title: [Effectiveness of cognitive-behavioral therapy in children and adolescents with obsessive-compulsive disorders treated in an outpatient clinic].
abstract: Cognitive-behavioral therapy (CBT) is considered as treatment of first choice for children and adolescents with obsessive-compulsive disorders (OCD). However, its effectiveness has so far mostly been examined in randomized controlled trials with strictly manualized interventions. Only few studies have examined whether the effectiveness of CBT for juvenile OCD generalizes to clinical practice.
  
  
  
  To test the effectiveness of CBT under routine care conditions, data of n = 53 patients with parent-ratings and n = 53 patients with self-ratings that were treated in a university-based outpatient clinic for child and adolescent psychotherapy was analyzed. Pre-post-mean-comparisons, effect sizes and the clinical significance of changes of the symptoms were examined.
  
  
  
  OCD and comorbid symptoms were significantly reduced during treatment. Strong effect sizes (Cohen’s d) were found for parent rated (d = 0.91) and patient rated (d = 0.88) OCD symptoms. Moderate to strong pre-post-effect sizes were found for the reduction of parent rated (d = 0.55 to d = 0.87) and patient rated (d = 0.46 to d = 0.74) comorbid symptoms. The percentage of children and adolescents who achieved clinically significant improvements and no longer showed dysfunctional OCD symptoms post-treatment was 46.3 % according to the parent-ratings and 59.4 % according to the self-ratings. Concerning comorbid symptoms the same was reached for between 22.5 % and 45.5 % of the patients (parent-ratings) and between 32.0 % and 81.8 % (self-ratings) respectively.
  
  
  
  Significant reductions in both OCD and comorbid symptoms were demonstrated over the course of cognitive-behavioral therapy of juvenile OCD disorders in a university outpatient clinic for child and adolescent psychotherapy. These results indicate that routine CBT treatment is an effective way to treat juvenile OCD disorders in clinical practice.
authors.affiliation: 2 Medizinische Fakultät, Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universität zu Köln.
authors.forename: Inga
authors.initials: I
authors.lastname: Beig
authors.affiliation: 1 Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) am Klinikum der Universität zu Köln.|2 Medizinische Fakultät, Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universität zu Köln.
authors.forename: Manfred
authors.initials: M
authors.lastname: Döpfner
authors.affiliation: 1 Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) am Klinikum der Universität zu Köln.
authors.forename: Hildegard
authors.initials: H
authors.lastname: Goletz
authors.affiliation: 2 Medizinische Fakultät, Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universität zu Köln.
authors.forename: Julia
authors.initials: J
authors.lastname: Plück
authors.affiliation: 1 Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) am Klinikum der Universität zu Köln.
authors.forename: Lydia
authors.initials: L
authors.lastname: Dachs
authors.affiliation: 1 Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) am Klinikum der Universität zu Köln.
authors.forename: Claudia
authors.initials: C
authors.lastname: Kinnen
authors.affiliation: 1 Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) am Klinikum der Universität zu Köln.|2 Medizinische Fakultät, Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universität zu Köln.
authors.forename: Daniel
authors.initials: D
authors.lastname: Walter
mesh_terms: D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D015897:Comorbidity; D005196:Family Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D010044:Outpatient Clinics, Hospital; D010552:Personality Assessment / Q000706:statistics & numerical data; D011594:Psychometrics; D057566:Self Report
keywords: cognitive behaviour therapy; children and adolescents; obsessive-compulsive disorder; comorbid disorder; effectiveness; routine treatment