Difficult-to-treat pediatric obsessive-compulsive disorder: Feasibility and preliminary results of a randomized pilot trial of D-cycloserine-augmented behavior therapy

Background: This study examined the feasibility and preliminary effectiveness of d-cycloserine (DCS)–augmented cognitive behavioral therapy (CBT) for children and adolescents with difficult-to-treat Obsessive Compulsive Disorder, in a double-blind randomized controlled pilot trial (RCT).Methods: Sev...

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Main Authors: Farrell, L., Waters, A., Boschen, M., Hattingh, Laetitia, McConnell, H., Milliner, E., Collings, N., Zimmer-Gembeck, M., Shelton, D., Ollendick, T., Testa, C., Storch, E.
Format: Journal Article
Published: Wiley-Liss, Inc 2013
Online Access:http://hdl.handle.net/20.500.11937/38575
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author Farrell, L.
Waters, A.
Boschen, M.
Hattingh, Laetitia
McConnell, H.
Milliner, E.
Collings, N.
Zimmer-Gembeck, M.
Shelton, D.
Ollendick, T.
Testa, C.
Storch, E.
author_facet Farrell, L.
Waters, A.
Boschen, M.
Hattingh, Laetitia
McConnell, H.
Milliner, E.
Collings, N.
Zimmer-Gembeck, M.
Shelton, D.
Ollendick, T.
Testa, C.
Storch, E.
author_sort Farrell, L.
building Curtin Institutional Repository
collection Online Access
description Background: This study examined the feasibility and preliminary effectiveness of d-cycloserine (DCS)–augmented cognitive behavioral therapy (CBT) for children and adolescents with difficult-to-treat Obsessive Compulsive Disorder, in a double-blind randomized controlled pilot trial (RCT).Methods: Seventeen children and adolescents (aged 8–18 years) with a primary diagnosis of OCD, which was deemed difficult-to-treat, were randomly assigned to either nine sessions of CBT including five sessions of DCS-augmented exposure and response prevention (ERP) [ERP + DCS] or nine sessions of CBT including five sessions of placebo-augmented ERP [ERP + PBO]. Weight-dependent DCS or placebo doses (25 or 50 mg) were taken 1 hour before ERP sessions.Results: At post treatment, both groups showed significant improvements with 94% of the entire sample classified as responders. However, a greater improvement in the ERP + DCS relative to the ERP + PBO condition was observed at 1-month follow-up on clinician-rated obsessional severity and diagnostic severity, and parent ratings of OCD severity. There were no changes across time or condition from 1- to 3-month follow-up.Conclusions: In this preliminary study, DCS-augmented ERP produced significant improvements in OCD severity from posttreatment to 1-month follow-up, relative to a placebo control condition, in severe and difficult-to-treat pediatric OCD. The significant effect on obsessional severity suggests that DCS augmentation might be associated with enhanced modification of obsessional thoughts during ERP, and warrants further investigation.
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spelling curtin-20.500.11937-385752019-02-19T05:35:13Z Difficult-to-treat pediatric obsessive-compulsive disorder: Feasibility and preliminary results of a randomized pilot trial of D-cycloserine-augmented behavior therapy Farrell, L. Waters, A. Boschen, M. Hattingh, Laetitia McConnell, H. Milliner, E. Collings, N. Zimmer-Gembeck, M. Shelton, D. Ollendick, T. Testa, C. Storch, E. Background: This study examined the feasibility and preliminary effectiveness of d-cycloserine (DCS)–augmented cognitive behavioral therapy (CBT) for children and adolescents with difficult-to-treat Obsessive Compulsive Disorder, in a double-blind randomized controlled pilot trial (RCT).Methods: Seventeen children and adolescents (aged 8–18 years) with a primary diagnosis of OCD, which was deemed difficult-to-treat, were randomly assigned to either nine sessions of CBT including five sessions of DCS-augmented exposure and response prevention (ERP) [ERP + DCS] or nine sessions of CBT including five sessions of placebo-augmented ERP [ERP + PBO]. Weight-dependent DCS or placebo doses (25 or 50 mg) were taken 1 hour before ERP sessions.Results: At post treatment, both groups showed significant improvements with 94% of the entire sample classified as responders. However, a greater improvement in the ERP + DCS relative to the ERP + PBO condition was observed at 1-month follow-up on clinician-rated obsessional severity and diagnostic severity, and parent ratings of OCD severity. There were no changes across time or condition from 1- to 3-month follow-up.Conclusions: In this preliminary study, DCS-augmented ERP produced significant improvements in OCD severity from posttreatment to 1-month follow-up, relative to a placebo control condition, in severe and difficult-to-treat pediatric OCD. The significant effect on obsessional severity suggests that DCS augmentation might be associated with enhanced modification of obsessional thoughts during ERP, and warrants further investigation. 2013 Journal Article http://hdl.handle.net/20.500.11937/38575 10.1002/da.22132 Wiley-Liss, Inc fulltext
spellingShingle Farrell, L.
Waters, A.
Boschen, M.
Hattingh, Laetitia
McConnell, H.
Milliner, E.
Collings, N.
Zimmer-Gembeck, M.
Shelton, D.
Ollendick, T.
Testa, C.
Storch, E.
Difficult-to-treat pediatric obsessive-compulsive disorder: Feasibility and preliminary results of a randomized pilot trial of D-cycloserine-augmented behavior therapy
title Difficult-to-treat pediatric obsessive-compulsive disorder: Feasibility and preliminary results of a randomized pilot trial of D-cycloserine-augmented behavior therapy
title_full Difficult-to-treat pediatric obsessive-compulsive disorder: Feasibility and preliminary results of a randomized pilot trial of D-cycloserine-augmented behavior therapy
title_fullStr Difficult-to-treat pediatric obsessive-compulsive disorder: Feasibility and preliminary results of a randomized pilot trial of D-cycloserine-augmented behavior therapy
title_full_unstemmed Difficult-to-treat pediatric obsessive-compulsive disorder: Feasibility and preliminary results of a randomized pilot trial of D-cycloserine-augmented behavior therapy
title_short Difficult-to-treat pediatric obsessive-compulsive disorder: Feasibility and preliminary results of a randomized pilot trial of D-cycloserine-augmented behavior therapy
title_sort difficult-to-treat pediatric obsessive-compulsive disorder: feasibility and preliminary results of a randomized pilot trial of d-cycloserine-augmented behavior therapy
url http://hdl.handle.net/20.500.11937/38575