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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 through-out 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 cognitive behavioural therapy (CBT) are effective and relieve youth-onset OCD symptoms, and most forms of this therapy also included exposure and response prevention (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), serotonin reuptake inhibitors (SRIs) (SMD = 2.51), selective (SSRIs) (SMD = 2.22); CBT-ERP combined with d-cyclsoerine (SMD = 2.87, 2.70, 3.20) or a placebo medication (SMD = 2.10, 2.93, 2.71, 1.69); and acceptance and commitment therapy 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 appears to be only minor differences in the effectiveness of 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.