Cognitive-Behavioral Therapy and Anxiety and Depression Level in Pediatric Obsessive-Compulsive Disorder:A Systematic Review and Meta-Analysis

  1. Ángel Rosa-Alcázar 1
  2. Julio Sánchez-Meca 2
  3. María Rubio-Aparicio 3
  4. Cristina Bernal-Ruiz 4
  5. Ana Isabel Rosa- Alcázar 4
  1. 1 Dept. of Psychology, Catholic University of Murcia, Spain
  2. 2 Dept. Basic Psychology & Methodology, University of Murcia, Spain.
  3. 3 Department of Health Psychology, Faculty of Health Science, University of Alicante, Spain
  4. 4 Dept. Personality, Assessment & Psychological Treatment, University of Murcia, Spain
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Revista:
Psicothema

ISSN: 0214-9915,  1886-144X

Año de publicación: 2022

Volumen: 34

Número: 3

Páginas: 353-364

Tipo: Artículo

DOI: 10.7334/PSICOTHEMA2021.478 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Psicothema

Objetivos de desarrollo sostenible

Resumen

Antecedentes: Aunque algunos metanálisis han identificado posibles moderadores asociados con los resultados del tratamiento en el trastorno obsesivo compulsivo (TOC) pediátrico, todavía no existe consenso sobre la influencia de los síntomas de ansiedad y depresión en la recuperación de éste. Se realizó un metanálisis para investigar los efectos de los síntomas ansioso-depresivos y sus comorbilidades sobre la eficacia de la TCC en el TOC pediátrico, así como otras posibles variables moderadoras que pudieran estar asociados con el resultado. Método: Realizamos una búsqueda exhaustiva de la literatura desde 1983 hasta marzo de 2021 que nos permitió localizar 22 artículos publicados que aplicaban la terapia cognitivo-conductual (TCC) en el TOC pediátrico, produciendo un total de 26 grupos de tratamiento. Algunas variables moderadoras analizadas fueron: edad, sexo, comorbilidad, linea base en ansiedad, depresión y obsesion-compulsión, calidad metodológica. Resultados: Los resultados mostraron que el tratamiento psicológico del TOC consigue una eficacia clínicamente relevante, tanto para las medidas de obsesiones y compulsiones (d+= 2.030), como para la ansiedad (d+= 0,613) y la depresión (d+= 0,451). Un modelo explicativo para los tamaños del efecto CY-BOCS (Escala obsesiva compulsiva de Yale-Brown para niños) reveló que tres variables moderadoras estaban relacionadas estadísticamente: la media del CY-BOCS en el pretest, el tamaño del efecto para la ansiedad y la media de edad de la muestra. Conclusiones: La TCC redujo los síntomas obsesivo-compulsivos y, en menor medida, los síntomas de ansiedad y depresión. Dado que los síntomas de ansiedad se reducen con la misma terapia, se ahorrarían recursos con respecto a la implementación y adición de otros tratamientos.

