title: [Psychotherapeutic and pharmacological treatment of pediatric obsessive-compulsive disorder].
abstract: Cognitive-behavioral therapy (CBT) and pharmacological treatments are often applied in cases of pediatric obsessive-compulsive disorder (OCD). Especially in combination both methods are particularly efficacious; nonetheless, 40 % of all patients treated remain symptomatic. Exposure with response prevention, based on the principle of habituation, is the intervention with the best evidence. More recent cognitive and metacognitive treatments focus on modifying expectations and may have the potential to improve treatment efficacy. Selective serotonin reuptake inhibitors (SSRIs) are the first line of treatment in severe cases of OCD. With treatment resistance, the SSRI should be changed, or alternatively clomipramine can be employed. Augmentation strategies suggest the combination of two SSRIs, SSRI und clomipramin, or SSRI and (atypical) neuroleptics. Following successful treatment, medication should be reduced very slowly. Novel treatments in children and adolescent have been reported for antiglutamatergic agents as riluzole or D-cycloserine, a partial agonist of N-methyl-D-aspartic acid (NMDA).
authors.affiliation: Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universitätsklinikum Aachen. tvloet@ukaachen.de
authors.forename: Timo D
authors.initials: TD
authors.lastname: Vloet
authors.forename: Michael
authors.initials: M
authors.lastname: Simons
authors.forename: Beate
authors.initials: B
authors.lastname: Herpertz-Dahlmann
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002997:Clomipramine / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003523:Cycloserine / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D018691:Excitatory Amino Acid Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D019782:Riluzole / Q000009:adverse effects / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D002997:Clomipramine; D003523:Cycloserine; D018691:Excitatory Amino Acid Antagonists; D019782:Riluzole; D017367:Selective Serotonin Reuptake Inhibitors