Moderators and predictors of response to cognitive behaviour therapy for pediatric obsessive-compulsive disorder: A systematic review
Open accessAbstract
We report a systematic review of moderators of CBT efficacy for pediatric OCD relative to other treatments. CENTRAL, MEDLINE, EMBASE, CINAHL, and PsycINFO were searched for RCTs reporting on effect moderation for CBT outcomes. Five studies (N = 365) examined 17 variables with three significant moderators identified. Compared to pill-placebo, CBT monotherapy was not effective for children with a family history of OCD but was for those without a family history. For children with a family history, CBT plus sertraline efficacy was attenuated but remained significant. For children with tics, CBT but not sertraline remained superior to pill-placebo. For non-responders to initial treatment with CBT, continuing CBT was inferior to commencing sertraline for those with tics but was not different for those without tics. A supplementary review identified older age, symptom and impairment severity, co-morbidity and family accommodation as consistent predictors of a poorer outcome to CBT. Current evidence for moderation effects is post-hoc, from single RCTs, has small Ns and requires replication. The review identifies family history of OCD and the presence of tics as factors requiring further examination in properly conducted trials and about which clinicians need to show care in their treatment recommendations.
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Higher levels of parental accommodation consistently predict poor treatment response among youth with OCD.
“Higher levels of parental accommodation consistently predict poor treatment response among samples of youth with OCD [83]”
From Intolerance of Uncertainty and Parental Accommodation: Promising Targets for Personalized Intervention for Youth Anxiety. (2020) · cites this paper as [83]
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Randomized Trial Comparing Standard versus Light Intensity Parent Training for Anxious Youth
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“The majority of the scarce systematic reviews with YP have been conducted on anxiety and depressive disorders [41–43], followed by non-suicidal self-injury [44], paediatric obsessive–compulsive disorders [45], anorexia and bulimia nervosa [46], and autism spectrum disorder [47].”
BackgroundBortoncello, C. F., Cardoso, N. D. O., Salvador, E. Z., de Avila, R. C., Machado, W. D. L., & Ferrão, Y. A. (2022) · Brazilian Journal of Psychiatry · doi:10.47626/1516-4446-2021-2264 · Cited by 8 · see citing works
- Authors
- Turner, C., O'Gorman, B., Nair, A., & O'Kearney, R.
- Affiliations
- The University of Queensland (AU)
- Australian National University (AU)
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2018-03
- Volume
- 261
- Pages
- 50-60
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2777772629
- Semantic Scholar
- 61e84f1f02cebeda7eee3f98439a752bc316dcd7
- Cited by
- 73
- References
- 63
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 13 · 2023: 12 · 2022: 3 · 2021: 9 · 2020: 10 · 2019: 11 · 2018: 5
- FWCI
- 1.09
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- pediatric obsessive-compulsive disorder, cognitive behavioral therapy, treatment moderators, predictors of treatment response, sertraline, tics, comorbidities, family accommodation, symptom severity, age
- MeSH terms
- Adolescent, Child, Combined Modality Therapy, Female, Humans, Male, Obsessive-Compulsive Disorder, Predictive Value of Tests, Tic Disorders, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Sertraline
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