Cognitive-Behavioral Therapy and Anxiety and Depression Level in Pediatric Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis/Terapia Cognitivo-Conductual y Niveles de Ansiedad y Depresion en el Trastorno Obsesivo-Compulsivo Pediatrico: una Revision Sistematica y Meta-Analisis

• Published in: Psicothema 2022-07, Vol.34 (3), p.353
• Main Authors: Rosa-Alcazar, Angel, Sanchez-Meca, Julio, Rubio-Aparicio, Maria, Bernal-Ruiz, Cristina, Rosa-Alcazar, Ana Isabel
• Format: Article
• Language: English
• ISSN: 0214-9915
• DOI: 10.7334/psicothema2021.478

Background: Although some meta-analyses have identified potential moderators associated with treatment outcomes for pediatric obsessive-compulsive disorder (OCD), there is as yet no consensus regarding the influence of anxiety and depression symptoms on the recovery from pediatric OCD. A meta-analysis was conducted to investigate the effects of depression and anxiety symptoms and their comorbidities on the efficacy of CBT in pediatric OCD, as well as other potential moderators that may be associated with outcomes. Method: An exhaustive literature search from 1983 to March 2021 located 22 published articles that applied cognitive-behavioral therapy (CBT) to pediatric OCD, producing a total of 26 treatment groups. Some of the moderator variables analyzed included age, gender, comorbidity baseline in anxiety, depression and obsession, and methodological quality. Results: Results showed that the psychological treatment of OCD achieves clinically significant effectiveness, both for measures of obsessions and compulsions ([d.sub.+] = 2.030), and for anxiety ([d.sub.+] = 0.613) and depression ([d.sub.+] = 0.451). An explanatory model for the CY-BOCS effect sizes showed that three moderator variables were statistically related: the mean of the CY-BOCS (Children's Yale Brown Obsessive Compulsive Scale) in pretest, the effect size for anxiety, and the mean age of the sample. Conclusions: CBT reduced obsessive-compulsive symptoms and, to a lesser extent, anxiety and depression symptoms. Since anxiety symptoms are reduced with the same therapy, resources would be saved compared to other treatments. Keywords: Cognitive-behavioral therapy Pediatric OCD Anxiety symptoms Depression symptoms Anxiety Depression Antecedentes: Aunque algunos metanálisis han identificado posibles moderadores asociados con los resultados del tratamiento en el trastorno obsesivo compulsivo (TOC) pediátrico, todavía no existe consenso sobre la influencia de los síntomas de ansiedad y depresión en la recuperación de éste. Se realizó un metanálisis para investigar los efectos de los síntomas ansioso-depresivos y sus comorbilidades sobre la eficacia de la TCC en el TOC pediátrico, así como otras posibles variables moderadoras que pudieran estar asociados con el resultado. Método: Realizamos una búsqueda exhaustiva de la literatura desde 1983 hasta marzo de 2021 que nos permitió localizar 22 artículos publicados que aplicaban la terapia cognitivo-conductual (TCC) en el TOC pediátrico, produciendo un