Adapted cognitive behavior therapy for obsessive-compulsive disorder with co-occurring autism spectrum disorder: A clinical effectiveness study / Oskar FLYGARE in Autism, 24-1 (January 2020)  

Public ISBD [article]  inAutism > 24-1 (January 2020) . - p.190-199 Titre : Adapted cognitive behavior therapy for obsessive-compulsive disorder with co-occurring autism spectrum disorder: A clinical effectiveness study Type de document : texte imprimé Auteurs : Oskar FLYGARE, Auteur ; Erik ANDERSSON, Auteur ; Helene RINGBERG, Auteur ; Anna-Clara HELLSTADIUS, Auteur ; Johan EDBACKEN, Auteur ; Jesper ENANDER, Auteur ; Matti DAHL, Auteur ; Kristina ASPVALL, Auteur ; Indra WINDH, Auteur ; Ailsa RUSSELL, Auteur ; David MATAIX-COLS, Auteur ; C. RUCK, Auteur Article en page(s) : p.190-199 Langues : Anglais (eng) Mots-clés : autism spectrum disorder  cognitive behavior therapy  obsessive-compulsive disorder Index. décimale : PER Périodiques Résumé : Obsessive-compulsive disorder and autism spectrum disorder commonly co-occur. Adapted cognitive behavior therapy for obsessive-compulsive disorder in adults with autism spectrum disorder has not previously been evaluated outside the United Kingdom. In this study, 19 adults with obsessive-compulsive disorder and autism spectrum disorder were treated using an adapted cognitive behavior therapy protocol that consisted of 20 sessions focused on exposure with response prevention. The primary outcome was the clinician-rated Yale-Brown Obsessive-Compulsive Scale. Participants were assessed up to 3 months after treatment. There were significant reductions on the Yale-Brown Obsessive-Compulsive Scale at post-treatment (d = 1.5), and improvements were sustained at follow-up (d = 1.2). Self-rated obsessive-compulsive disorder and depressive symptoms showed statistically significant reductions. Improvements in general functioning and quality of life were statistically non-significant. Three participants (16%) were responders at post-treatment and four (21%) were in remission from obsessive-compulsive disorder. At follow-up, three participants (16%) were responders and one (5%) was in full remission. Adapted cognitive behavior therapy for obsessive-compulsive disorder in adults with co-occurring autism spectrum disorder is associated with reductions in obsessive-compulsive symptoms and depressive symptoms. However, outcomes are modest; few patients were completely symptom free, and treatment engagement was low with few completed exposures and low adherence to homework assignments. We identify and discuss the need for further treatment refinement for this vulnerable group. En ligne : http://dx.doi.org/10.1177/1362361319856974 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=414 [article] Adapted cognitive behavior therapy for obsessive-compulsive disorder with co-occurring autism spectrum disorder: A clinical effectiveness study [texte imprimé] / Oskar FLYGARE, Auteur ; Erik ANDERSSON, Auteur ; Helene RINGBERG, Auteur ; Anna-Clara HELLSTADIUS, Auteur ; Johan EDBACKEN, Auteur ; Jesper ENANDER, Auteur ; Matti DAHL, Auteur ; Kristina ASPVALL, Auteur ; Indra WINDH, Auteur ; Ailsa RUSSELL, Auteur ; David MATAIX-COLS, Auteur ; C. RUCK, Auteur . - p.190-199. Langues : Anglais (eng) in Autism > 24-1 (January 2020) . - p.190-199 Mots-clés : autism spectrum disorder  cognitive behavior therapy  obsessive-compulsive disorder Index. décimale : PER Périodiques Résumé : Obsessive-compulsive disorder and autism spectrum disorder commonly co-occur. Adapted cognitive behavior therapy for obsessive-compulsive disorder in adults with autism spectrum disorder has not previously been evaluated outside the United Kingdom. In this study, 19 adults with obsessive-compulsive disorder and autism spectrum disorder were treated using an adapted cognitive behavior therapy protocol that consisted of 20 sessions focused on exposure with response prevention. The primary outcome was the clinician-rated Yale-Brown Obsessive-Compulsive Scale. Participants were assessed up to 3 months after treatment. There were significant reductions on the Yale-Brown Obsessive-Compulsive Scale at post-treatment (d = 1.5), and improvements were sustained at follow-up (d = 1.2). Self-rated obsessive-compulsive disorder and depressive symptoms showed statistically significant reductions. Improvements in general functioning and quality of life were statistically non-significant. Three participants (16%) were responders at post-treatment and four (21%) were in remission from obsessive-compulsive disorder. At follow-up, three participants (16%) were responders and one (5%) was in full remission. Adapted cognitive behavior therapy for obsessive-compulsive disorder in adults with co-occurring autism spectrum disorder is associated with reductions in obsessive-compulsive symptoms and depressive symptoms. However, outcomes are modest; few patients were completely symptom free, and treatment engagement was low with few completed exposures and low adherence to homework assignments. We identify and discuss the need for further treatment refinement for this vulnerable group. En ligne : http://dx.doi.org/10.1177/1362361319856974 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=414

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 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] / 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

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