Anne Katrine Pagsberg, Nicole Nadine Lønfeldt, Christine Lykke Thoustrup, Nicoline Løcke Jepsen Korsbjerg, Camilla Funch Uhre, Sofie Heidenheim Christensen, Valdemar Funch Uhre, Anna-Rosa Cecilie Mora-Jensen, Melanie Ritter, Linea Pretzmann, Helga Kristensen Ingstrup, Birgitte Borgbjerg Moltke, Gitte Sommer Harboe, Emilie Damløv Thorsen, Line Katrine Harder Clemmensen, Jane Lindschou, Janus Engstrøm, Christian Gluud, Hartwig Roman Siebner, Per Hove Thomsen, Katja Hybel, Frank Verhulst, William Baare, Pia Jeppesen, Jens Richardt Møllegaard Jepsen, Signe Vangkilde, Markus Harboe Olsen, Julie Hagstrøm, Kerstin Jessica Plessen
{"title":"以家庭为基础的认知行为疗法与以家庭为基础的心理教育和放松训练治疗儿童和青少年强迫症:一项随机临床试验(TECTO)。","authors":"Anne Katrine Pagsberg, Nicole Nadine Lønfeldt, Christine Lykke Thoustrup, Nicoline Løcke Jepsen Korsbjerg, Camilla Funch Uhre, Sofie Heidenheim Christensen, Valdemar Funch Uhre, Anna-Rosa Cecilie Mora-Jensen, Melanie Ritter, Linea Pretzmann, Helga Kristensen Ingstrup, Birgitte Borgbjerg Moltke, Gitte Sommer Harboe, Emilie Damløv Thorsen, Line Katrine Harder Clemmensen, Jane Lindschou, Janus Engstrøm, Christian Gluud, Hartwig Roman Siebner, Per Hove Thomsen, Katja Hybel, Frank Verhulst, William Baare, Pia Jeppesen, Jens Richardt Møllegaard Jepsen, Signe Vangkilde, Markus Harboe Olsen, Julie Hagstrøm, Kerstin Jessica Plessen","doi":"10.1007/s00787-025-02797-4","DOIUrl":null,"url":null,"abstract":"<p><p>Few randomized clinical trials (RCTs) have compared cognitive behavioral therapy (CBT) versus active control interventions for pediatric obsessive-compulsive disorder (OCD), and the range of investigated outcomes has been limited. We investigated benefits and harms of family-based CBT with exposure and response prevention (FCBT) versus family-based psychoeducation and relaxation training (FPRT) in pediatric OCD. This single-center RCT was investigator-initiated, independently funded, including participants with OCD aged 8-17 years with a Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) entry score ≥ 16. We randomized participants 1:1 to 14 sessions of FCBT versus FPRT. Allocation was masked to assessors and statisticians. The primary outcome was CY-BOCS end-of-treatment-score (week-16) analyzed by intention-to-treat. Adverse events were reported by the Negative Effects Questionnaire (NEQ-20). One-hundred-and-thirty participants were randomized, 52.3% females; mean age 13.3 (SD = 2.9) years; mean CY-BOCS total score 25.8 (SD = 4.9); n = 64 to FCBT versus n = 66 to FPRT. Sixteen participants dropped out (four from FCBT, 12 from FPRT). The mean CY-BOCS total score at end-of-treatment was significantly lower for FCBT (15.9, SD = 8.7) versus FPRT (19.9, SD = 8.1), estimate - 3.89, 95%CI [-6.83, - 0.96), p = 0.01, effect size = 0.47, 95% CI [0.09, 0.85]. This difference was below our predefined minimal clinically important difference of four points. The average weekly NEQ frequency score showed no significant group differences. FCBT was associated with significantly larger symptom reduction than FPRT, but with a modest effect. FCBT and FPRT appeared comparably tolerable. A rigorous methodology enabled the counteraction of several biases. Limitations included missing self-reported data and inability of masking participants and treatment providers.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":4.9000,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Family-based cognitive behavioral therapy versus family-based psychoeducation and relaxation training for obsessive-compulsive disorder in children and adolescents: a randomized clinical trial (TECTO).\",\"authors\":\"Anne Katrine Pagsberg, Nicole Nadine Lønfeldt, Christine Lykke Thoustrup, Nicoline Løcke Jepsen Korsbjerg, Camilla Funch Uhre, Sofie Heidenheim Christensen, Valdemar Funch Uhre, Anna-Rosa Cecilie Mora-Jensen, Melanie Ritter, Linea Pretzmann, Helga Kristensen Ingstrup, Birgitte Borgbjerg Moltke, Gitte Sommer Harboe, Emilie Damløv Thorsen, Line Katrine Harder Clemmensen, Jane Lindschou, Janus Engstrøm, Christian Gluud, Hartwig Roman Siebner, Per Hove Thomsen, Katja Hybel, Frank Verhulst, William Baare, Pia Jeppesen, Jens Richardt Møllegaard Jepsen, Signe Vangkilde, Markus Harboe Olsen, Julie Hagstrøm, Kerstin Jessica Plessen\",\"doi\":\"10.1007/s00787-025-02797-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Few randomized clinical trials (RCTs) have compared