Intensive treatments for children and adolescents with anxiety or obsessive-compulsive disorders: a systematic review and meta-analysis
<p>Anxiety and obsessive-compulsive disorders have a significant negative impact on youth. Cognitive behavioural therapy (CBT) is recommended and established as effective first-step treatment, but persistent symptoms and non-response are common. Intensive psychological treatments deliver more...
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2024
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| _version_ | 1826315382663675904 |
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| author | Ganzevoort, COW Wolters, LH Hornstra, R Grieve, CM Højgaard, DRMA Skarphedinsson, GA Weidle, B Bertie, L-A Tomlinson, M Waite, P Nauta, MH |
| author_facet | Ganzevoort, COW Wolters, LH Hornstra, R Grieve, CM Højgaard, DRMA Skarphedinsson, GA Weidle, B Bertie, L-A Tomlinson, M Waite, P Nauta, MH |
| author_sort | Ganzevoort, COW |
| collection | OXFORD |
| description | <p>Anxiety and obsessive-compulsive disorders have a significant negative impact on youth. Cognitive behavioural therapy (CBT) is recommended and established as effective first-step treatment, but persistent symptoms and non-response are common. Intensive psychological treatments deliver more or longer sessions over a shorter time span, with fewer session gaps. However, an understanding of their effectiveness, characteristics, acceptability, and feasibility is lacking. Systematically searching five databases yielded four controlled and 36 uncontrolled studies (<em>N</em>=2707) involving youth with primary anxiety or obsessive-compulsive disorders, many of whom received prior treatments. Intensive treatments were acceptable and feasible, with low drop-out rates. Between-group analyses compared intensive treatment with standard treatment (<em>k =</em> 2) or waitlist (<em>k =</em> 2), revealing no significant post-treatment differences in symptom severity or remission. Uncontrolled within-group analyses of intensive treatments showed large improvements from pre- to post-treatment in symptoms (<em>k</em> = 47), remission (<em>k</em> = 17), impairment (<em>k</em> = 22), functioning (<em>k</em> = 5), and quality of life (<em>k</em> = 2), with larger effects at follow-ups. Intensive treatments show promise for youth with anxiety or obsessive-compulsive disorders by potentially offering high treatment completion rates and comparable outcomes to standard CBT, aiding earlier recovery and reducing overall suffering. This systematic review/meta-analysis provides a comprehensive overview of intensive treatments, their theoretical considerations, and empirical findings. Future RCTs should compare the effectiveness of standard and intensive treatments and identify optimal populations for their use.</p> |
| first_indexed | 2024-12-09T03:24:27Z |
| format | Journal article |
| id | oxford-uuid:d49ee8c1-559e-4757-aefb-cb0688562672 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-12-09T03:24:27Z |
| publishDate | 2024 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:d49ee8c1-559e-4757-aefb-cb06885626722024-11-26T09:19:57ZIntensive treatments for children and adolescents with anxiety or obsessive-compulsive disorders: a systematic review and meta-analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:d49ee8c1-559e-4757-aefb-cb0688562672EnglishSymplectic ElementsElsevier2024Ganzevoort, COWWolters, LHHornstra, RGrieve, CMHøjgaard, DRMASkarphedinsson, GAWeidle, BBertie, L-ATomlinson, MWaite, PNauta, MH<p>Anxiety and obsessive-compulsive disorders have a significant negative impact on youth. Cognitive behavioural therapy (CBT) is recommended and established as effective first-step treatment, but persistent symptoms and non-response are common. Intensive psychological treatments deliver more or longer sessions over a shorter time span, with fewer session gaps. However, an understanding of their effectiveness, characteristics, acceptability, and feasibility is lacking. Systematically searching five databases yielded four controlled and 36 uncontrolled studies (<em>N</em>=2707) involving youth with primary anxiety or obsessive-compulsive disorders, many of whom received prior treatments. Intensive treatments were acceptable and feasible, with low drop-out rates. Between-group analyses compared intensive treatment with standard treatment (<em>k =</em> 2) or waitlist (<em>k =</em> 2), revealing no significant post-treatment differences in symptom severity or remission. Uncontrolled within-group analyses of intensive treatments showed large improvements from pre- to post-treatment in symptoms (<em>k</em> = 47), remission (<em>k</em> = 17), impairment (<em>k</em> = 22), functioning (<em>k</em> = 5), and quality of life (<em>k</em> = 2), with larger effects at follow-ups. Intensive treatments show promise for youth with anxiety or obsessive-compulsive disorders by potentially offering high treatment completion rates and comparable outcomes to standard CBT, aiding earlier recovery and reducing overall suffering. This systematic review/meta-analysis provides a comprehensive overview of intensive treatments, their theoretical considerations, and empirical findings. Future RCTs should compare the effectiveness of standard and intensive treatments and identify optimal populations for their use.</p> |
| spellingShingle | Ganzevoort, COW Wolters, LH Hornstra, R Grieve, CM Højgaard, DRMA Skarphedinsson, GA Weidle, B Bertie, L-A Tomlinson, M Waite, P Nauta, MH Intensive treatments for children and adolescents with anxiety or obsessive-compulsive disorders: a systematic review and meta-analysis |
| title | Intensive treatments for children and adolescents with anxiety or obsessive-compulsive disorders: a systematic review and meta-analysis |
| title_full | Intensive treatments for children and adolescents with anxiety or obsessive-compulsive disorders: a systematic review and meta-analysis |
| title_fullStr | Intensive treatments for children and adolescents with anxiety or obsessive-compulsive disorders: a systematic review and meta-analysis |
| title_full_unstemmed | Intensive treatments for children and adolescents with anxiety or obsessive-compulsive disorders: a systematic review and meta-analysis |
| title_short | Intensive treatments for children and adolescents with anxiety or obsessive-compulsive disorders: a systematic review and meta-analysis |
| title_sort | intensive treatments for children and adolescents with anxiety or obsessive compulsive disorders a systematic review and meta analysis |
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