Early childhood OCD: Preliminary findings from a family-based cognitive-behavioral approach
Early childhood OCD: Preliminary findings from a family-based cognitive-behavioral approach
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DOI：
10.1097/chi.0b013e31816765f9
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发表时间：
2008-05-01
影响因子：
13.3
通讯作者：
Leonard, Henrietta L.
中科院分区：
文献类型：
--
作者：
Freeman, Jennifer B.;Garcia, Abbe M.;Leonard, Henrietta L.
目的：比较以家庭为基础的认知行为治疗（CBT）与以家庭为基础的放松治疗（RT）对5 ~ 8岁强迫症（OCD）儿童的相对疗效。方法：42名患有原发性强迫症的幼儿随机接受12次以家庭为基础的CBT或以家庭为基础的FIT。由对治疗分配不知情的独立评估者在治疗前后进行评估。主要结果包括儿童耶鲁-布朗强迫量表和临床总体印象改善的评分。结果如下：对于意向治疗样本，CBT与中度治疗效果相关（d = 0.53），尽管在常规水平下组间无显著差异。对于完整样本，CBT有很大的影响（d = 0.85），有一个显着的组差异有利于CBT。在意向治疗样本中，CBT组50%的儿童达到缓解，而RT组为20%。在完整样本中，CBT组69%的儿童达到临床缓解，而RT组为20%。结论：结果表明，早发性强迫症儿童受益于针对其发展需要和家庭背景的治疗方法。CBT在减少强迫症症状方面是有效的，并帮助大量儿童获得临床缓解。
Objective: To examine the relative efficacy of family-based cognitive-behavioral therapy (CBT) versus family-based relaxation treatment (RT) for young children ages 5 to 8 years with obsessive-compulsive disorder (OCD). Method: Forty-two young children with primary OCD were randomized to receive 12 sessions of family-based CBT or family-based FIT. Assessments were conducted before and after treatment by independent raters blind to treatment assignment. Primary outcomes included scores on the Children's Yale-Brown Obsessive Compulsive Scale and Clinical Global Impressions-Improvement. Results: For the intent-to-treat sample, CBT was associated with a moderate treatment effect (d = 0.53), although there was not a significant difference between the groups at conventional levels. For the completer sample, CBT had a large effect (d = 0.85), and there was a significant group difference favoring CBT. In the intent-to-treat sample, 50% of children in the CBT group achieved remission as compared to 20% in the RT group. In the completer sample, 69% of children in the CBT group achieved a clinical remission compared to 20% in the RT group. Conclusions: Results indicate that children with early-onset OCD benefit from a treatment approach tailored to their developmental needs and family context. CBT was effective in reducing OCD symptoms and in helping a large number of children achieve a clinical remission.