Contemporary study of OCD - POTS

POTS team (2004)

What was the aim of this study?

• To investigate the effectiveness of CBT as a treatment for OCD, compared to drugs alone or combined with drugs

Who was this study funded by?

The national institution for mental health (in USA) in order to find best intervention, as statistics show that up to 50% adults with OCD

For the procedure, what was the sample?

Volunteer sample of 112 adolescents and children (7-17 yrs old)

What were the medical states of the participants?

(severity, co-morbidity)

• The severity of the symptoms were measured using the Childrens Yale-Brown Obsessive Compulsive Scale (CY-BOCS) - only those with score of 16+ included

• Those with co-morbidity included e.g. major depression. Those with ADHD included if medicated.

What conditions were the children allocated to?

Each child allocated to one of 4:

• CBT only

• Drugs only

• Combination

• Placebo

How long did study last?

12 weeks, OCD symptoms were assessed at weeks 4,8 and 12

Who was monitoring the progress?

Each child had their own psychiatrist throughout, and an independent evaluator assessed the children at the intervals

What type of study was it?

Longitudinal

What results were found?

• Of the 112 starter, 97 completed the study

• All conditions showed improvements at the 12 weeks as measured on CY-BOCS

• In the CBT alone, 39.3% entered remission compared to 21.4% in the drugs alone condition

What were the differences found in the: CBT alone condition, drugs alone, combination and placebo.

• CBT alone- -12

• Drugs alone- -7

• Combination- -12.6

• Placebo- -4.7

What conclusions were drawn

• Effect of CBT leads to higher improvement rate than drugs

• Improvement slightly higher when 2 treatment

Evaluating POTS

Generalisability

Large sample- 112 and low drop out rate (87%)

Only 7-17 years

Volunteer sample

Reliability

Several techniques to increase reliability - CBT followed strict protocols and drug increase guided by strict schedules.

Validity

Well controlled procedures - assessors were blind to condition each participant was in to avoid bias in evaluation.

However, 12 participants and clinicians were aware that those on combined treatment were receiving real drugs and not placebos.

Ethics

Researchers were sensitive to ethical issues

Children’s parents gave written consent , ensured confidentiality and security of data.

Those on placebo left untreated during the study

However, after study they were offered treatment.