Dissertation Defence: A Critical Review of Meta-Analyse Recommendations For Treating Child-Adolescent Onset Obsessive-Compulsive Disorder (OCD)
August 5 at 11:00 am - 3:00 pm
Jasmine Serena Schwartz, supervised by Dr. Edward H. Taylor, will defend their dissertation titled “A Critical Review of Meta-Analyse Recommendations For Treating Child-Adolescent Onset Obsessive-Compulsive Disorder (OCD)” in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Interdisciplinary Graduate Studies.
An abstract for Jasmine Serena Schwartz’s dissertation is included below.
Examinations are open to all members of the campus community as well as the general public. [Registration is not required for in-person exams.
Abstract
Problem: Obsessive-compulsive disorder (OCD) is one of the most common mental illnesses among children and adolescents, it negatively impacts important areas of functioning, rarely subsides without intervention, and when left untreated has been found to cause clinically significant distress throughout a lifetime. While research in this area is increasing, recommendations on the most effective treatments are sometimes inconsistent.
Aims: This study aimed to analyze current research to address the problem of conflicting recommendations and to identify which treatments are known to be the most effective.
Methods: To accomplish the aims, the researcher surveyed available literature on youth and OCD interventions between the years of 2003 and 2022. Twenty-four meta-analyses were compared for methodology, measurement instrumentation, subject and population descriptions, treatment interventions, and findings. The findings were compared based on the standardized mean difference (SMD), their confidence intervals (CI), standard error (SE) or variance.
Results: The study validated previous findings that (1) evidence-based treatments are effective for symptom reduction, (2) only minor differences in changes in symptoms based on the CY-BOCS exist between treatments with and without medication, and (3) talk therapies, especially CBT are effective and relieve youth-onset OCD symptoms, and most forms of this therapy also included ERP interventions. Examination of primary studies focused on combined medication with talk therapy showed that each treatment assessed was significantly effective (SMD = 0.82-3.41). CBT in combination with: medication (SMD = 2.68), SRIs (SMD = 2.51), SSRIs (SMD = 2.22); CBT-ERP combined with: DCS (SMD = 2.87, 2.70, 3.20) or a placebo medication (SMD = 2.10, 2.93, 2.71, 1.69); and ACT combined with SSRI (SMD = 1.72) each showed a large effect. These forms of combined treatments were more effective than SSRIs alone (SMD = 0.95) and sertraline alone (SMD = 0.95).
Conclusion: There appear to be only minor differences in the effectiveness of all evidence-based interventions, including prescription drugs. Therefore, except when there is a danger of self-harming or harming others, CBT should be implemented for treating youth with OCD before medication treatment is introduced.
