New Research Shows Better Ways To Help Young People With OCD

Findings from a Patient-Centered Outcomes Research Institute (PCORI)-funded systematic review conducted by the Agency for Health Care Research and Quality (AHRQ) have provided important insights into diagnosing and treating obsessive compulsive disorder (OCD) in children and teens.

What OCD Looks Like in Young People

OCD often emerges during childhood or adolescence, affecting about one in every 100 children in the United States.

• Children might experience unwanted or intrusive thoughts and behaviors that feel impossible to ignore, happen frequently and disrupt their daily life.
• They often develop repetitive behaviors to cope with anxiety or avoid triggers.
• These repetitive behaviors might seem unrelated to their thoughts but feel necessary to them.
• More than half of all OCD cases begin during childhood or adolescence.

Treatment Approaches and New Evidence

Current clinical guidelines from the American Academy of Pediatrics (AAP) recommend cognitive behavioral therapy with exposure response prevention (ERP) as a first-line treatment for OCD. Through ERP, patients gradually face their fears and learn new ways to respond to anxiety-producing situations.

For patients experiencing more severe symptoms, AAP recommends combining ERP with antidepressants known as selective serotonin reuptake inhibitors (SSRIs) to provide additional support during therapy.

However, every person experiences OCD differently, and what works best can vary from patient to patient. This systematic review aimed to better understand how clinicians can match each patient with the most effective treatment for their specific situation.

Analyzing data from 71 randomized control trials, findings showed:

1. ERP therapy, whether used alone or combined with SSRIs, showed greater effectiveness than SSRI treatment alone.
2. ERP therapy demonstrated comparable effectiveness whether delivered in person or through telehealth.
   1. The telehealth finding is particularly significant for expanding access to treatment, as telehealth can make quality care accessible to families who live far from specialists or have scheduling challenges.

Early Detection

In addition to assessing treatment options, the PCORI-funded, AHRQ-led review sought to evaluate the accuracy of assessments for pediatric OCD. While a full diagnosis requires an expert clinical evaluation, the review found one tool, the Child Behavior Checklist-Obsessive Compulsive subscale, had the most support for facilitating early detection and referral to a specialist. This tool helps clinicians spot potential signs of OCD earlier, allowing them to help ensure children and teens get the right support before the condition affects other areas of their life. Without treatment, OCD can lead to depression and other complications in adulthood.

Impact

With OCD affecting one to two percent of young people in the United States, these findings are key to diagnosing and treatment options. Timely diagnosis and effective treatment can help to alleviate symptoms in childhood and promote healthy development through adulthood.

The Role of PCORI

PCORI is the leading funder of patient-centered comparative clinical effectiveness research (CER) in the United States. Their mission focuses on funding research to answer questions about which treatments work best for specific patients under various circumstances, prioritizing issues that matter most to patients, their caregivers and the broader healthcare community. Beyond direct CER funding, PCORI supports systematic reviews that synthesize existing high-quality medical and public health studies to answer patient-centered questions.