Kunnskapsgrunnlaget for serotonin reopptakshemmere (SRIer) for tvangslidelse (OCD) hos barn og unge: perspektiver basert på en systematisk oversikt og metaanalyse

The place of and evidence for serotonin reuptake inhibitors (SRIs) for obsessive compulsive disorder (OCD) in children and adolescents: Views based on a systematic review and meta-analysis

Forfattere
Ivarsson, T. Skarphedinsson, G. Kornor, H. Axelsdottir, B. Biedilae, S. Heyman, I. Asbahr, F. Thomsen, P. H. Fineberg, N. March, J. Accreditation Task Force of The Canadian Institute for Obsessive Compulsive Disorders
Årstall
2015
Tidsskrift
Psychiatry Research
Volum
227
Sider
93-103
Serotonin reuptake inhibiting drugs (SRI) have been used in the treatment of paediatric obsessive-compulsive disorder over the past 30 years. We performed a systematic review and meta-analysis of the literature to discuss the place of and evidence for the use of SRI in paediatric OCD, based on 14 publications of methodologically sound, randomized and controlled studies. Both SRI and specific SRIs were examined and comparisons of SRI, placebo, cognitive behaviour therapy (CBT), combined (COMBO) treatments (SRI+CBT) made to investigate their relative efficacy. Using the Cochrane methodology, and as measures of effect size mean difference and Hedge's g, SRIs proved to be superior to drug placebo, with a modest effect size. From direct comparisons of CBT and SRI treatments, we conclude that CBT has the superior efficacy. COMBO versus CBT shows that SRI treatment adds little to concomitant CBT, while COMBO shows favourable outcome versus SRI alone. In pre-trial partial treatment responders, those who failed a SRI had better outcome from adding CBT as compared to continuing a SRI. Those who failed CBT treatment did as well with continued CBT as with switching to a SRI. The studies of combinations and sequences of treatments need to be developed further. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Angstproblematikk

Tvangsforstyrrelser (OCD)

Tiltak

Medikamentell behandling

Antidepressiva

Aldersgruppe

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

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