Continued cognitive behavior therapy versus sertraline for children and adolescents with obsessive-compulsive disorder that were non-responders to cognitive behavior therapy - A randomized controlled trial

Objectives: To investigate the effectiveness of sertraline (SRT) versus continued CBT in children and adolescents that did not respond to an initial course of CBT. Background: Expert guidelines recommend cognitive-behavior therapy (CBT) as a first line treatment in pediatric obsessive-compulsive disorder (OCD) and the addition of selective serotonin reuptake inhibitors (SSRI) when CBT is not effective. However, the recommendations for CBT non-responders are not supported by empirical data. Method: Randomized controlled trial (RCT) conducted in five sites in Denmark, Sweden and Norway, 54 children and adolescents, age 7-17 years, with DSM-IV primary OCD were randomized to SRT or continued CBT for sixteen weeks. These participants had been classified as non-responders to CBT following 14 weekly sessions. Primary outcomes were the CY-BOCS total score and clinical response (CY-BOCS