The pharmacological and psychological treatments have proven their efficacy in children and adolescents with obsessive-compulsive disorder (OCD). However, only a few network meta-analyses have examined if the pharmacological or psychological treatments alone, or combined, are most effective.

A recent study conducted a database search and picked randomized controlled trials of pharmacological or psychological treatments, monotherapy or in combination, for children and adolescents with OCD. Change in symptom severity as a result of treatment was looked for, using the Yale-Brown Obsessive-Compulsive Scale (YBOCS) or Childrens Yale-Brown Obsessive-Compulsive Scale (CY-BOCS).

18 studies with 1353 participants and 12 types of treatments were included. Regarding efficacy, all pharmacological and psychotherapy treatments were found to be more effective than placebo. Among the 12 treatments, the efficacy of pharmacological treatment combined with cognitive-behavioural therapy (CBT) was found to be more effective than pharmacological treatment alone. On evaluating pharmacological treatment alone, escitalopram was found to be significantly more effective than clomipramine, fluvoxamine, paroxetine and sertraline.

Thus the available evidence favors the combination of pharmacological and psychological treatment to be the most effective for children and adolescents with OCD.

Source:  Journal of Psychiatric Research. 2022;148: 95-102. https://doi.org/10.1016/j.jpsychires.2022.01.057.