Referencias bibliográficas

  • American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: American Psychiatric Association.
  • American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
  • Anholt, G.E., Aderka, I,M., van Balkom, A.J., Smit, J., Hermes, H., de Haan, E., & Oppen, P. (2011). The impact of depression on the treatment of obsessive–compulsive disorder: results from a 5-year follow-up. Journal of Affective Disorders, 135(1-3), 201-207. https://doi.org/10.1016/j.jad.2011.07.018
  • Barrett, P., Farrell, L., Dadds, M., & Boulter, N. (2005). Cognitive behavioral family treatment of childhood obsessive-compulsive disorder: long-term follow-up and predictors of outcome. Journal of American Academy Child Adolescent Psychiatry, 44, 1005-1014. https://doi.org/10.1097/01.chi.0000172555.26349.94
  • Barrett, P. M., Farrell, L., & March, J. S. (2004). Cognitive-behavioral family treatment of childhood obsessive compulsive disorder: a controlled trial. Journal of American Academy Child Adolescent Psychiatry, 43, 46-62. https://doi.org/10.1097/01.chi.0000172555.26349.94
  • Barrett, P.M., Farrell, L., Pina, A.A., Peris, T.S., & Piacentini, J. (2008). Evidence-based psychosocial treatments for child and adolescent obsessive–compulsive disorder. Journal of Clinical Child & Adolescent Psychology, 37(1), 131-155. https://doi.org/10.1080/15374410701817956
  • Benazon, N.R., Moore, G.J., & Rosenberg, D.R. (2003). Neurochemical analyses in pediatric obsessive-compulsive disorder in patients treated with cognitive-behavioral therapy. Journal of the American Academy of Child & Adolescent Psychiatry, 42(11), 1279-1285. https://doi.org/10.1097/01.chi.0000087562.01900.de
  • Björgvinsson, T., Wetterneck, C.T., Powell, D.M., Chasson, G.S., Webb, S.A., Hart, J., Heffelfinger, S., Azzouz, R., Entricht, T., Davidson, J., & Stanley, M. A. (2008). Treatment outcome for adolescent obsessivecompulsive disorder in a specialized hospital setting. Journal of Psychiatric Practice®, 14(3), 137-145. https://doi.org/10.1097/01.pra.0000320112.36648.3e
  • Bolton, D., Williams, T., Perrin, S., Atkinson, L., Gallop, C., Waite, P., & Salkovskis, P. (2011). Randomized controlled trial of full and brief cognitive-behaviour therapy and wait-list for paediatric obsessive-compulsive disorder. Journal of Child Psychology and Psychiatry, 52(12), 1269-1278. https://doi.org/10.1111/j.1469-7610.2011.02419.x
  • Borenstein, M.J., Hedges, L.V., Higgins, J., & Rothstein, H. (2009). Introduction to meta-analysis. Wiley.
  • Borenstein, M., Hedges, L.V., Higgins, J.P.T., & Rothstein, H. (2014). Comprehensive meta-analysis Vers. 3.3. Biostat Inc.
  • Canals, J., Hernández-Martínez, C., Cosi, S., & Voltas, N. (2012). The epidemiology of obsessive–compulsive disorder in Spanish school children. Journal of Anxiety Disorders, 26(7), 746-752. https://dx.doi.org/10.1016/j.janxdis.2012.06.003
  • Canavera, K. E., Ollendick, T.H., May, J.T.E., & Pincus, D.B. (2010). Clinical correlates of comorbid obsessive–compulsive disorder and depression in youth Child Psychiatry & Human Development, 41(6), 583-594. https://doi.org/10.1007/s10578-010-0189-y
  • Cervin, M., Perrin, S., Olsson, E., Aspvall, K., Geller, D.A., Wilhelm S,, McGuire, J., Lázaro, L., Martínez González, A., Barcaccia, B., Pozza, A., Goodman, W., Murphy, T., Seçer, İ., Piqueras, J., Rodríguez-Jiménez, T., Godoy, A., Rosa-Alcázar, A.I., Rosa-Alcázar, Á., Ruiz-García, B….& Mataix-Coles, D. (2020). The centrality of doubting and checking in the network structure of obsessive-compulsive symptom dimensions in youth. Journal of the American Academy of Child & Adolescent Psychiatry, 59(7), 880-889. https://doi.org/10.1016/j.jaac.2019.06.018
