Efficacy and acceptability of cognitive-behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive-compulsive disorder: a network meta-analysis / Matti CERVIN in Journal of Child Psychology and Psychiatry, 65-5 (May 2024)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 65-5 (May 2024) . - p.594-609 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 et/ou numérique 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 [article] Efficacy and acceptability of cognitive-behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive-compulsive disorder: a network meta-analysis [Texte imprimé et/ou numérique] / 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

Long-term clinical and cost-effectiveness of a therapist-supported online remote behavioural intervention for tics in children and adolescents: extended 12- and 18-month follow-up of a single-blind randomised controlled trial / Chris HOLLIS in Journal of Child Psychology and Psychiatry, 64-6 (June 2023)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 64-6 (June 2023) . - p.941-951 Titre : Long-term clinical and cost-effectiveness of a therapist-supported online remote behavioural intervention for tics in children and adolescents: extended 12- and 18-month follow-up of a single-blind randomised controlled trial Type de document : Texte imprimé et/ou numérique Auteurs : Chris HOLLIS, Auteur ; Charlotte L. HALL, Auteur ; Kareem KHAN, Auteur ; Rebecca JONES, Auteur ; Louise MARSTON, Auteur ; Marie LE NOVERE, Auteur ; Rachael HUNTER, Auteur ; Per ANDRÉN, Auteur ; Sophie D. BENNETT, Auteur ; Beverley J. BROWN, Auteur ; Liam R. CHAMBERLAIN, Auteur ; E. Bethan DAVIES, Auteur ; Amber EVANS, Auteur ; Natalia KOUZOUPI, Auteur ; Caitlin MCKENZIE, Auteur ; Charlotte SANDERSON, Auteur ; Isobel HEYMAN, Auteur ; Joseph KILGARIFF, Auteur ; Cristine GLAZEBROOK, Auteur ; David MATAIX-COLS, Auteur ; Eva SERLACHIUS, Auteur ; Elizabeth MURRAY, Auteur ; Tara MURPHY, Auteur Article en page(s) : p.941-951 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Background Little is known about the long-term effectiveness of behavioural therapy for tics. We aimed to assess the long-term clinical and cost-effectiveness of online therapist-supported exposure and response prevention (ERP) therapy for tics 12 and 18 months after treatment initiation. Methods ORBIT (online remote behavioural intervention for tics) was a two-arm (1:1 ratio), superiority, single-blind, multicentre randomised controlled trial comparing online ERP for tics with online psychoeducation. The trial was conducted across two Child and Adolescent Mental Health Services in England. Participants were recruited from these two sites, across other clinics in England, or by self-referral. This study was a naturalistic follow-up of participants at 12- and 18-month postrandomisation. Participants were permitted to use alternative treatments recommended by their clinician. The key outcome was the Yale Global Tic Severity Scale Total Tic Severity Score (YGTSS-TTSS). A full economic evaluation was conducted. Registrations are ISRCTN (ISRCTN70758207); ClinicalTrials.gov (NCT03483493). Results Two hundred and twenty-four participants were enrolled: 112 to ERP and 112 to psychoeducation. The sample was predominately male (177; 79%) and of white ethnicity (195; 87%). The ERP intervention reduced baseline YGTSS-TTSS by 2.64 points (95% CI: ?4.48 to ?0.79) with an effect size of ?0.36 (95% CI: ?0.61 to ?0.11) after 12?months and by 2.01 points (95% CI: ?3.86 to ?0.15) with an effect size of ?0.27 (95% CI -0.52 to ?0.02) after 18?months, compared with psychoeducation. Very few participants (<10%) started new tic treatment during follow-up. The cost difference in ERP compared with psychoeducation was £304.94 (?139.41 to 749.29). At 18?months, the cost per QALY gained was £16,708 for ERP compared with psychoeducation. Conclusions Remotely delivered online ERP is a clinical and cost-effective intervention with durable benefits extending for up to 18?months. This represents an efficient public mental health approach to increase access to behavioural therapy and improve outcomes for tics. En ligne : http://dx.doi.org/https://doi.org/10.1111/jcpp.13756 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=504 [article] Long-term clinical and cost-effectiveness of a therapist-supported online remote behavioural intervention for tics in children and adolescents: extended 12- and 18-month follow-up of a single-blind randomised controlled trial [Texte imprimé et/ou numérique] / Chris HOLLIS, Auteur ; Charlotte L. HALL, Auteur ; Kareem KHAN, Auteur ; Rebecca JONES, Auteur ; Louise MARSTON, Auteur ; Marie LE NOVERE, Auteur ; Rachael HUNTER, Auteur ; Per ANDRÉN, Auteur ; Sophie D. BENNETT, Auteur ; Beverley J. BROWN, Auteur ; Liam R. CHAMBERLAIN, Auteur ; E. Bethan DAVIES, Auteur ; Amber EVANS, Auteur ; Natalia KOUZOUPI, Auteur ; Caitlin MCKENZIE, Auteur ; Charlotte SANDERSON, Auteur ; Isobel HEYMAN, Auteur ; Joseph KILGARIFF, Auteur ; Cristine GLAZEBROOK, Auteur ; David MATAIX-COLS, Auteur ; Eva SERLACHIUS, Auteur ; Elizabeth MURRAY, Auteur ; Tara MURPHY, Auteur . - p.941-951. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 64-6 (June 2023) . - p.941-951 Index. décimale : PER Périodiques Résumé : Background Little is known about the long-term effectiveness of behavioural therapy for tics. We aimed to assess the long-term clinical and cost-effectiveness of online therapist-supported exposure and response prevention (ERP) therapy for tics 12 and 18 months after treatment initiation. Methods ORBIT (online remote behavioural intervention for tics) was a two-arm (1:1 ratio), superiority, single-blind, multicentre randomised controlled trial comparing online ERP for tics with online psychoeducation. The trial was conducted across two Child and Adolescent Mental Health Services in England. Participants were recruited from these two sites, across other clinics in England, or by self-referral. This study was a naturalistic follow-up of participants at 12- and 18-month postrandomisation. Participants were permitted to use alternative treatments recommended by their clinician. The key outcome was the Yale Global Tic Severity Scale Total Tic Severity Score (YGTSS-TTSS). A full economic evaluation was conducted. Registrations are ISRCTN (ISRCTN70758207); ClinicalTrials.gov (NCT03483493). Results Two hundred and twenty-four participants were enrolled: 112 to ERP and 112 to psychoeducation. The sample was predominately male (177; 79%) and of white ethnicity (195; 87%). The ERP intervention reduced baseline YGTSS-TTSS by 2.64 points (95% CI: ?4.48 to ?0.79) with an effect size of ?0.36 (95% CI: ?0.61 to ?0.11) after 12?months and by 2.01 points (95% CI: ?3.86 to ?0.15) with an effect size of ?0.27 (95% CI -0.52 to ?0.02) after 18?months, compared with psychoeducation. Very few participants (<10%) started new tic treatment during follow-up. The cost difference in ERP compared with psychoeducation was £304.94 (?139.41 to 749.29). At 18?months, the cost per QALY gained was £16,708 for ERP compared with psychoeducation. Conclusions Remotely delivered online ERP is a clinical and cost-effective intervention with durable benefits extending for up to 18?months. This represents an efficient public mental health approach to increase access to behavioural therapy and improve outcomes for tics. En ligne : http://dx.doi.org/https://doi.org/10.1111/jcpp.13756 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=504

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