Randomized,placebo-controlled trial of cognitive-behavioral therapy alone or combined with sertraline in the treatment of pediatric obsessive–compulsive disorder

Background

To examine the efficacy of sequential sertraline and cognitive-behavioral therapy (CBT) treatment relative to CBT with pill placebo over 18 weeks in children and adolescents with obsessive–compulsive disorder (OCD).

Methods

Forty-seven children and adolescents with OCD (Range = 7–17 years) were randomized to 18-weeks of treatment in one of three arms: 1) sertraline at standard dosing + CBT (RegSert + CBT); 2) sertraline titrated slowly but achieving at least 8 weeks on the maximally tolerated daily dose + CBT (SloSert + CBT); or 3) pill placebo + CBT (PBO + CBT). Assessments were conducted at screening, baseline, weeks 1–9, 13, and 17, and post-treatment. Raters and clinicians were blinded to sertraline (but not CBT) randomization status. Primary outcomes included the Children's Yale-Brown Obsessive–Compulsive Scale, and response and remission status. Secondary outcomes included the Child Obsessive Compulsive Impact Scale–Parent/Child, Children's Depression Rating Scale-Revised, Multidimensional Anxiety Scale for Children, and Clinical-Global Impressions-Severity.

Results

All groups exhibited large within-group effects across outcomes. There was no group by time interaction across all outcomes suggesting that group changes over time were comparable.

Conclusions

Among youth with OCD, there was no evidence that sequentially provided sertraline with CBT differed from those receiving placebo with CBT.

ClinicalTrials.gov Identifier

NCT00382291.     

Talkativeness in Cognitively Normal Women at Genetic Risk for Alzheimer’s Disease

Previous research has suggested a correlation between some linguistic patterns and the risk for Alzheimer’s disease (AD). There is increasing clinical need to identify factors that can be used alone or in combination to predict the onset of AD. The purpose of the present study was to explore the association of language skills and genetic risk for Alzheimer’s disease. Oral and written language samples of cognitively normal women with a susceptibility gene for AD (ApoE e4) were compared to those of noncarriers on measures of grammatical complexity, topic relevance, and talkativeness by observers unaware of participant genotypes. Participants included 29 ApoE e4 carriers 49-73 years of age, and 29 e4 noncarriers 48-76 years of age, most of whom had a first-degree relative with AD. Carriers and noncarriers were group matched for age, educational level, and estimated IQ. Participant groups did not differ significantly in language complexity or topic relevance. However, the ApoE e4 group was significantly more talkative than the noncarrier group (p < .05).