Rosslare guesthouses Family accommodation was found to mediate the relationship between symptom severity and functional impairment; the use of family-based approaches to cognitive behavioral therapy, plettenberg bay guesthouses with one of the aims of reducingmitigating FA, may provide rosslare guesthouses better treatment outcomes in pediatric OCD. Obsessive-compulsive disorder; Child; Adolescent; Pediatric; Insight; Family accommodation Background Obsessive-compulsive disorder (OCD) is a chronic anxiety disorder characterized by the presence of unwanted and recurrent thoughts, ideas, feelings, or mental images (collectively referred to as obsessions) that drive the patient to engage in behaviors or mental acts (referred to as compulsions) designed to prevent or reduce anxiety.
OCD occurs not only in adults, but also in children and adolescents and results in substantial distress rosslare guesthouses and functional impairment 1.
Childhood OCD, estimated to affect 1 to 4% of the population 2 , is associated with significant multi-domain impairment 3. This, together rosslare guesthouses rosslare guesthouses with the observation that majority rosslare guesthouses of the adult cases of OCD alnwick guesthouses (up to 80%) have an onset during childhood 4 , underscores the importance of early intervention. Current treatment options for pediatric OCD include cognitive behavioral therapy bedford guesthouses (CBT), pharmacotherapy, or both. According to the AACAP practice parameters 2012 5 , CBT is recommended as the first-line treatment for mild to moderate cases guesthouses salzburg of OCD in children. In more severe cases, selective serotonin rosslare guesthouses reuptake inhibitors (SSRIs) can be added to CBT.
These recommendations are based on the numerous studies that have shown the efficacy and acceptability of CBT, including well-conducted systematic trials 6 -10.
A meta-analysis 11 of five randomized controlled trials of CBT in children (N161) found a large mean pooled effect size for CBT of 1.45 (95% confidence interval CI 0.682.22).
In addition, CBT has been demonstrated to be effective when delivered individually, or using a family-based or group-setting approach 12 -15. Besides being the first-line treatment for OCD, CBT has pet friendly guesthouses other advantages, particularly related to patients with comorbid disorders, for example, comorbid tic disorders were found rosslare guesthouses to adversely impact treatment outcome of SSRIs, but not that of CBT 16. In addition, group CBT was found to be effective for youth with complex lijiang guesthouses comorbid conditions, including depression, attention deficithyperactivity york guesthouses disorder (ADHD) and pervasive developmental disorders (PDD) 12. Current practice parameters recommend addition of pharmacotherapy to CBT for more severe cases of the disorder. Although addition of pharmacotherapy to CBT confers additional benefit 10 ,17 , many children still fail to respond to the combined treatment and remain symptomatic. In recent clinical intervention studies investigating CBT, pharmacological treatment, or the combination of both in pediatric OCD, results indicated remission rates of 39% with CBT, and from 54% rosslare guesthouses to a maximum of 69% with the combination therapy 10 ,rosslare guesthouses 17. This emphasizes the need to further investigate the factors that affect treatment outcome and devise novel strategies (based on these factors) for treating pediatric OCD. Among the many factors that were anticipated to be predictors of treatment outcome, OCD severity, OCD-related functional impairment, insight, comorbid externalizing symptoms, and family accommodation (FA) were sihanoukville guesthouses found to be significant 18.