  • Chacón, S., Sanduvete, S., Portell, M., & Anguera, M. T. (2013). Reporting a program evaluation: Needs, program plan, intervention, and decisions. International Journal of Clinical and Health Psychology, 13(1), 58-66
  • Chacón-Moscoso, S., Sanduvete-Chaves, S., & Sánchez-Martín, M. (2016). The development of a checklist to enhance methodological quality in intervention programs. Frontiers in Psychology, 7, 1811. https://doi.org/10.3389/fpsyg.2016.01811
  • Farrell, L.J., Oar, E.L., Waters, A.M., McConnell, H., Tiralongo, E., Garbharran, V., & Ollendick, T. (2016). Brief intensive CBT for pediatric OCD with E-therapy maintenance. Journal of Anxiety Disorders, 42, 85-94. ttps://doi.org/10.1016/j.janxdis.2016.06.005
  • Farrell, L.J., Schlup, B., & Boschen, M.J. (2010). Cognitive–behavioral treatment of childhood obsessive–compulsive disorder in communitybased clinical practice: Clinical significance and benchmarking against efficacy. Behaviour Research Therapy, 48(5), 409-417. https://doi.org/10.1016/j.brat.2010.01.004
  • Farrell, L., Waters, A., Milliner, E., & Ollendick, T. (2012). Comorbidity and treatment response in pediatric obsessive-compulsive disorder: a pilot study of group cognitive-behavioral treatment. Psychiatry Research, 199(2), 115-123. https://doi.org/10.1016/j.psychres.2012.04.035
  • Geller, D.A., & March, J. (2012). Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. Focus, 10, 360-373. https://doi.org/10.1016/j.jaac.2011.09.019
  • Ginsburg, G.S., Kingery, J.N., Drake, K.L., & Grados, M.A. (2008). Predictors of treatment response in pediatric obsessive-compulsive disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 47(8), 868-878. https://doi.org/10.1097/CHI.0b013e3181799ebd
  • Higgins, J.P.T., Savović, J., Page, M.J., Elbers, R.G., & Sterne, J.A.C. (2021). Assessing risk of bias in a randomized trial. In J.P.T. Higgins, J. Thomas, J. Chandler, M. Cumpston, T. Li, M.J. Page, & V.A. Welch (Eds.), Cochrane handbook for systematic reviews of interventions version 6.2. Cochrane. www.training.cochrane.org/handbook.
  • Higgins, J.P.T., Thompson, S.G., Deeks, J.J., & Altman, D.G. (2003). Measuring inconsistency in meta-analyses. British Mededical Journal, 327(7414), 557-560. https://dx.doi.org/10.1136%2Fbmj.327.7414.557
  • Himle, J.A., Van Etten, M., & Fischer, D.J. (2003). Group Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder: A Review. Brief Treatment & Crisis Intervention, 3(2), 217-229.
  • Højgaard, D.R., Hybel, K.A., Mortensen, E.L., Ivarsson, T., Nissen, J.B., Weidle, B., Karin, M., Torp, N.C., Dahl, K., Valderhaug, R., Skarphedinsson, G., Storch, E.A., & Thomsen, P.H. (2018). Obsessive-compulsive symptom dimensions: association with comorbidity profiles and cognitive-behavioral therapy outcome in pediatric obsessivecompulsive disorder. Psychiatry Research, 270, 317-323. https://doi.org/10.1016/j.psychres.2018.09.054
  • Iniesta-Sepúlveda, M., Rosa-Alcázar, A.I., Sánchez-Meca, J., ParadaNavas, J.L., & Rosa-Alcázar, Á. (2017). Cognitive-behavioral high parental involvement treatments for pediatric obsessive-compulsive disorder: A meta-analysis. Journal Anxiety Disorders, 49, 53-64. https://doi.org/10.1016/j.janxdis.2017.03.010
  • Kessler, R.C., Petukhova, M., Sampson, N.A., Zaslavsky, A.M., & Wittchen, H.U. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21(13), 169- 184. https://doi.org/10.1002/mpr.1359
