{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:45:31Z","timestamp":1790729131772,"version":"4.1.0"},"reference-count":167,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"\n CONTEXT<\/jats:title>\n We examined treatments for obsessive-compulsive disorder (OCD) in children and adolescents.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n The objective was to evaluate the comparative efficacy of behavioral and pharmacologic treatments.<\/jats:p>\n <\/jats:sec>\n \n DATA SOURCES<\/jats:title>\n Sources include 6 databases and the ClinicalTrials.gov registry; search was last updated on May 15, 2024.<\/jats:p>\n <\/jats:sec>\n \n STUDY SELECTION<\/jats:title>\n Dual screening was augmented by Abstrackr machine learning algorithm.<\/jats:p>\n <\/jats:sec>\n \n DATA EXTRACTION<\/jats:title>\n Data include participant characteristics, intervention details, and risk of bias.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Results are from 71 randomized controlled trials. In the random effects network meta-analysis of OCD symptom severity, assessed by the Children\u2019s Yale-Brown Obsessive-Compulsive Scale Total (CY-BOCS), exposure and response prevention therapy (ERP) is more effective than waitlist (net mean difference [NMD], \u221210.5; 95% CI, \u221212.6 to \u22128.4) and probably more effective vs behavioral control (NMD, \u22125.3; 95% CI, \u22128.0 to \u22122.7). Remote ERP is more effective than waitlist (NMD, \u22129.4; 95% CI, \u221211.9 to \u22127.0) and as effective as in-person ERP. Selective serotonin reuptake inhibitors (SSRIs) are more effective than placebo (NMD, \u22124.4; 95% CI, \u22126.1 to \u22122.6). Clomipramine is probably more effective than placebo (NMD, \u22124.5; 95% CI, \u22126.8 to \u22122.1). ERP is probably more effective than SSRI (NMD, \u22122.7; 95% CI, \u22125.4 to \u22120.0), and combined ERP and an SSRI are probably more effective than SSRI alone (NMD, \u22123.0; 95% CI, \u22125.1 to \u22121.0). Overall, treatments including ERP (ERP+SSRI, ERP, and remote ERP) comprise the 3 highest-ranked interventions.<\/jats:p>\n <\/jats:sec>\n \n LIMITATIONS<\/jats:title>\n Non\u2013CY-BOCS outcomes were sparsely reported.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n ERP, delivered in-person or via telehealth, SSRIs, and clomipramine are all effective treatments. ERP, alone or in combination with an SSRI, is probably more effective than an SSRI alone.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2024-068992","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T00:01:54Z","timestamp":1733443314000},"source":"Crossref","is-referenced-by-count":13,"title":["Treatment of Obsessive-Compulsive Disorder in Children and Youth: A Meta-Analysis"],"prefix":"10.1542","volume":"155","author":[{"given":"Dale W.","family":"Steele","sequence":"first","affiliation":[{"name":"1Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island"},{"name":"2Departments of Emergency Medicine and Pediatrics, Brown University, Warren Alpert Medical School, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghid","family":"Kanaan","sequence":"additional","affiliation":[{"name":"1Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo L.","family":"Caputo","sequence":"additional","affiliation":[{"name":"1Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer B.","family":"Freeman","sequence":"additional","affiliation":[{"name":"3Department of Psychiatry and Human Behavior, Brown University, Warren Alpert Medical School, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth H.","family":"Brannan","sequence":"additional","affiliation":[{"name":"3Department of Psychiatry and Human Behavior, Brown University, Warren Alpert Medical School, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan M.","family":"Balk","sequence":"additional","affiliation":[{"name":"1Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Trikalinos","sequence":"additional","affiliation":[{"name":"1Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island"},{"name":"4Department of Biostatistics, Brown University School of Public Health, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaelen P.","family":"Adam","sequence":"additional","affiliation":[{"name":"1Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, Brown University School of Public Health, 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