Group cognitive-behavioral therapy versus sertraline for the treatment of children and adolescents with obsessive-compulsive disorder.
OBJECTIVE
To compare the effectiveness of group cognitive-behavioral therapy (GCBT) and of sertraline in treatment-naïve children and adolescents with obsessive-compulsive disorder.


METHODS
Between 2000 and 2002, 40 subjects between 9 and 17 years old were randomized to receive GCBT (n = 20) or sertraline (n = 20). GCBT consisted of a manual-based 12-week cognitive-behavioral protocol adapted for groups, and treatment with sertraline involved medication intake for 12 weeks. Subjects were assessed before, during, and after treatment (at 1, 3, 6, and 9 months after treatment conclusion). Primary outcome measure was the Children's Yale-Brown Obsessive-Compulsive Scale. Repeated-measures analyses of variance were done.


RESULTS
Both GCBT and sertraline conditions had significant improvement in obsessive-compulsive disorder symptoms as measured by the Children's Yale-Brown Obsessive-Compulsive Scale after 12 weeks of treatment. After the 9-month follow-up period, subjects in the GCBT condition had a significantly lower rate of symptom relapse than those in the sertraline group.


CONCLUSIONS
The treatment with GCBT may be effective in decreasing obsessive-compulsive symptoms in childhood obsessive-compulsive disorder and should be considered as an alternative to either individual cognitive-behavioral therapy or a medication, such as sertraline. Results support the effectiveness and the maintenance of gains of GCBT in the treatment of youngsters with obsessive-compulsive disorder.
Asbahr
Fernando Ramos
FR
Laboratory of Medical Investigation (LIM-23), University of São Paulo Medical School, São Paulo, Brazil. frasbahr@usp.br
Castillo
Ana Regina
AR
Ito
Ligia Montenegro
LM
Latorre
Maria Rosário Dias de Oliveira
MR
Moreira
Michele Nunes
MN
Lotufo-Neto
Francisco
F
D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D011615:Psychotherapy, Group; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*
D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline