Talk Therapy Combined with Medication Helps OCD Kids

Children and teens taking specific medication for obsessive-compulsive disorder (OCD) experience significant improvements in their symptoms when treated with a full course of adjunctive cognitive-behavior therapy (CBT), new research shows.

Published in the September 21^st issue of the Journal of the American Medical Association, the study sought to determine if CBT as an added treatment to drug therapy would be as effective among young patients as it is for adults.

Lead by Martin Franklin, PhD, of the University Of Pennsylvania School Of Medicine in Philadelphia, the team conducted a trial of 124 OCD-diagnosed youngsters who had been taking at least one SRI medication for a minimum of three months but still experiencing symptoms. The participants were 7 to 17 years old and were outpatients between 2004-2009 at the University of Pennsylvania, Duke University or Brown University.

SRIs, or serotonin reuptake inhibitors, belong to a class of medications frequently prescribed in varying doses for anxiety disorders and depression. Prozac, Zoloft, Paxil, and Luvox are the most common SRIs given for OCD, with the medication designed to increase serotonin activity in the brain. Serotonin is a known neurotransmitter that regulates emotions and sends messages via a network of receptors throughout the central nervous system.  

OCD is an anxiety disorder marked by ongoing obsessions and compulsions that become invasive and interfere with the ability to proceed in daily routines. Compulsions are repeated actions that individuals engage in to alleviate their persistent, anxiety-provoking obsessions. A person experiencing an excessive fear of germs, for instance, may repeatedly wash his hands to try to lessen his anxiety about contamination.  Unfortunately, the repetitive actions only aggravate the illness, though awareness of the increasing severity of the condition varies among patients.

OCD frequently begins in adolescence, but it has been evidenced in younger children as well. About 1 million children and teens in the country suffer from the psychiatric disorder, with scientists believing that biological and environmental factors play a role in its development.

CBT is a short-term form of talk therapy that follows a specific set of guidelines to help people explore and identify thoughts and feelings associated with their behaviors. The approach empowers patients to change their actions even if they cannot change certain undesirable situations. 

For this study evaluating the impact of adding CBT for young sufferers on medication, researchers randomly assigned participants to either receive 7 CBT sessions over 12 weeks with a psychologist, to receive instructions on CBT, or to remain as a control group receiving no additional treatment beyond medication.  All continued their medications throughout the trial, with 42 participants included in each group respectively. The outcomes were measured by determining if the youngsters improved their scores by at least 30% on the Children’s Yale-Brown Obsessive Compulsive Score.

The findings revealed that the group undergoing CBT along with drug therapy showed significant improvement in their OCD scores by at least 30%, a marked change not seen in the other two groups. In fact, those receiving training on CBT procedures did not show any significant improvements, prompting researchers to suggest that effective CBT with trained psychologists is critical in making an impact in the children’s condition.