Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: a pilot randomized controlled trial.
AIMS
To examine the feasibility, acceptability and preliminary efficacy of family-based exposure/response prevention therapy (E/RP) versus treatment as usual (TAU) in a cohort of very young children with early onset obsessive-compulsive disorder (OCD).


METHODS
Thirty-one children ages 3-8 years (M = 5.8 years) with a primary diagnosis of OCD were randomized to E/RP or TAU. The E/RP condition received 12 sessions of family-based E/RP twice weekly over 6 weeks. Families were assessed at baseline, post-treatment, 1-month and 3-month follow up. The Children's Yale Brown Obsessive Compulsive Scale and Clinical Global Impression served as primary outcome measures.


RESULTS
A large group effect emerged in favor of the E/RP group (d = 1.69). Sixty-five percent of the E/RP group was considered treatment responders as compared to 7% in the TAU group. Symptom remission was achieved in 35.2% of the E/RP group and 0% of the TAU group. There was no attrition and satisfaction was high; gains were maintained at 3 months.


CONCLUSIONS
Even amongst children as young as 3 years, developmentally tailored E/RP is efficacious and well-tolerated in reducing OCD symptoms. Key adaptations for younger children include extensive parent involvement, targeting family accommodation, and frequent meetings while delivering a full course of E/RP.


CLINICALTRIALSGOV IDENTIFIER
NCT01447966 http://clinicaltrials.gov/ct2/show/NCT01447966?term=ocd+and+st+petersburg&rank=1.
['Lewin|Adam B|AB|', 'Park|Jennifer M|JM|', 'Jones|Anna M|AM|', 'Crawford|Erika A|EA|', 'De Nadai|Alessandro S|AS|', 'Menzel|Jessie|J|', 'Arnold|Elysse B|EB|', 'Murphy|Tanya K|TK|', 'Storch|Eric A|EA|']
D000367:Age Factors D001521:Behavior Therapy D002648:Child D002675:Child, Preschool D003131:Combined Modality Therapy D005196:Family Therapy D005260:Female D006801:Humans D007171:Implosive Therapy D008297:Male D009771:Obsessive-Compulsive Disorder D010865:Pilot Projects D011569:Psychiatric Status Rating Scales
Very young children OCD Accommodation Cognitive therapy Exposure-response prevention Preschool