  • Knapp, G., & Hartung, J. (2003). Improved tests for a random effects metaregression with a single covariate. Statistics in Medicine, 22(17), 2693– 2710. https://doi.org/10.1002/sim.1482
  • Kovacs, M. (1992). Children’s depression inventory CDI manual. MultiHealth Systems.
  • Lavell, C.H., Farrell, L.J., Waters, A.M., & Cadman, J. (2016). Predictors of treatment response to group cognitive behavioural therapy for pediatric obsessive-compulsive disorder. Psychiatry Research, 245,186-193. https://doi.org/10.1016/j.psychres.2016.08.033
  • Lebowitz E.R. (2016). Treatment of extreme family accommodation in a youth with obsessive-compulsive disorder. In A.E. Storch , & Lewin, A.B. (eds), Clinical handbook of obsessive-compulsive and related disorders (pp. 321-335). Sprinter International Publishing Switzerland.
  • Lenhard, F., Vigerland, S., Andersson, E., Hallberg, A., Thermaenius, H., & Serlachius, E. (2014). Internet-delivered cognitive behavior therapy for adolescents with obsessive-compulsive disorder: an open trial. PLoS One, 9(6), e100773. https://doi.org/10.1371/journal.pone.0164311
  • March, J.S., Franklin, M., Nelson, A., & Foa, E. (2001). Cognitive-behavioral psychotherapy for pediatric obsessive-compulsive disorder. Journal of Clinical Child & Adolescent Psychology, 30(1), 8-18. https://doi.org/10.1207/S15374424JCCP3001_3
  • March, J.S., Parker, J.D., Sullivan, K., Stalling, P., & Conners, C.K. (1997). The Multidimensional Anxiety Scale for children: factor structure, reliability, and validity. Journal of the American Academy of Child & Adolescent Psychiatry, 36(4), 554-565. https://doi.org/10.1097/00004583-199704000-00019
  • Martin, J., & Thienemann, M. (2005). Group cognitive–behavior therapy with family involvement for middle-school-age children with obsessive–compulsive disorder: A pilot study. Child Psychiatry and Human Development, 36(1), 113-127. https://doi.org/10.1007/s10578-005-3496-y
  • McGuire, J.F., Piacentini, J., Lewin, A.B., Brennan, E.A., Murphy, T.K., & Storch, E.A. (2015). A meta-analysis of cognitive behavior therapy and medication for child obsessive-compulsive disorder: Moderators of treatment efficacy, response, and remission. Depression Anxiety, 32(8), 580-593. https://doi.org/10.1002/da.22389
  • Meyer, J.M., McNamara, J.P., Reid, A.M., Storch, E.A., Geffken, G.R., Mason, D.M., Murphy, T., & Bussing, R. (2014). Prospective relationship between obsessive–compulsive and depressive symptoms during multimodal treatment in pediatric obsessive–compulsive disorder. Child Psychiatry & Human Development, 45(2), 163-172. https://doi.org/10.1007/s10578-013-0388-4
  • Moher, D., Liberati, A., Tetzlaff, J., & Altman, D.G., (2009). The PRISMA Group. Preferred reporting items for systematic reviews and metaAnalyses: The PRISMA statement. PLoS Medicine, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097
  • Morris, S.B. (2000). Distribution of the standardized mean change effect size for meta-analysis on repeated measures. British Journal of Mathematical and Statistical Psychology, 53(1), 17-29. https://doi.org/10.1348/000711000159150
  • Murray, K., Jassi, A., Mataix-Cols, D., Barrow, F., & Krebs, G. (2015). Outcomes of cognitive behaviour therapy for obsessive–compulsive disorder in young people with and without autism spectrum disorders: A case controlled study. Psychiatry Research, 228(1), 8-13. https://doi.org/10.1016/j.psychres.2015.03.012
  • Olatunji, B.O., Davis, M.L., Powers, M.B., & Smits, J.A. (2013). Cognitive-behavioral therapy for obsessive-compulsive disorder: A meta-analysis of treatment outcome and moderators. Journal Psychiatry Research, 47(1), 33-41. https://doi.org/10.1016/j.jpsychires.2012.08.020
