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Family-based cognitive behavioral therapy versus family-based psychoeducation and relaxation training for obsessive-compulsive disorder in children and adolescents: a randomized clinical trial (TECTO).

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Title: Family-based cognitive behavioral therapy versus family-based psychoeducation and relaxation training for obsessive-compulsive disorder in children and adolescents: a randomized clinical trial (TECTO).
Authors: Pagsberg, Anne Katrine (AUTHOR), Lønfeldt, Nicole Nadine (AUTHOR), Thoustrup, Christine Lykke (AUTHOR), Korsbjerg, Nicoline Løcke Jepsen (AUTHOR), Uhre, Camilla Funch (AUTHOR), Christensen, Sofie Heidenheim (AUTHOR), Uhre, Valdemar Funch (AUTHOR), Mora-Jensen, Anna-Rosa Cecilie (AUTHOR), Ritter, Melanie (AUTHOR), Pretzmann, Linea (AUTHOR), Ingstrup, Helga Kristensen (AUTHOR), Moltke, Birgitte Borgbjerg (AUTHOR), Harboe, Gitte Sommer (AUTHOR), Thorsen, Emilie Damløv (AUTHOR), Clemmensen, Line Katrine Harder (AUTHOR), Lindschou, Jane (AUTHOR), Engstrøm, Janus (AUTHOR), Gluud, Christian (AUTHOR), Siebner, Hartwig Roman (AUTHOR), Thomsen, Per Hove (AUTHOR)
Source: European Child & Adolescent Psychiatry. Dec2025, Vol. 34 Issue 12, p3955-3971. 17p.
Subjects: Family psychotherapy, Statistical sampling, Logistic regression analysis, Questionnaires, Psychoeducation, Group psychotherapy, Treatment effectiveness, Randomized controlled trials, Mann Whitney U Test, Obsessive-compulsive disorder, Quality of life, Cognitive therapy, Behavior therapy, Relaxation techniques, Regression analysis, Evaluation, Adolescence, Children
Abstract: Few randomized clinical trials (RCTs) have compared cognitive behavioral therapy (CBT) versus active control interventions for pediatric obsessive-compulsive disorder (OCD), and the range of investigated outcomes has been limited. We investigated benefits and harms of family-based CBT with exposure and response prevention (FCBT) versus family-based psychoeducation and relaxation training (FPRT) in pediatric OCD. This single-center RCT was investigator-initiated, independently funded, including participants with OCD aged 8–17 years with a Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) entry score ≥ 16. We randomized participants 1:1 to 14 sessions of FCBT versus FPRT. Allocation was masked to assessors and statisticians. The primary outcome was CY-BOCS end-of-treatment-score (week-16) analyzed by intention-to-treat. Adverse events were reported by the Negative Effects Questionnaire (NEQ-20). One-hundred-and-thirty participants were randomized, 52.3% females; mean age 13.3 (SD = 2.9) years; mean CY-BOCS total score 25.8 (SD = 4.9); n = 64 to FCBT versus n = 66 to FPRT. Sixteen participants dropped out (four from FCBT, 12 from FPRT). The mean CY-BOCS total score at end-of-treatment was significantly lower for FCBT (15.9, SD = 8.7) versus FPRT (19.9, SD = 8.1), estimate − 3.89, 95%CI [–6.83, − 0.96), p = 0.01, effect size = 0.47, 95% CI [0.09, 0.85]. This difference was below our predefined minimal clinically important difference of four points. The average weekly NEQ frequency score showed no significant group differences. FCBT was associated with significantly larger symptom reduction than FPRT, but with a modest effect. FCBT and FPRT appeared comparably tolerable. A rigorous methodology enabled the counteraction of several biases. Limitations included missing self-reported data and inability of masking participants and treatment providers. