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Tics Moderate Sertraline, but Not Cognitive-Behavior Therapy Response in Pediatric Obsessive-Compulsive Disorder Patients Who Do Not Respond to Cognitive-Behavior Therapy.

Skarphedinsson G, Compton S, Thomsen PH, Weidle B, Dahl K, Nissen JB, Torp NC, Hybel K, Melin KH, Valderhaug R, Wentzel-Larsen T, Ivarsson T - J Child Adolesc Psychopharmacol (2015)

Bottom Line: In the Nordic Long-Term OCD Study, children and adolescents with OCD who were rated as nonresponders to 14 weeks of open-label CBT were randomized to continued CBT (n=28) or SRT treatment (n=22) for an additional 16 weeks of treatment.In patients without tic disorder, results showed no significant between-group differences on average CY-BOCS scores.Children and adolescents with OCD and comorbid tic disorder, who are nonresponders to an initial 14 week course of CBT, may benefit more from a serotonin reuptake inhibitor (SRI) than from continued CBT.

View Article: PubMed Central - PubMed

Affiliation: 1 Center for Child and Adolescent Mental Health , Eastern and Southern Norway, Oslo, Norway .

ABSTRACT

Objective: The purpose of this study was to investigate whether the presence of tic disorder is negatively associated with sertraline (SRT) outcomes, but not with continued cognitive-behavioral therapy (CBT), in a sample of youth who were unresponsive to an initial full course of CBT.

Methods: In the Nordic Long-Term OCD Study, children and adolescents with OCD who were rated as nonresponders to 14 weeks of open-label CBT were randomized to continued CBT (n=28) or SRT treatment (n=22) for an additional 16 weeks of treatment. We investigated whether the presence or absence of comorbid tic disorder moderated treatment outcomes on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS).

Results: Twelve out of 50 (24.0%) participants were diagnosed with comorbid tic disorder, with 7 receiving continued CBT and 5 receiving SRT, respectively. In patients without tic disorder, results showed no significant between-group differences on average CY-BOCS scores. However, in patients with comorbid tic disorder, those who received SRT had significantly lower average CY-BOCS scores than those who received continued CBT.

Conclusions: Children and adolescents with OCD and comorbid tic disorder, who are nonresponders to an initial 14 week course of CBT, may benefit more from a serotonin reuptake inhibitor (SRI) than from continued CBT.

No MeSH data available.


Related in: MedlinePlus

Adjusted intent-to-treat Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) total score by days from baseline by treatment and presence or absence of tic disorder.
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Related In: Results  -  Collection


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f1: Adjusted intent-to-treat Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) total score by days from baseline by treatment and presence or absence of tic disorder.

Mentions: Figure 1 displays the estimated population mean CY-BOCS growth curve trajectory over time for participants with and without tic disorder. The final model suggests that before onset of SRT, the average weekly rate of improvement on the CY-BOCS was −0.287 for participants without a comorbid tic disorder and −0.147 for participants with a comorbid tic disorder, which was not significantly different. This suggests that the rate of change during Step 1 treatments was the same for those subjects with and without a comorbid tic disorder. However, as is illustrated in Figure 1, at the onset of Step 2 treatments, those subjects who received SRT were 0.810 points higher on the CY-BOCS relative to those who received continued CBT. The average weekly rate of improvement increased to −0.293 for those without a comorbid tic disorder (2.2% faster than the corresponding rate during Step 1) and −0.573 for those with comorbid tic disorder (290% faster than the corresponding rate during Step 1) (Table 1).


Tics Moderate Sertraline, but Not Cognitive-Behavior Therapy Response in Pediatric Obsessive-Compulsive Disorder Patients Who Do Not Respond to Cognitive-Behavior Therapy.

Skarphedinsson G, Compton S, Thomsen PH, Weidle B, Dahl K, Nissen JB, Torp NC, Hybel K, Melin KH, Valderhaug R, Wentzel-Larsen T, Ivarsson T - J Child Adolesc Psychopharmacol (2015)

Adjusted intent-to-treat Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) total score by days from baseline by treatment and presence or absence of tic disorder.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4491151&req=5

f1: Adjusted intent-to-treat Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) total score by days from baseline by treatment and presence or absence of tic disorder.
Mentions: Figure 1 displays the estimated population mean CY-BOCS growth curve trajectory over time for participants with and without tic disorder. The final model suggests that before onset of SRT, the average weekly rate of improvement on the CY-BOCS was −0.287 for participants without a comorbid tic disorder and −0.147 for participants with a comorbid tic disorder, which was not significantly different. This suggests that the rate of change during Step 1 treatments was the same for those subjects with and without a comorbid tic disorder. However, as is illustrated in Figure 1, at the onset of Step 2 treatments, those subjects who received SRT were 0.810 points higher on the CY-BOCS relative to those who received continued CBT. The average weekly rate of improvement increased to −0.293 for those without a comorbid tic disorder (2.2% faster than the corresponding rate during Step 1) and −0.573 for those with comorbid tic disorder (290% faster than the corresponding rate during Step 1) (Table 1).

Bottom Line: In the Nordic Long-Term OCD Study, children and adolescents with OCD who were rated as nonresponders to 14 weeks of open-label CBT were randomized to continued CBT (n=28) or SRT treatment (n=22) for an additional 16 weeks of treatment.In patients without tic disorder, results showed no significant between-group differences on average CY-BOCS scores.Children and adolescents with OCD and comorbid tic disorder, who are nonresponders to an initial 14 week course of CBT, may benefit more from a serotonin reuptake inhibitor (SRI) than from continued CBT.

View Article: PubMed Central - PubMed

Affiliation: 1 Center for Child and Adolescent Mental Health , Eastern and Southern Norway, Oslo, Norway .

ABSTRACT

Objective: The purpose of this study was to investigate whether the presence of tic disorder is negatively associated with sertraline (SRT) outcomes, but not with continued cognitive-behavioral therapy (CBT), in a sample of youth who were unresponsive to an initial full course of CBT.

Methods: In the Nordic Long-Term OCD Study, children and adolescents with OCD who were rated as nonresponders to 14 weeks of open-label CBT were randomized to continued CBT (n=28) or SRT treatment (n=22) for an additional 16 weeks of treatment. We investigated whether the presence or absence of comorbid tic disorder moderated treatment outcomes on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS).

Results: Twelve out of 50 (24.0%) participants were diagnosed with comorbid tic disorder, with 7 receiving continued CBT and 5 receiving SRT, respectively. In patients without tic disorder, results showed no significant between-group differences on average CY-BOCS scores. However, in patients with comorbid tic disorder, those who received SRT had significantly lower average CY-BOCS scores than those who received continued CBT.

Conclusions: Children and adolescents with OCD and comorbid tic disorder, who are nonresponders to an initial 14 week course of CBT, may benefit more from a serotonin reuptake inhibitor (SRI) than from continued CBT.

No MeSH data available.


Related in: MedlinePlus