  • Olino, T. M., Gillo, S., Rowe, D., Palermo, S., Nuhfer, E. C., Birmaher, B., & Gilbert, A. R. (2011). Evidence for successful implementation of exposure and response prevention in a naturalistic group format for pediatric OCD. Depression and Anxiety, 28(4), 342-348. https://doi.org/10.1002/da.20789
  • Öst, L.G., Riise, E.N., Wergeland, G.J., Hansen, B., & Kvale, G. (2016). Cognitive behavioral and pharmacological treatments of OCD in children: A systematic review and meta-analysis. Journal of Anxiety Disorders, 43, 58-69. https://doi.org/10.1016/j.janxdis.2016.08.003
  • Peris, T.S., Rozenman, M., Bergman, R.L., Chang, S., O’Neill, J., & Piacentini, J. (2017). Developmental and clinical predictors of comorbidity for youth with obsessive compulsive disorder. Journal Psychiatry Research, 93, 72-78. https://doi.org/10.1016/j.jpsychires.2017.05.002
  • Piacentini, J., Bergman, R.L., Jacobs, C., McCracken, J.T., & Kretchman, J. (2002). Open trial of cognitive behavior therapy for childhood obsessive-compulsive disorder. Journal Anxiety Disorders, 16(2), 207- 219. https://doi.org/10.1016/S0887-6185(02)00096-8
  • Ramos-Asbahr, F., Castillo, A.R., Ito, L.M., Latorre, M.R., Moreira, M.N., & Lotufo-Neto, F. (2005). Group cognitive-behavioral therapy versus sertraline for the treatment of children and adolescents with obsessivecompulsive disorder Journal of the American Academy of Child & Adolescent Psychiatry, 44(11), 1128-1136. https://doi.org/10.1097/01.chi.0000177324.40005.6f
  • Reynolds, S.A., Clark, S., Smith, H., Langdon, P.E., Payne, R., Bowers, G., Norton, E., & McIlwham, H. (2013). Randomized controlled trial of parent-enhanced CBT compared with individual CBT for obsessivecompulsive disorder in young people. Journal of Consulting and Clinical Psychology, 81(6), 1021. https://psycnet.apa.org/doi/10.1037/a0034429
  • Rickelt, J., Viechtbauer, W., Lieverse, R., Overbeek, T., van Balkom, A.J., van Oppen P., van den Heuvel, O., Marcelis. M., Eikelenboom, M., Tibi, L., & Schruers, K. R. (2016). The relation between depressive and obsessive-compulsive symptoms in obsessive-compulsive disorder: results from a large, naturalistic follow-up study. Journal of Affective Disorders, 203, 241-247. https://doi.org/10.1016/j.jad.2016.06.009
  • Rosa-Alcázar, A.I., Iniesta-Sepúlveda, M., & Rosa-Alcázar, A. (2012). Effectiveness of cognitive-behavioral treatments of obsessive–compulsive disorder in children and adolescents: a qualitative review. Anales de Psicología, 28, 313–326.
  • Rosa-Alcázar, A.I, Sánchez-Meca, J., Rosa-Alcázar, Á., Iniesta-Sepúlveda, M., Olivares-Rodríguez, J., & Parada-Navas, J.L. (2015). Psychological treatment of obsessive-compulsive disorder in children and adolescents: a meta-analysis. The Spanish Journal of Psychology, 18, e20, 1-22. https://doi.org/10.1017/sjp.2015.22
  • Rothstein, H.R., Sutton, A.J., & Borenstein, M. (2005). Publication bias in meta-analysis: Prevention, assessment, and adjustments. Wiley.
  • Rubio-Aparicio, M., Sánchez-Meca, J., Marín-Martínez, F., & LópezLópez, J.A. (2018). Guidelines for reporting systematic reviews and meta-analyses. Anales Psicología, 34, 412-420. https://doi.org/10.6018/analesps.34.2.320131
  • Salemink, E., Wolters, L., & de Haan, E. (2015). Augmentation of treatment as usual with online cognitive bias modification of interpretation training in adolescents with obsessive compulsive disorder: a pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 49, 12-119. https://doi.org/10.1016/j.jbtep.2015.02.003
