated that adding exposure with response prevention (ERP) has an additional positive effect. Clinical improvement and remission rates increased considerably when more treatment sessions were provided. Conclusions: These results suggest that improvement after an initial 12-week course of treatment may not allow for the prediction of non-responders/non-remitters and for the termination of treatment. Overall, the findings show that results from randomized controlled trials are transferrable to routine care.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Adam, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Goletz, Hildegard UNSPECIFIED UNSPECIFIED UNSPECIFIED Dengs, Stefanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Klingenberger, Nora UNSPECIFIED UNSPECIFIED UNSPECIFIED Koennecke, Sonja UNSPECIFIED UNSPECIFIED UNSPECIFIED Vonderbank, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Hautmann, Christopher UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Plueck, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Doepfner, Manfred UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-658657
DOI:	10.1186/s13034-022-00537-z
Journal or Publication Title:	Child Adolesc. Psychiatry Ment. Health
Volume:	16
Number:	1
Date:	2022
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1753-2000
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SIGNAL-DETECTION ANALYSIS; PEDIATRIC OCD TREATMENT; PHARMACOLOGICAL-TREATMENTS; PSYCHOSOCIAL TREATMENTS; CLINICAL-SIGNIFICANCE; CHILDHOOD; EXPOSURE; EFFICACY; METAANALYSIS; SERTRALINE Multiple languages Pediatrics; Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/65865