Per Hove Thomsen

The place of and evidence for serotonin reuptake inhibitors (SRIs) for obsessive compulsive disorder (OCD) in children and adolescents: Views based on a systematic review and meta-analysis

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Tord Ivarsson, Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
  • ,
  • Gudmundur Skarphedinsson, Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
  • ,
  • Hege Kornør, Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway, Danmark
  • Brynhildur Axelsdottir, Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway, Danmark
  • Sølvi Biedilæ, Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway, Danmark
  • Isobel Heyman, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1JH, U, Danmark
  • Fernando Asbahr, Child and Adolescent Anxiety Disorders Program, Department of Psychiatry, University of Sao Paulo Medical School, Brazil, Danmark
  • Per Hove Thomsen
  • Naomi Fineberg, National Obsessive Compulsive Disorders Specialist Service, hertfordshire Partnership NHS Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, Herts, UK
  • ,
  • John March, Duke University Medical Center, Durham, NC, USA, USA
  • Accreditation Task Force of The Canadian Institute for Obsessive Compulsive Disorders

Serotonin reuptake inhibiting drugs (SRI) have been used in the treatment of paediatric obsessive-compulsive disorder over the past 30 years. We performed a systematic review and meta-analysis of the literature to discuss the place of and evidence for the use of SRI in paediatric OCD, based on 14 publications of methodologically sound, randomized and controlled studies. Both SRI and specific SRIs were examined and comparisons of SRI, placebo, cognitive behaviour therapy (CBT), combined (COMBO) treatments (SRI+CBT) made to investigate their relative efficacy. Using the Cochrane methodology, and as measures of effect size mean difference and Hedge's g, SRIs proved to be superior to drug placebo, with a modest effect size. From direct comparisons of CBT and SRI treatments, we conclude that CBT has the superior efficacy. COMBO versus CBT shows that SRI treatment adds little to concomitant CBT, while COMBO shows favourable outcome versus SRI alone. In pre-trial partial treatment responders, those who failed a SRI had better outcome from adding CBT as compared to continuing a SRI. Those who failed CBT treatment did as well with continued CBT as with switching to a SRI. The studies of combinations and sequences of treatments need to be developed further.

OriginalsprogEngelsk
TidsskriftPsychiatry Research
Vol/bind227
Nummer1
Sider (fra-til)93-103
Antal sider11
ISSN0165-1781
DOI
StatusUdgivet - 30 maj 2015

Se relationer på Aarhus Universitet Citationsformater

ID: 94155737