  • Sánchez-Meca, J., Rosa-Alcázar, A.I., Iniesta-Sepúlveda, M., & RosaAlcázar, Á. (2014). Differential efficacy of cognitive-behavioral therapy and pharmacological treatments for pediatric obsessive–compulsive disorder: A meta-analysis. Journal Anxiety Disorders, 28(1), 31-44. https://doi.org/10.1016/j.janxdis.2013.10.007
  • Scahill, L., Riddle, M.A., McSwiggin-Hardin, M., Ort, S.I., King, R.A., Goodman, W.K., Cicchetti, D., & Leckman, J.F. (1997). Children’s YaleBrown obsessive compulsive scale: reliability and validity. Journal of the American Academy of Child & Adolescent Psychiatry, 36(6), 844- 852. https://doi.org/10.1097/00004583-199706000-00023
  • Söchting, I., & Third, B. (2011). Behavioral group treatment for obsessivecompulsive disorder in adolescence: A pilot study. International Journal of Group Psychotherapy, 61(1), 84-97. https://doi.org/10.1521/ijgp.2011.61.1.84
  • Storch, E.A, Bagner, D.M., Geffken, G.R., Adkins, J.W., Murphy, T.K., & Goodman, W.K. (2007). Sequential cognitive-behavioral therapy for children with obsessive-compulsive disorder with and inadequate medication response: A case series of five patients. Depression and Anxiety, 24(6), 375-381. https://dx.doi.org/10.1002/da.20260
  • Storch, E.A., Bussing, R., Small, B.J., Geffken, G.R., McNamara, J.P., Rahman, O., Lewin, A., Garvan, C., Goodman, W., & Murphy, T.K. (2013). Randomized, placebo-controlled trial of cognitive-behavioral therapy alone or combined with sertraline in the treatment of pediatric obsessive–compulsive disorder. Behaviour Research and Therapy, 51(12), 823-829. https://doi.org/10.1016/j.brat.2013.09.007
  • Storch, E.A, Caporino, N.E., Morgan, J.R., Lewin, A.B., Rojas, A., Brauer, L., Larson, M.J., & Murphy, T.K. (2011). Preliminary investigation of web-camera delivered cognitive-behavioral therapy for youth with obsessive-compulsive disorder. Psychiatry Research, 189(3), 407-412.
  • Storch, E.A, Geffken, G.R, Merlo, L.J., Mann, G., Duke, D., Munson, M., Adkins, J., Grabill, K.M., Murphy, T., & Goodman, W.K. (2007). Family-based cognitive-behavioral therapy for pediatric obsessivecompulsive disorder: Comparison of intensive and weekly approaches. Journal of the American Academy of Child & Adolescent Psychiatry, 46(4), 469-478. https://doi.org/10.1097/chi.0b013e31803062e7
  • Storch, E.A., Lehmkuhl, H.D., Ricketts, E., Geffken, G.R,. Marien, W., & Murphy, T.K. (2010). An open trial of intensive family based cognitive-behavioral therapy in youth with obsessive-compulsive disorder who are medication partial responders or nonresponders. Journal of Clinical Child & Adolescent Psychology, 39(2), 260-268
  • Storch, E.A., Lewin, A.B., Geffken, G.R., Morgan, J.R., & Murphy, T.K. (2010). The role of comorbid disruptive behavior in the clinical expression of pediatric obsessive-compulsive disorder. Behaviour Research Therapy, 48(12), 1204-1210. https://doi.org/10.1016/j.brat.2010.09.004
  • Storch, E.A, Merlo, L.J., Larson, M.J., Geffken, G.R., Lehmkuhl, H.D., Jacob, M.L., Murphy, T., & Goodman, W.K. (2008). Impact of comorbidity on cognitive-behavioral therapy response in pediatric obsessive-compulsive disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 47(5), 583-592. https://doi.org/10.1097/CHI.0b013e31816774b1
  • Storch, E.A., Murphy, T.K., Geffken, G.R., Mann, G., Adkins, J., Merlo, L.J., Duke, D., Munson, M., Swaine, Z., Wayne, K., & Goodman, W.K. (2006). Cognitive-behavioral therapy for PANDAS-related obsessivecompulsive disorder: findings from a preliminary waitlist controlled open trial. Journal of the American Academy of Child & Adolescent Psychiatry, 45(10), 1171-1178. https://doi.org/10.1097/01.chi.0000231973.43966.a0
