Behavior therapy versus clomipramine for the treatment of obsessive-compulsive disorder in children and adolescents.
OBJECTIVE
To compare, via a pilot study, the effectiveness of behavior therapy and of drug treatment in children and adolescents with obsessive-compulsive disorder.


METHODS
Twenty-two children aged between 8 and 18 years were randomly assigned to behavior therapy (n = 12) or open clomipramine (n = 10) in a parallel design lasting 12 weeks. Behavior therapy included exposure and response prevention administered in weekly sessions. The mean dosage of clomipramine was 2.5 mg/kg (range = 1.4-3.3 mg/kg). The main outcome variables were the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) and the Leyton Obsessional Inventory-Child Version (LOI-CV).


RESULTS
Significant improvement was obtained in both treatment conditions. Behavior therapy produced stronger therapeutic changes than clomipramine on the CY-BOCS (p < .05), whereas on the LOI-CV no significant differences between the results of the two treatments were found. Five of the nine initial nonresponders showed significant changes after extension of treatment for another 12 weeks.


CONCLUSIONS
Behavior therapy is shown to be a good alternative for drug treatment and deserves further study in larger samples of children with obsessive-compulsive disorder.
de Haan
E
E
Outpatient Department, Reinier de GraafGasthuis, Delft, The Netherlands. E.deHaan@amc.uva.nl
Hoogduin
K A
KA
Buitelaar
J K
JK
Keijsers
G P
GP
D001521:Behavior Therapy; D002648:Child; D002997:Clomipramine / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D010043:Outcome and Process Assessment, Health Care; D010552:Personality Assessment; D010865:Pilot Projects; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*
D002997:Clomipramine; D017367:Selective Serotonin Reuptake Inhibitors