cognitive behavioral therapy (CBT) versus active control interventions for pediatric obsessive-compulsive disorder (OCD), and the range of investigated outcomes has been limited. We investigated benefits and harms of family-based CBT with exposure and response prevention (FCBT) versus family-based psychoeducation and relaxation training (FPRT) in pediatric OCD. This single-center RCT was investigator-initiated, independently funded, including participants with OCD aged 8-17 years with a Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) entry score ≥ 16. We randomized participants 1:1 to 14 sessions of FCBT versus FPRT. Allocation was masked to assessors and statisticians. The primary outcome was CY-BOCS end-of-treatment-score (week-16) analyzed by intention-to-treat. Adverse events were reported by the Negative Effects Questionnaire (NEQ-20). One-hundred-and-thirty participants were randomized, 52.3% females; mean age 13.3 (SD = 2.9) years; mean CY-BOCS total score 25.8 (SD = 4.9); n = 64 to FCBT versus n = 66 to FPRT. Sixteen participants dropped out (four from FCBT, 12 from FPRT). The mean CY-BOCS total score at end-of-treatment was significantly lower for FCBT (15.9, SD = 8.7) versus FPRT (19.9, SD = 8.1), estimate - 3.89, 95%CI [-6.83, - 0.96), p = 0.01, effect size = 0.47, 95% CI [0.09, 0.85]. This difference was below our predefined minimal clinically important difference of four points. The average weekly NEQ frequency score showed no significant group differences. FCBT was associated with significantly larger symptom reduction than FPRT, but with a modest effect. FCBT and FPRT appeared comparably tolerable. A rigorous methodology enabled the counteraction of several biases. 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Family-based cognitive behavioral therapy versus family-based psychoeducation and relaxation training for obsessive-compulsive disorder in children and adolescents: a randomized clinical trial (TECTO).
Few randomized clinical trials (RCTs) have compared cognitive behavioral therapy (CBT) versus active control interventions for pediatric obsessive-compulsive disorder (OCD), and the range of investigated outcomes has been limited. We investigated benefits and harms of family-based CBT with exposure and response prevention (FCBT) versus family-based psychoeducation and relaxation training (FPRT) in pediatric OCD. This single-center RCT was investigator-initiated, independently funded, including participants with OCD aged 8-17 years with a Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) entry score ≥ 16. We randomized participants 1:1 to 14 sessions of FCBT versus FPRT. Allocation was masked to assessors and statisticians. The primary outcome was CY-BOCS end-of-treatment-score (week-16) analyzed by intention-to-treat. Adverse events were reported by the Negative Effects Questionnaire (NEQ-20). One-hundred-and-thirty participants were randomized, 52.3% females; mean age 13.3 (SD = 2.9) years; mean CY-BOCS total score 25.8 (SD = 4.9); n = 64 to FCBT versus n = 66 to FPRT. Sixteen participants dropped out (four from FCBT, 12 from FPRT). The mean CY-BOCS total score at end-of-treatment was significantly lower for FCBT (15.9, SD = 8.7) versus FPRT (19.9, SD = 8.1), estimate - 3.89, 95%CI [-6.83, - 0.96), p = 0.01, effect size = 0.47, 95% CI [0.09, 0.85]. This difference was below our predefined minimal clinically important difference of four points. The average weekly NEQ frequency score showed no significant group differences. FCBT was associated with significantly larger symptom reduction than FPRT, but with a modest effect. FCBT and FPRT appeared comparably tolerable. A rigorous methodology enabled the counteraction of several biases. Limitations included missing self-reported data and inability of masking participants and treatment providers.
期刊介绍:
European Child and Adolescent Psychiatry is Europe''s only peer-reviewed journal entirely devoted to child and adolescent psychiatry. It aims to further a broad understanding of psychopathology in children and adolescents. Empirical research is its foundation, and clinical relevance is its hallmark.
European Child and Adolescent Psychiatry welcomes in particular papers covering neuropsychiatry, cognitive neuroscience, genetics, neuroimaging, pharmacology, and related fields of interest. Contributions are encouraged from all around the world.