Cognitive Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder
Condition: Obsessive-Compulsive Disorder
MeSH terms: Compulsive Personality Disorder; Obsessive-Compulsive Disorder
Study type: Interventional

Summary: 
      This study will examine the way cognitive behavioral therapy changes the structure of the
      brain in patients with obsessive-compulsive disorder and will thereby determine what makes
      cognitive behavioral therapy an effective treatment.
    

Detailed description: 
      Obsessive-compulsive disorder (OCD) afflicts 2% to 4% of children and adolescents, who suffer
      from persistent, unwanted thoughts and repetitive behaviors. One of the most effective
      treatments of OCD is cognitive behavioral therapy (CBT), yet researchers do not know how CBT
      affects the brain. In this study, brain scans will be performed to determine concentrations
      of several neurometabolites, which are chemicals involved in providing energy to the brain.
      Of particular importance are the neurometabolites glutamine and glutamate, which, in addition
      to providing energy to the brain, are among the most common excitatory neurotransmitters.
      Disruption of glutamine and glutamate is thought to be related to OCD. By examining where in
      the brain levels of glutamate and glutamine change, researchers will attempt to determine
      whether CBT modifies brain activity, whether a circuit targeted by researchers is affected by
      CBT, and how brain activity in people with OCD differs from that of people without the
      disorder in terms of the targeted circuit.

      Children and adolescents ages 8 through 17 with OCD will be randomly assigned to either
      receive a 12-week CBT intervention or be placed on a waiting list for 8 weeks before
      receiving the 12-week intervention. A group of non-OCD participants in the same age group
      will be used as a control. All groups will undergo magnetic resonance spectroscopic imaging
      (MRSI), which will measure the concentrations of neurometabolites in multiple brain regions.
      The control group and the group initially given the CBT intervention will be scanned upon
      entry of the study and after 12 weeks. The group initially placed on a waiting list will be
      scanned three times: once upon entry, once after the 8-week waiting period, and once after
      the 12-week CBT intervention. To determine which participants are benefitting from the
      treatment, the Yale-Brown Obsessive-Compulsive Scale and other clinical and neurocognitive
      measures will be administered concurrently with each brain scan.
    

Intervention name(s): Cognitive Behavioral Therapy (CBT); Waitlist
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Nondrug psychotherapy administered weekly for 12 weeks; Contact waitlist weekly for 12 weeks
Other intervention name(s): Behavioral therapy; Psychotherapy; Exposure and response prevention; Waiting for treatment; In line for treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Obsessive-Compulsive Disorder; OCD; Cognitive-Behavioral Therapy; CBT; MRSI; Glutamate