Using the Cochrane methodology , and as measures of effect size mean difference and Hedge 's g , SRIs proved to be superior to drug placebo , with a modest effect size .
From direct comparisons of CBT and SRI treatments , we conclude that CBT has the superior efficacy .
COMBO versus CBT shows that SRI treatment adds little to concomitant CBT , while COMBO shows favourable outcome versus SRI alone .
In pre-trial partial treatment responders , those who failed a SRI had better outcome from adding CBT as compared to continuing a SRI .
Those who failed CBT treatment did as well with continued CBT as with switching to a SRI .
Serotonin reuptake inhibiting drugs ( SRI ) have been used in the treatment of paediatric obsessive-compulsive disorder over the past 30 years .
Long-term sertraline treatment of children and adolescents with obsessive-compulsive disorder.
OBJECTIVE To evaluate the safety and effectiveness of sertraline in the long-term treatment of pediatric obsessive-compulsive disorder ( OCD ) . METHOD Children ( 6 - 12 years ; n= 72 ) and adolescents ( 13 - 18 years ; n = 65 ) with DSM-III-R-defined OCD who had completed a 12-week , double-blind , placebo-controlled sertraline study were given open-label sertraline 50 to 200 mg/day in this 52-week extension study . Concomitant psychotherapy was allowed during the extension study Outcome was evaluated by the Children 's Yale-Brown Obsessive Compulsive Scale ( CY-BOCS ) , National Institute of Mental Health Global Obsessive-Compulsive Scale , and Clinical Global Impression Severity ( CGI-S ) and Improvement ( CGI-I ) scores . RESULTS Significant improvement ( p < .0001 ) was demonstrated on all four outcome parameters on an intent-to-treat analysis for the overall study population ( n = 132 ) , as well as the child and the adolescent sample s. At endpoint , 72 % of children and 61 % of adolescents met response criteria ( > 25 % decrease in CY-BOCS and a CGI-I score of 1 or 2 ) . Significant ( p < .05 ) improvements were also demonstrated from the extension study baseline to endpoint on all outcome parameters in those patients who received sertraline during the 12-week , double-blind acute study . Long-term sertraline treatment was well tolerated , and there were no discontinuations due to changes in vital signs , laboratory values , or electrocardiograms . CONCLUSION Sertraline ( 50 - 200 mg/day ) was effective and generally well tolerated in the treatment of childhood and adolescent OCD for up to 52 weeks . Improvement was seen with continued treatment
Using the Cochrane methodology , and as measures of effect size mean difference and Hedge 's g , SRIs proved to be superior to drug placebo , with a modest effect size .
From direct comparisons of CBT and SRI treatments , we conclude that CBT has the superior efficacy .
COMBO versus CBT shows that SRI treatment adds little to concomitant CBT , while COMBO shows favourable outcome versus SRI alone .
In pre-trial partial treatment responders , those who failed a SRI had better outcome from adding CBT as compared to continuing a SRI .
Those who failed CBT treatment did as well with continued CBT as with switching to a SRI .
Serotonin reuptake inhibiting drugs ( SRI ) have been used in the treatment of paediatric obsessive-compulsive disorder over the past 30 years .