Evaluation of cognitive behaviour therapy for paediatric obsessive-compulsive disorder in the context of tic disorders

Sophie Bennett; Daniel Stark; Roz Shafran; Isobel Heyman; Georgina Krebs

doi:10.1016/j.jbtep.2015.03.004

Evaluation of cognitive behaviour therapy for paediatric obsessive-compulsive disorder in the context of tic disorders

J Behav Ther Exp Psychiatry. 2015 Dec;49(Pt B):223-229. doi: 10.1016/j.jbtep.2015.03.004. Epub 2015 Mar 14.

Authors

Sophie Bennett¹, Daniel Stark², Roz Shafran³, Isobel Heyman⁴, Georgina Krebs⁵

Affiliations

¹ UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK. Electronic address: Sophie.Bennett.10@ucl.ac.uk.
² Psychological Medicine Team, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK. Electronic address: Daniel.Stark@gosh.nhs.uk.
³ UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK. Electronic address: R.Shafran@ucl.ac.uk.
⁴ UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK; Psychological Medicine Team, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK. Electronic address: I.Heyman@ucl.ac.uk.
⁵ Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK; OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK. Electronic address: Georgina.1.Krebs@kcl.ac.uk.

PMID: 25843610
DOI: 10.1016/j.jbtep.2015.03.004

Abstract

Background and objectives: Paediatric obsessive-compulsive disorder (OCD) and tic disorders (TD) often present together. However, there has been relatively little research on whether comorbid tic disorders influence response to cognitive behaviour therapy (CBT) for OCD. This study aimed to examine the outcomes of CBT for paediatric patients with OCD and a tic disorder compared to a matched group of children with OCD and no tics. Outcomes were compared post-treatment and at 3 or 6 month follow-up.

Methods: Participants were 29 young people with tic disorders and OCD (OCD + TD) and 29 young people with OCD without tic disorders (OCD-TD) who were matched according to age, gender and baseline OCD symptom severity. All participants received a course of CBT and outcomes were assessed using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS).

Results: OCD symptoms reduced over the course of CBT to an equivalent extent in the OCD + TD and OCD-TD groups. Response or remission rates did not differ significantly at either post-intervention or follow-up between those with OCD + TD and those with OCD-TD. For both groups, response rates were high - 72% of both groups were classified as responders post-intervention and, at follow-up, 81% of the OCD + TD group and 82% of the OCD no tics group responded. Those with OCD + TD responded in significantly fewer sessions than those with OCD without tics.

Limitations: A number of potential confounding factors were not assessed and therefore could not be controlled for, such as other comorbidities and stability of medication.

Conclusions: Paediatric patients with OCD and tic disorders respond equally well to standard CBT for OCD as compared to those with OCD and no tics.

Keywords: Cognitive behaviour therapy; Comorbidity; OCD; Tic disorders.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Analysis of Variance
Case-Control Studies
Child
Cognitive Behavioral Therapy / methods*
Female
Follow-Up Studies
Humans
Male
Obsessive-Compulsive Disorder* / complications
Obsessive-Compulsive Disorder* / psychology
Obsessive-Compulsive Disorder* / rehabilitation
Psychiatric Status Rating Scales
Retrospective Studies
Tic Disorders / complications*
Tic Disorders / rehabilitation*
Treatment Outcome