Differensiell effekt av kognitiv atferdsterapi og medikamentell behandling av tvangslidelser hos barn: en metaanalyse

Differential efficacy of cognitive-behavioral therapy and pharmacological treatments for pediatric obsessive-compulsive disorder: a meta-analysis

Forfattere
Sanchez-Meca, J. Rosa-Alcazar, A. I. Iniesta-Sepulveda, M. Rosa-Alcazar, A.
Årstall
2014
Tidsskrift
Journal of Anxiety Disorders
Volum
28
Sider
31-44
The aim of this paper is to present a meta-analysis about the differential efficacy of cognitive-behavioral therapy (CBT), pharmacological and combined treatment for pediatric obsessive-compulsive disorder (OCD). The literature research and the application of the inclusion criteria enabled us to locate 18 studies, yielding a total of 24 independent comparisons between a treated (10 pharmacological, 11 CBT, and 3 combined interventions) and a control group. All types of interventions were efficacious in reducing obsessive-compulsive symptoms, with effect sizes adjusted by the type of control group of d=1.203 for CBT, d=0.745 for pharmacological treatments, and d=1.704 for mixed treatments. Depression, anxiety and other secondary responses were also improved, especially with CBT interventions. The analysis of moderator variables showed that the CBT protocol and the total of intervention hours exhibited a significant influence on the effect size. Within pharmacological treatment, clomipramine (d=1.305) was more efficacious than selective serotonin reuptake inhibitors (d=0.644), but its adverse effects were more severe. Finally, the clinical implications of the results are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Angstproblematikk

Angst og engstelighet (inkl. både vansker og lidelse)

Tvangsforstyrrelser (OCD)

Tiltak

Psykologiske behandlingsmetoder

Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi

Medikamentell behandling

Antidepressiva

Aldersgruppe

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

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