caa a22 4500 605477523 CHVBK 20210128100401.0 cr unu---uuuuu 210128e20150501xx s 000 0 eng 10.1007/s00787-014-0613-0 doi (NATIONALLICENCE)springer-10.1007/s00787-014-0613-0 Continued cognitive-behavior therapy versus sertraline for children and adolescents with obsessive-compulsive disorder that were non-responders to cognitive-behavior therapy: a randomized controlled trial [Elektronische Daten] [Gudmundur Skarphedinsson, Bernhard Weidle, Per Thomsen, Kitty Dahl, Nor Torp, Judith Nissen, Karin Melin, Katja Hybel, Robert Valderhaug, Tore Wentzel-Larsen, Scott Compton, Tord Ivarsson] Expert guidelines recommend cognitive-behavior therapy (CBT) as a first-line treatment in pediatric obsessive-compulsive disorder (OCD) and the addition of selective serotonin reuptake inhibitors when CBT is not effective. However, the recommendations for CBT non-responders are not supported by empirical data. Our objective was to investigate the effectiveness of sertraline (SRT) versus continued CBT in children and adolescents that did not respond to an initial course of CBT. Randomized controlled trial conducted in five sites in Denmark, Sweden and Norway, 54 children and adolescents, age 7-17years, with DSM-IV primary OCD were randomized to SRT or continued CBT for 16weeks. These participants had been classified as non-responders to CBT following 14 weekly sessions. Primary outcomes were the CY-BOCS total score and clinical response (CY-BOCS <16). The study was a part of the Nordic Long-Term OCD Treatment Study (NordLOTS). Intent-to-treat sample included 50 participants, mean age 14.0 (SD=2.7) and 48% (n=24) males. Twenty-one of 28 participants (75%) completed continued CBT and 15 of 22 participants (69.2%) completed SRT. Planned pairwise comparison of the CY-BOCS total score did not reveal a significant difference between the treatments (p=.351), the response rate was 50.0% in the CBT group and 45.4% in the SRT group. The multivariate χ 2 test suggested that there were no statistically significant differences between groups (p=.727). Within-group effect sizes were large and significant across both treatments. These large within-group effect sizes suggest that continued treatment for CBT non-responders is beneficial. However, there was no significant between-group differences in SRT or continued CBT at post-treatment. The Author(s), 2014 Cognitive-behavior therapy nationallicence Selective serotonin reuptake inhibitors nationallicence Sertraline nationallicence Obsessive-compulsive disorder nationallicence Children and adolescents nationallicence Treatment outcome nationallicence Skarphedinsson Gudmundur Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway aut Weidle Bernhard Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Klostergate 46, 7491, Trondheim, Norway aut Thomsen Per Research Department, Center for Child and Adolescent psychiatry, Aarhus University Hospital, Skovagervej 2, Indgang 81, 0824, Risskov, Denmark aut Dahl Kitty Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway aut Torp Nor Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway aut Nissen Judith Research Department, Center for Child and Adolescent psychiatry, Aarhus University Hospital, Skovagervej 2, Indgang 81, 0824, Risskov, Denmark aut Melin Karin Department of Child and Adolescent Psychiatry, BUP Specialmottagning, Queen Silvia's Children's Hospital, Sahlgrenska University Hospital, 41685, Gothenburg, Sweden aut Hybel Katja Research Department, Center for Child and Adolescent psychiatry, Aarhus University Hospital, Skovagervej 2, Indgang 81, 0824, Risskov, Denmark aut Valderhaug Robert Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Klostergate 46, 7491, Trondheim, Norway aut Wentzel-Larsen Tore Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway aut Compton Scott Duke University Medical Center, DUMC 3527, 27710, Durham, NC, USA aut Ivarsson Tord Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway aut European Child & Adolescent Psychiatry Springer Berlin Heidelberg 24/5(2015-05-01), 591-602 1018-8827 24:5<591 2015 24 787 https://doi.org/10.1007/s00787-014-0613-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00787-014-0613-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Skarphedinsson Gudmundur Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway aut NATIONALLICENCE 700 1- Weidle Bernhard Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Klostergate 46, 7491, Trondheim, Norway aut NATIONALLICENCE 700 1- Thomsen Per Research Department, Center for Child and Adolescent psychiatry, Aarhus University Hospital, Skovagervej 2, Indgang 81, 0824, Risskov, Denmark aut NATIONALLICENCE 700 1- Dahl Kitty Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway aut NATIONALLICENCE 700 1- Torp Nor Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway aut NATIONALLICENCE 700 1- Nissen Judith Research Department, Center for Child and Adolescent psychiatry, Aarhus University Hospital, Skovagervej 2, Indgang 81, 0824, Risskov, Denmark aut NATIONALLICENCE 700 1- Melin Karin Department of Child and Adolescent Psychiatry, BUP Specialmottagning, Queen Silvia's Children's Hospital, Sahlgrenska University Hospital, 41685, Gothenburg, Sweden aut NATIONALLICENCE 700 1- Hybel Katja Research Department, Center for Child and Adolescent psychiatry, Aarhus University Hospital, Skovagervej 2, Indgang 81, 0824, Risskov, Denmark aut NATIONALLICENCE 700 1- Valderhaug Robert Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Klostergate 46, 7491, Trondheim, Norway aut NATIONALLICENCE 700 1- Wentzel-Larsen Tore Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway aut NATIONALLICENCE 700 1- Compton Scott Duke University Medical Center, DUMC 3527, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Ivarsson Tord Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway aut NATIONALLICENCE 773 0- European Child & Adolescent Psychiatry Springer Berlin Heidelberg 24/5(2015-05-01), 591-602 1018-8827 24:5<591 2015 24 787