Effectiveness of BIG-CBT in Children and Adolescents with Obsessive-Compulsive Disorder: A comparison of treatment outcomes and symptom profiles across children and adolescents with OCD only and children and adolescents with OCD and comorbid autism spectrum disorder.

Introduction: Obsessive-compulsive disorder (OCD) in children and adolescents is highly comorbid with autism spectrum disorder (ASD) (37.2%). ASD may negatively affect the effectiveness of OCD treatment. Standard cognitive behavior therapy (CBT) appeared to be less effective for children with OCD and comorbid ASD. Brief intensive group CBT (BIG-CBT) may therefore be a valuable extension. This study aimed to examine whether the presence of a comorbid ASD diagnosis affects the effectiveness of BIG-CBT in children with OCD. In addition, children with OCD and ASD often present with different symptom profiles compared to children with OCD alone. Therefore, the second aim was to investigate potential differences in types of obsessions and compulsions between these groups. Insights from this study may inform more tailored treatment strategies, which makes this clinically relevant. Methods: A retrospective pre-post mixed-subjects design was employed, using existing data from patient files....Show moreIntroduction: Obsessive-compulsive disorder (OCD) in children and adolescents is highly comorbid with autism spectrum disorder (ASD) (37.2%). ASD may negatively affect the effectiveness of OCD treatment. Standard cognitive behavior therapy (CBT) appeared to be less effective for children with OCD and comorbid ASD. Brief intensive group CBT (BIG-CBT) may therefore be a valuable extension. This study aimed to examine whether the presence of a comorbid ASD diagnosis affects the effectiveness of BIG-CBT in children with OCD. In addition, children with OCD and ASD often present with different symptom profiles compared to children with OCD alone. Therefore, the second aim was to investigate potential differences in types of obsessions and compulsions between these groups. Insights from this study may inform more tailored treatment strategies, which makes this clinically relevant. Methods: A retrospective pre-post mixed-subjects design was employed, using existing data from patient files. The final sample contained 154 children (ages 8 – 21 years) who completed a five-day intensive BIG-CBT at Levvel, Amsterdam UMC. Treatment outcomes were measured using Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) difference scores (pretest – posttest). Additionally, the five most prevalent types of obsessions and compulsions within the sample were measured to examine potential differences in symptom profiles. Gender and other comorbidities, besides ASD, were included as covariates. Results: No significant difference in CY-BOCS scores (p = .42) was observed between children with OCD alone (M 8.0, SD 6.6) and those with OCD and ASD (M 8.8, SD 7.0). Similarly, there were no significant main effects of group for each of the five types of obsessions and compulsions (p’s > .05). Conclusion: Findings illustrate that BIG-CBT appeared similarly effective and that symptom profiles were comparable in both groups. This suggests that the presence of an ASD diagnosis did not influence OCD treatment outcomes or symptom profiles. The discrepancy between our results and previous research warrants further investigations into this topic, with the aim of further clarifying whether tailored interventions strategies are needed for children with OCD and ASD. In conclusion, these findings indicate that children with OCD and ASD response similarly to BIG-CBT as children with only OCD. Moreover, no differences in types of obsessions or compulsions were observed. Solely based on these results, treatment adjustments are not necessary.Show less

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Effectiveness of BIG-CBT in Children and Adolescents with Obsessive-Compulsive Disorder: A comparison of treatment outcomes and symptom profiles across children and adolescents with OCD only and children and adolescents with OCD and comorbid autism spectrum disorder.