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Comparing the Efficacy of Pharmacological and Psychological Treatment, Alone and in Combination, in Children and Adolescents with Obsessive-Compulsive Disorder: A Network Meta-Analysis

31 Pages Posted: 8 Jul 2021

See all articles by Yuanmei Tao

Yuanmei Tao

Sichuan University - Department of Psychiatry

Hancong Li

Sichuan University - West China School of Medicine

Lu Li

Sichuan University - West China School of Public Health

Hang Zhang

Sichuan University - Department of Psychiatry

Hanmei Xu

Sichuan University - Department of Psychiatry

Hong Zhang

Sichuan University - Department of Psychiatry

Shoukang Zou

Sichuan University - Department of Psychiatry

Fang Deng

Sichuan University - Department of Psychiatry

Lijuan Huang

Sichuan University - Department of Psychiatry

Yanping Wang

Sichuan University - Department of Psychiatry

Xiaolan Wang

Sichuan University - Department of Psychiatry

Xiaowei Tang

Sichuan University - Department of Psychiatry

Xia Fu

Sichuan University - Department of Psychiatry

Li Yin

Sichuan University - Mental Health Center

More...

Abstract

Background: Studies have shown that pharmacological and psychological treatments are effective for children and adolescents with obsessive-compulsive disorder (OCD). However, few network meta-analyses have examined whether pharmacological or psychological treatments on their own, or combined, are most effective.

Methods: We conducted a database search and selected randomized controlled trials of pharmacological or psychological treatments, alone or in combination, for children and adolescents with OCD. The primary outcome was change in symptom severity as a result of treatment, as assessed using the Yale-Brown Obsessive Compulsive Scale (BOCS) or Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) .

Findings: We included 18 studies with 1353 participants and 12 kinds of treatments. In terms of efficacy, all pharmacological and psychotherapy treatments were more effective than placebo. Among the 12 treatments, the efficacy of pharmacological treatment combined with cognitive behavioral therapy (CBT) was better than pharmacological treatment alone. When pharmacological treatment was used alone, escitalopram was significantly better than clomipramine(CY-BOCS average change 3.42; 95% CI 2.11, 4.65), fluvoxamine(CY-BOCS average change 3.59; 95% CI 1.09, 6.20), paroxetine(CY-BOCS average change 2 .80; 95% CI 0.01, 5.64) and sertraline(CY-BOCS average change 3.49; 95% CI 1.53, 5.64).

Interpretation: The available evidence suggests that the combination of pharmacological and psychological treatment is likely to be most effective for children and adolescents with OCD.

Funding: The National Nature Science Foundation of China (81801357, 81801350), the Science and Technology Education Program of the Sichuan Province (2020JDKP0013), the Key R&D Projects of the Science and Technology Department of Sichuan Province(2020YFS0259 ), and the Chengdu Key Technology R&D Program (2019-YF05– 00284-SN).

Declaration of Interest: None to declare.

Suggested Citation

Tao, Yuanmei and Li, Hancong and Li, Lu and Zhang, Hang and Xu, Hanmei and Zhang, Hong and Zou, Shoukang and Deng, Fang and Huang, Lijuan and Wang, Yanping and Wang, Xiaolan and Tang, Xiaowei and Fu, Xia and Yin, Li, Comparing the Efficacy of Pharmacological and Psychological Treatment, Alone and in Combination, in Children and Adolescents with Obsessive-Compulsive Disorder: A Network Meta-Analysis. Available at SSRN: https://ssrn.com/abstract=3882525 or http://dx.doi.org/10.2139/ssrn.3882525

Yuanmei Tao

Sichuan University - Department of Psychiatry ( email )

China

Hancong Li

Sichuan University - West China School of Medicine ( email )

Sichuan
China

Lu Li

Sichuan University - West China School of Public Health ( email )

China

Hang Zhang

Sichuan University - Department of Psychiatry ( email )

China

Hanmei Xu

Sichuan University - Department of Psychiatry ( email )

China

Hong Zhang

Sichuan University - Department of Psychiatry ( email )

China

Shoukang Zou

Sichuan University - Department of Psychiatry ( email )

China

Fang Deng

Sichuan University - Department of Psychiatry ( email )

China

Lijuan Huang

Sichuan University - Department of Psychiatry ( email )

China

Yanping Wang

Sichuan University - Department of Psychiatry ( email )

China

Xiaolan Wang

Sichuan University - Department of Psychiatry ( email )

China

Xiaowei Tang

Sichuan University - Department of Psychiatry ( email )

China

Xia Fu

Sichuan University - Department of Psychiatry ( email )

China

Li Yin (Contact Author)

Sichuan University - Mental Health Center ( email )