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 .
Randomized, placebo-controlled trial of cognitive-behavioral therapy alone or combined with sertraline in the treatment of pediatric obsessive-compulsive disorder.
BACKGROUND To examine the efficacy of sequential sertraline and cognitive-behavioral therapy ( CBT ) treatment relative to CBT with pill placebo over 18 weeks in children and adolescents with obsessive-compulsive disorder ( OCD ) . METHODS Forty-seven children and adolescents with OCD ( Range = 7 - 17 years ) were r and omized to 18-weeks of treatment in one of three arms : 1 ) sertraline at st and ard dosing + CBT ( RegSert + CBT ) ; 2 ) sertraline titrated slowly but achieving at least 8 weeks on the maximally tolerated daily dose + CBT ( SloSert + CBT ) ; or 3 ) pill placebo + CBT ( PBO + CBT ) . Assessment s were conducted at screening , baseline , weeks 1 - 9 , 13 , and 17 , and post-treatment . Raters and clinicians were blinded to sertraline ( but not CBT ) r and omization status . Primary outcomes included the Children 's Yale-Brown Obsessive-Compulsive Scale , and response and remission status . Secondary outcomes included the Child Obsessive Compulsive Impact Scale-Parent/Child , Children 's Depression Rating Scale-Revised , Multidimensional Anxiety Scale for Children , and Clinical -Global Impressions-Severity . RESULTS All groups exhibited large within-group effects across outcomes . There was no group by time interaction across all outcomes suggesting that group changes over time were comparable . CONCLUSIONS Among youth with OCD , there was no evidence that sequentially provided sertraline with CBT differed from those receiving placebo with CBT . CLINICAL TRIALSGOV IDENTIFIER NCT00382291
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 .