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Efficacy and accept...
Efficacy and acceptability of cognitive-behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive-compulsive disorder: a network meta-analysis
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- Cervin, Matti (författare)
- Lund University,Lunds universitet,Barn- och ungdomspsykiatri,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Innovations in pediatric mental health,Forskargrupper vid Lunds universitet,Child and Adolescent Psychiatry,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups
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- McGuire, Joseph (författare)
- Johns Hopkins University School of Medicine
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- D'Souza, Johann (författare)
- University of Houston
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- De Nadai, Alessandro (författare)
- Texas State University
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- Aspvall, Kristina (författare)
- Karolinska Institutet,Stockholm County Council,Karolinska Institute
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- Goodman, Wayne K. (författare)
- Baylor College of Medicine
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- Andrén, Per (författare)
- Karolinska Institutet,Karolinska Institute,Lund University,Lunds universitet,Barn- och ungdomspsykiatri,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Innovations in pediatric mental health,Forskargrupper vid Lunds universitet,Child and Adolescent Psychiatry,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups
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- Schneider, Sophie C. (författare)
- Baylor College of Medicine
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- Geller, Daniel (författare)
- Harvard Medical School
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- Mataix-Cols, David (författare)
- Karolinska Institutet,Karolinska Institute,Lund University,Lunds universitet,Innovations in pediatric mental health,Forskargrupper vid Lunds universitet,Lund University Research Groups
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- Storch, Eric (författare)
- Baylor College of Medicine
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(creator_code:org_t)
- 2024
- 2024
- Engelska 16 s.
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Ingår i: Journal of Child Psychology and Psychiatry. - 0021-9630. ; 65:5, s. 594-609
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- BackgroundCognitive-behavioral therapy (CBT) and serotonin reuptake inhibitors (SRIs) are recommended treatments for pediatric obsessive-compulsive disorder (OCD), but their relative efficacy and acceptability have not been comprehensively examined. Further, it remains unclear whether the efficacy of in-person CBT is conserved when delivered in other formats, such as over telephone/webcam or as Internet-delivered CBT (ICBT).MethodsPubMed, PsycINFO, trial registries, and previous systematic reviews were searched for randomized controlled trials (RCTs) comparing CBT (in-person, webcam/telephone-delivered, or ICBT) or SRIs with control conditions or each other. Network meta-analyses were conducted to examine efficacy (post-treatment Children's Yale-Brown Obsessive Compulsive Scale) and acceptability (treatment discontinuation). Confidence in effect estimates was evaluated with CINeMA (Confidence in Network Meta-Analysis).ResultsThirty eligible RCTs and 35 contrasts comprising 2,057 youth with OCD were identified. In-person CBT was significantly more efficacious than ICBT, waitlist, relaxation training, and pill placebo (MD range: 3.95–11.10; CINeMA estimate of confidence: moderate) but did not differ significantly from CBT delivered via webcam/telephone (MD: 0.85 [−2.51, 4.21]; moderate), SRIs (MD: 3.07 [−0.07, 6.20]; low), or the combination of in-person CBT and SRIs (MD: −1.20 [−5.29, 2.91]; low). SRIs were significantly more efficacious than pill placebo (MD: 4.59 [2.70, 6.48]; low) and waitlist (MD: 8.03 [4.24, 11.82]; moderate). No significant differences for acceptability emerged, but confidence in estimates was low.ConclusionsIn-person CBT and SRIs produce clear benefits compared to waitlist and pill placebo and should be integral parts of the clinical management of pediatric OCD, with in-person CBT overall having a stronger evidence base. The combination of in-person CBT and SRIs may be most efficacious, but few studies hinder firm conclusions. The efficacy of CBT appears conserved when delivered via webcam/telephone, while more trials evaluating ICBT are needed.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
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Cervin, Matti
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McGuire, Joseph
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D'Souza, Johann
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De Nadai, Alessa ...
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Aspvall, Kristin ...
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Goodman, Wayne K ...
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visa fler...
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Andrén, Per
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Schneider, Sophi ...
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Geller, Daniel
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Mataix-Cols, Dav ...
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Storch, Eric
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Lunds universitet
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