title: Differential efficacy of cognitive-behavioral therapy and pharmacological treatments for pediatric obsessive-compulsive disorder: a meta-analysis.
abstract: The aim of this paper is to present a meta-analysis about the differential efficacy of cognitive-behavioral therapy (CBT), pharmacological and combined treatment for pediatric obsessive-compulsive disorder (OCD). The literature research and the application of the inclusion criteria enabled us to locate 18 studies, yielding a total of 24 independent comparisons between a treated (10 pharmacological, 11 CBT, and 3 combined interventions) and a control group. All types of interventions were efficacious in reducing obsessive-compulsive symptoms, with effect sizes adjusted by the type of control group of d=1.203 for CBT, d=0.745 for pharmacological treatments, and d=1.704 for mixed treatments. Depression, anxiety and other secondary responses were also improved, especially with CBT interventions. The analysis of moderator variables showed that the CBT protocol and the total of intervention hours exhibited a significant influence on the effect size. Within pharmacological treatment, clomipramine (d=1.305) was more efficacious than selective serotonin reuptake inhibitors (d=0.644), but its adverse effects were more severe. Finally, the clinical implications of the results are discussed.
authors: Faculty of Psychology, Espinardo Campus, University of Murcia, 30100 Murcia, Spain. Electronic address: jsmeca@um.es.
authors: Julio
authors: J
authors: Sánchez-Meca
authors: Faculty of Psychology, Espinardo Campus, University of Murcia, 30100 Murcia, Spain. Electronic address: airosa@um.es.
authors: Ana I
authors: AI
authors: Rosa-Alcázar
authors: Faculty of Health Sciences, Campus de Los Jerónimos, Catholic University of Murcia, 30107 Murcia, Spain. Electronic address: miniesta@ucam.edu.
authors: Marina
authors: M
authors: Iniesta-Sepúlveda
authors: Faculty of Psychology, Espinardo Campus, University of Murcia, 30100 Murcia, Spain. Electronic address: arosaymj@hotmail.com.
authors: Angel
authors: A
authors: Rosa-Alcázar
mesh_terms: D002648:Child; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors
keywords: Children and adolescents; Cognitive-behavioral therapy; Meta-analysis; Obsessive–compulsive disorder; Pharmacological treatment