Update on the Treatment of Pediatric Obsessive-Compulsive Disorder

Abstract

This article provides an update on the evidence base for the treatment of pediatric obsessive-compulsive disorder (OCD). Recent meta-analyses have found that cognitive-behavioral therapy (CBT) is the most efficacious monotherapy for pediatric OCD, and that serotonin reuptake inhibitors demonstrate a moderate treatment effect. There is little evidence to indicate when CBT should be combined with pharmacology, despite it being recommended for all severe cases. Although access to high-quality CBT is often limited, there is promising evidence supporting the use of intensive CBT and therapist-guided e-therapy. There is insufficient information about the efficacy and safety of second-line pharmacological interventions in pediatric populations even though they are widely used. Although existing treatments can be highly efficacious for pediatric OCD, there is a clear need to increase access to evidence-based treatments, improve response and remission rates in available treatments, and evaluate second-line interventions for treatment nonresponders. [ Psychiatr Ann. 2017;47(11):537–541.]