Two recent studies showed that cognitive-behavioral therapy (CBT) was a highly successful form of treatment for children and adolescents with both obsessive-compulsive disorder (OCD) and chronic fatigue syndrome (CFS).

A study published in JAMA (Journal of the American Medical Association) observed the effect of behavioral therapy on obsessive-compulsive symptoms in 112 children (age range 7-17 years) compared to the effect of the SSRI antidepressant Zoloft (Sertraline).

The CBT group had a remission rate of 39 percent compared to a remission rate of 21 percent for the medication group. Treatment consisted of 14 one-hour sessions of therapy over a 12 week period that included (1) psychoeducation, (2) cognitive training, (3) mapping OCD target symptoms, and (4) exposure and response (ritual) prevention. The researchers concluded that because of the significant risk from antidepressants (manic episodes and suicidal behavior) children and adolescents with OCD should begin treatment with cognitive-behavioral therapy.

A second study evaluated the effect of cognitive-behavioral therapy on chronic fatigue syndrome (CFS). This study included 71 adolescents (10-17 years) diagnosed with CFS. Treatment consisted of 10 therapy sessions where the patients were encouraged to begin a program of gradually increased exercise. The control group was put on a wait list.

Patients in the therapy group reported a significantly greater decrease in fatigue severity and functional impairment compared to the control group. At five months the participants in the therapy group experienced improved concentration, better sleep, less muscle pain, and less headaches. The control group reported an increase in these symptoms. Most significantly, almost 60 percent of the patients in the therapy group returned to full-time education, an important indication of recovery.

Both of these studies confirm that an approach encompassing education, encouragement, emotional support, and self-discipline are successful means to overcome serious disorders in children and adolescents.

Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: The pediatric OCD treatment study (POTS) randomized controlled trial JAMA 2004; 292:1969-1976.

Reference:

Stulmeijer M, et al. Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomized controlled trial. British Medical Journal 2005 (Jan 1); 330:14-19.