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  • Difficult-To-Treat Pediatric Obsessive-Compulsive Disorder: Feasibility and Preliminary Results of a Randomized Pilot Trial of D-Cycloserine-Augmented Behavior Therapy

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    Author(s)
    Farrell, Lara J
    Waters, Allison M
    Boschen, Mark J
    Hattingh, Laetitia
    McConnell, Harry
    Milliner, Ella L
    Collings, Nigel
    Zimmer-Gembeck, Melanie
    Shelton, Doug
    Ollendick, Thomas H
    Testa, Chris
    Storch, Eric A
    Griffith University Author(s)
    Farrell, Lara J.
    Boschen, Mark J.
    Zimmer-Gembeck, Melanie
    Waters, Allison M.
    Year published
    2013
    Metadata
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    Abstract
    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 ...
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    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 posttreatment, 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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    Journal Title
    Depression and Anxiety
    Volume
    30
    Issue
    8
    DOI
    https://doi.org/10.1002/da.22132
    Copyright Statement
    © 2013 Wiley Periodicals Inc. This is the pre-peer reviewed version of the following article: Difficult-To-Treat Pediatric Obsessive-Compulsive Disorder: Feasibility and Preliminary Results of a Randomized Pilot Trial of D-Cycloserine-Augmented Behavior Therapy, Depression and Anxiety, Volume 30, Issue 8, 2013, pages 723–731, which has been published in final form at http://dx.doi.org/10.1002/da.22132.
    Subject
    Clinical sciences
    Other psychology not elsewhere classified
    Clinical and health psychology
    Social and personality psychology
    Publication URI
    http://hdl.handle.net/10072/52674
    Collection
    • Journal articles

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