[article]
| Titre : |
Efficacy and acceptability of cognitive-behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive-compulsive disorder: a network meta-analysis |
| Type de document : |
texte imprimé |
| Auteurs : |
Matti CERVIN, Auteur ; Joseph F. MCGUIRE, Auteur ; Johann M. D'SOUZA, Auteur ; Alessandro S. DE NADAI, Auteur ; Kristina ASPVALL, Auteur ; Wayne K. GOODMAN, Auteur ; Per ANDRÉN, Auteur ; Sophie C. SCHNEIDER, Auteur ; Daniel A. GELLER, Auteur ; David MATAIX-COLS, Auteur ; Eric A. STORCH, Auteur |
| Article en page(s) : |
p.594-609 |
| Langues : |
Anglais (eng) |
| Index. décimale : |
PER Périodiques |
| Résumé : |
Background Cognitive-behavioral therapy (CBT) and serotonin reuptake inhibitors (SRIs) are recommended treatments for pediatric obsessive-compulsive disorder (OCD), but their relative efficacy and acceptability have not been comprehensively examined. Further, it remains unclear whether the efficacy of in-person CBT is conserved when delivered in other formats, such as over telephone/webcam or as Internet-delivered CBT (ICBT). Methods PubMed, PsycINFO, trial registries, and previous systematic reviews were searched for randomized controlled trials (RCTs) comparing CBT (in-person, webcam/telephone-delivered, or ICBT) or SRIs with control conditions or each other. Network meta-analyses were conducted to examine efficacy (post-treatment Children's Yale-Brown Obsessive Compulsive Scale) and acceptability (treatment discontinuation). Confidence in effect estimates was evaluated with CINeMA (Confidence in Network Meta-Analysis). Results Thirty eligible RCTs and 35 contrasts comprising 2,057 youth with OCD were identified. In-person CBT was significantly more efficacious than ICBT, waitlist, relaxation training, and pill placebo (MD range: 3.95-11.10; CINeMA estimate of confidence: moderate) but did not differ significantly from CBT delivered via webcam/telephone (MD: 0.85 [ 2.51, 4.21]; moderate), SRIs (MD: 3.07 [ 0.07, 6.20]; low), or the combination of in-person CBT and SRIs (MD: 1.20 [ 5.29, 2.91]; low). SRIs were significantly more efficacious than pill placebo (MD: 4.59 [2.70, 6.48]; low) and waitlist (MD: 8.03 [4.24, 11.82]; moderate). No significant differences for acceptability emerged, but confidence in estimates was low. Conclusions In-person CBT and SRIs produce clear benefits compared to waitlist and pill placebo and should be integral parts of the clinical management of pediatric OCD, with in-person CBT overall having a stronger evidence base. The combination of in-person CBT and SRIs may be most efficacious, but few studies hinder firm conclusions. The efficacy of CBT appears conserved when delivered via webcam/telephone, while more trials evaluating ICBT are needed. |
| En ligne : |
https://doi.org/10.1111/jcpp.13934 |
| Permalink : |
https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=526 |
in Journal of Child Psychology and Psychiatry > 65-5 (May 2024) . - p.594-609
[article] Efficacy and acceptability of cognitive-behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive-compulsive disorder: a network meta-analysis [texte imprimé] / Matti CERVIN, Auteur ; Joseph F. MCGUIRE, Auteur ; Johann M. D'SOUZA, Auteur ; Alessandro S. DE NADAI, Auteur ; Kristina ASPVALL, Auteur ; Wayne K. GOODMAN, Auteur ; Per ANDRÉN, Auteur ; Sophie C. SCHNEIDER, Auteur ; Daniel A. GELLER, Auteur ; David MATAIX-COLS, Auteur ; Eric A. STORCH, Auteur . - p.594-609. Langues : Anglais ( eng) in Journal of Child Psychology and Psychiatry > 65-5 (May 2024) . - p.594-609
| Index. décimale : |
PER Périodiques |
| Résumé : |
Background Cognitive-behavioral therapy (CBT) and serotonin reuptake inhibitors (SRIs) are recommended treatments for pediatric obsessive-compulsive disorder (OCD), but their relative efficacy and acceptability have not been comprehensively examined. Further, it remains unclear whether the efficacy of in-person CBT is conserved when delivered in other formats, such as over telephone/webcam or as Internet-delivered CBT (ICBT). Methods PubMed, PsycINFO, trial registries, and previous systematic reviews were searched for randomized controlled trials (RCTs) comparing CBT (in-person, webcam/telephone-delivered, or ICBT) or SRIs with control conditions or each other. Network meta-analyses were conducted to examine efficacy (post-treatment Children's Yale-Brown Obsessive Compulsive Scale) and acceptability (treatment discontinuation). Confidence in effect estimates was evaluated with CINeMA (Confidence in Network Meta-Analysis). Results Thirty eligible RCTs and 35 contrasts comprising 2,057 youth with OCD were identified. In-person CBT was significantly more efficacious than ICBT, waitlist, relaxation training, and pill placebo (MD range: 3.95-11.10; CINeMA estimate of confidence: moderate) but did not differ significantly from CBT delivered via webcam/telephone (MD: 0.85 [ 2.51, 4.21]; moderate), SRIs (MD: 3.07 [ 0.07, 6.20]; low), or the combination of in-person CBT and SRIs (MD: 1.20 [ 5.29, 2.91]; low). SRIs were significantly more efficacious than pill placebo (MD: 4.59 [2.70, 6.48]; low) and waitlist (MD: 8.03 [4.24, 11.82]; moderate). No significant differences for acceptability emerged, but confidence in estimates was low. Conclusions In-person CBT and SRIs produce clear benefits compared to waitlist and pill placebo and should be integral parts of the clinical management of pediatric OCD, with in-person CBT overall having a stronger evidence base. The combination of in-person CBT and SRIs may be most efficacious, but few studies hinder firm conclusions. The efficacy of CBT appears conserved when delivered via webcam/telephone, while more trials evaluating ICBT are needed. |
| En ligne : |
https://doi.org/10.1111/jcpp.13934 |
| Permalink : |
https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=526 |
|  |
Efficacy and acceptability of cognitive-behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive-compulsive disorder: a network meta-analysis in Journal of Child Psychology and Psychiatry, 65-5 (May 2024)