  • Thompson-Hollands, J., Edson, A., Tompson, M.C., & Comer, J.S. (2014). Family involvement in the psychological treatment of obsessive– compulsive disorder: A meta-analysis. Journal of Family Psychology, 28(3), 287. https://dx.doi.org/10.1037%2Fa0036709
  • Thienemann, M., Martin, J., Cregger, B., Thompson, H., & DyerFriedman, J. (2001). Manual-driven group cognitive-behavioral therapy for adolescents with obsessive-compulsive disorder: A pilot study. Journal of the American Academy of Child & Adolescent Psychiatry, 40(11), 1254-1260. https://doi.org/10.1097/00004583-200111000-00004
  • Torp, N.C., Dahl, K., Skarphedinsson, G., Compton, S., Thomsen, P.H., Weidle, B., Hybel, K., Valderhaug, R., Melin, K., Nissen, J., & Ivarsson, T. (2015). Predictors associated with improved cognitive-behavioral therapy outcome in pediatric obsessive-compulsive disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 54(3), 200- 207 https://doi.org/10.1016/j.jaac.2014.12.007
  • Turner, C.M. (2006). Cognitive-behavioral theory and therapy for obsessive–compulsive disorder in children and adolescents: Current status and future directions. Clinical Psychology Review, 26(7), 912- 938. https://doi.org/10.1016/j.cpr.2005.10.004
  • Turner, C., O’Gorman, B., Nair, A., & O’Kearney, R. (2018). Moderators and predictors of response to cognitive behaviour therapy for pediatric obsessive-compulsive disorder: A systematic review. Psychiatry Research, 261, 50-60. https://doi.org/10.1016/j.psychres.2017.12.034
  • Veale, D., Naismith, I., Miles, S., Gledhill, L.J., Stewart, G., & Hodsoll, J. (2016). Outcomes for residential or inpatient intensive treatment of obsessive–compulsive disorder: A systematic review and meta-analysis. Journal of Obsessive-Compulsive and Related Disorders, 8, 38–49. https://doi.org/10.1016/j.jocrd.2015.11.005
  • Verhagen, A. P., De Vet, H. C., De Bie, R. A., Kessels, A. G., Boers, M., Bouter, L. M., & Knipschild, P. G. (1998). The Delphi list: A criteria list for quality assessment of randomised clinical trials for conducting systematic reviews developed by Delphi consensus. Journal of Clinical Epidemiology, 51(12), 1235-1241.
  • Voltas, N., Hernández-Martínez, C., Arija, V., Aparicio, E., & Canals, J. (2014). A Prospective Study of Paediatric Obsessive–Compulsive Symptomatology in a Spanish Community Sample. Child Psychiatry & Human Development, 45(4), 377-387 https://doi.org/10.1007/s10578-013-0408-4
  • Whiteside, S. P., & Jacobsen, A. B. (2010). An uncontrolled examination of a 5-day intensive treatment for pediatric OCD. Behavior Therapy, 41(3), 414-422. https://doi.org/10.1016/j.beth.2009.11.003
  • American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed). Washington, DC: American Psychiatric Publishing.
  • Williams, T.I., Salkovskis, P.M., Forrester, L., Turner, S., White, H., & Allsop, M.A. (2010). A randomized controlled trial of cognitive behavioral treatment for obsessive compulsive disorder in children and adolescents. European Child & Adolescent Psychiatry, 19(5), 449-456. https://doi.org/10.1007/s00787-009-0077-9
  • Wu, M.S., McGuire, J.F., Martino, C., Phares, V., Selles, R.R., & Storch, E.A. (2016). A meta-analysis of family accommodation and OCD symptom severity. Clinical Psychology Review, 45, 34-44.
  • Wu, M.S., & Storch, E.A. (2016). Personalizing cognitive-behavioral treatment for pediatric obsessive-compulsive disorder. Expert Review of Precision Medicine and Drug Development, 1(4), 397-405. https://doi.org/10.1080/23808993.2016.1209972
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