A randomised controlled feasibility trial comparing clinical and cost effectiveness of cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitors (SSRI) and their combination in the management of obsessive compulsive disorder.

2014 ◽  
Author(s):  
Solange Wyatt
Keyword(s):  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioural Therapy ◽  
Feasibility Trial ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Cognitive Behavioural ◽  
Randomised Controlled

scholarly journals Cost-effectiveness of selective serotonin reuptake inhibitors and routine specialist care with and without cognitive–behavioural therapy in adolescents with major depression

2007 ◽  
Vol 191 (6) ◽  
pp. 521-527 ◽  
Author(s):  
Sarah Byford ◽  
Barbara Barrett ◽  
Chris Roberts ◽  
Paul Wilkinson ◽  
Bernadka Dubicka ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Major Depression ◽  
Cognitive Behavioural Therapy ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Clinical Care ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Short Term ◽  
Cognitive Behavioural

BackgroundMajor depression is an important and costly problem among adolescents, yet evidence to support the provision of cost-effective treatments is lacking.AimsTo assess the short-term cost-effectiveness of combined selective serotonin reuptake inhibitors (SSRIs) and cognitive–behavioural therapy (CBT) together with clinical care compared with SSRIs and clinical care alone in adolescents with major depression.MethodPragmatic randomised controlled trial in the UK. Outcomes and costs were assessed at baseline, 12 and 28 weeks.ResultsThe trial comprised 208 adolescents, aged 11–17 years, with major or probable major depression who had not responded to a brief initial psychosocial intervention. There were no significant differences in outcome between the groups with and without CBT. Costs were higher in the group with CBT, although not significantly so (P=0.057). Cost-effectiveness analysis and exploration of the associated uncertainty suggest there is less than a 30% probability that CBT plus SSRIs is more cost-effective than SSRIs alone.ConclusionsA combination of CBT plus SSRIs is not more cost-effective in the short-term than SSRIs alone for treating adolescents with major depression in receipt of routine specialist clinical care.

scholarly journals Internet-delivered cognitive behavioural therapy for young children with obsessive–compulsive disorder: development and initial evaluation of the BIP OCD Junior programme

BJPsych Open ◽  
2018 ◽  
Vol 4 (3) ◽  
pp. 106-112 ◽  
Author(s):  
Kristina Aspvall ◽  
Per Andrén ◽  
Fabian Lenhard ◽  
Erik Andersson ◽  
David Mataix-Cols ◽  
...  
Keyword(s):  
Young Children ◽  
Obsessive Compulsive Disorder ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Primary Outcome Measure ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Cognitive Behavioural ◽  
Evidence Based Treatments ◽  
Randomised Controlled

BackgroundInternet-delivered cognitive behavioural therapy (ICBT) is a promising approach for increasing access to evidence-based treatments.AimsTo develop and evaluate the feasibility and preliminary efficacy of an ICBT programme for young children with obsessive–compulsive disorder (OCD), named BIP OCD Junior.MethodEleven children aged 7–11 years were enrolled in a 12-week open trial of parent- and therapist-guided ICBT for OCD. The primary outcome measure was the Children's Yale–Brown Obsessive–Compulsive Scale (CY-BOCS).ResultsThere was a significant improvement in OCD symptoms post-treatment, with a large within-group effect size on the CY-BOCS (Cohen's d = 1.86, 95% CI 0.83 to 2.86). Results were maintained at 3-month follow-up. Both children and parents rated the treatment as credible and were highly satisfied with the intervention.ConclusionsBIP OCD Junior is a feasible and credible treatment option for young children with OCD. Randomised controlled trials are needed to further establish its efficacy and cost-effectiveness relative to gold standard face-to-face CBT.Declaration of interestNone.

scholarly journals Is Intensive Cognitive Behavioural Therapy an Efficacious and Acceptable Treatment Format for Adults with Obsessive Compulsive Disorder? A Systematic Review of Randomised Controlled Trials

2020 ◽  
Author(s):  
Josie Frances Adeline Millar ◽  
Andreas Bauer ◽  
Sarah Halligan ◽  
Sophie-Anne Purnell ◽  
Gemma Taylor ◽  
...  
Keyword(s):  
Systematic Review ◽  
Obsessive Compulsive Disorder ◽  
Cognitive Behavioural Therapy ◽  
Randomised Controlled Trials ◽  
Behavioural Therapy ◽  
Controlled Trials ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Cognitive Behavioural ◽  
Randomised Controlled

Background: Clinical guidelines recommend the use of an intensive version of cognitive behavioural therapy (iCBT) in obsessive compulsive disorder (OCD) when evidence-based treatment has previously failed. This systematic review aimed to 1) assess the efficacy of iCBT for adults with OCD; 2) assess the acceptability of iCBT for adults with OCD.Methods: PROSPERO ID: CRD42018106840. We searched the Cochrane Controlled Register of Trials (CENTRAL), Cochrane Library, PubMed, Embase and PsycINFO for articles published between 1966 and November 2018, and reference lists and other sources for registered or ongoing studies. We included Randomised Controlled Trials (RCTs) of adults with OCD comparing iCBT to active or non-active controls. iCBT was defined as: at least five hours of CBT delivered per week in no more than four weeks for at least 10 CBT hours. The primary outcome was change in OCD symptoms from baseline to follow-up; secondary outcome was attrition; risk of bias was assessed using the Cochrane Tool. Results: Searches retrieved 5125 records, with only four RCTs with a total of 313 participants meeting inclusion criteria. Large effect sizes in favour of iCBT relative to controls were found, range (1.35 to 3.18). Drop-out rate across studies was low. However, none of the included studies focused on participants with a specific history of treatment failure. Studies were highly heterogeneous, which precluded meta-analysis. Conclusions: There was evidence that iCBT may be efficacious and acceptable. Further high quality RCTs are required to assess the efficacy and acceptability of iCBT specifically for OCD non-responders.

scholarly journals Cost-effectiveness of internet-based cognitive-behavioural therapy for obsessive-compulsive disorder

2019 ◽  
Vol 18 ◽  
pp. 100277 ◽  
Author(s):  
Debra Osborne ◽  
Denny Meyer ◽  
Richard Moulding ◽  
Michael Kyrios ◽  
Eleanor Bailey ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Obsessive Compulsive Disorder ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Cognitive Behavioural

scholarly journals Cognitive–behavioural therapy with post-session d-cycloserine augmentation for paediatric obsessive–compulsive disorder: pilot randomised controlled trial

2014 ◽  
Vol 204 (1) ◽  
pp. 77-78 ◽  
Author(s):  
David Mataix-Cols ◽  
Cynthia Turner ◽  
Benedetta Monzani ◽  
Kayoko Isomura ◽  
Caroline Murphy ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
Cognitive Behavioural ◽  
Randomised Controlled

SummaryA partial N-methyl-d-aspartate agonist, d-cycloserine, enhances fear extinction when given before or shortly after exposure to feared stimuli in animals. In this pilot double-blind placebo-controlled trial (trial number: ISRCTN70977225), 27 youth with obsessive–compulsive disorder were randomised to either 50mg d-cycloserine or placebo administered immediately after each of ten cognitive–behavioural therapy (CBT) sessions, primarily consisting of exposure and ritual prevention. Both groups improved significantly and maintained their gains at 1-year follow-up, with no significant advantage of d-cycloserine over placebo at any time point. The effects of CBT may not be augmented or accelerated when d-cycloserine is administered after sessions.

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