Document Detail


The effect of fluvoxamine and behavior therapy on children and adolescents with obsessive-compulsive disorder.
MedLine Citation:
PMID:  11191690     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The efficacy of medications, consisting of serotonin partial and specific reuptake blockers, and behavior therapy, consisting of exposure and response prevention in addition to social skills training, cognitive therapy, and habit reversal, in the treatment of obsessive-compulsive disorder are well documented. The purpose of the study was to explore if adding behavior therapy to medication would enhance treatment efficacy. METHODS: Ten children/adolescents who had not previously responded to behavior therapy were randomly assigned to two groups: fluvoxamine alone or fluvoxamine with behavior therapy. All 10 patients received fluvoxamine for 10 weeks-five continued solely on fluvoxamine for one year and five engaged in behavior therapy for 20 sessions along with fluvoxamine and then continued solely on medication until the end of the year. RESULTS: Eight of 10 patients improved significantly on fluvoxamine at week 10 on the primary outcome variable, the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). According to the other measurements-National Institute of Mental Health-Global Obses-sive-Compulsive Scale, Clinical Global Impression-Improvement (assessing level of im-provement from week to week), and Clinical Global Impression-Severity of Illness Scale (as-sessing how ill the patient is from week to week)-improvement was not as evident. According to the CY-BOCS, those who received a combination of fluvoxamine and exposure with response prevention showed significantly more improvement than those who only took medication. At two-year follow-up, all patients continued to improve, with those in the combined approach improving more than those in the medication-alone group. CONCLUSIONS: Future studies should determine the specific effect of each treatment group, combined and singularly. Reasons for discrepancy in improvement ratings as noted by the different instruments are discussed. The addition of behavior therapy to fluvoxamine seems to enhance treatment efficacy, according to the CY-BOCS.
Authors:
F Neziroglu; J A Yaryura-Tobias; J Walz; D McKay
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of child and adolescent psychopharmacology     Volume:  10     ISSN:  1044-5463     ISO Abbreviation:  J Child Adolesc Psychopharmacol     Publication Date:  2000  
Date Detail:
Created Date:  2001-01-15     Completed Date:  2001-03-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9105358     Medline TA:  J Child Adolesc Psychopharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  295-306     Citation Subset:  IM    
Affiliation:
Bio-Behavioral Institute, Department of Biopsychosocial Research, Great Neck, New York 11021, USA. neziroglu@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antidepressive Agents, Second-Generation / therapeutic use*
Behavior Therapy*
Child
Combined Modality Therapy
Female
Fluoxetine / therapeutic use*
Humans
Male
Obsessive-Compulsive Disorder / drug therapy,  psychology,  therapy*
Psychiatric Status Rating Scales
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antidepressive Agents, Second-Generation; 54910-89-3/Fluoxetine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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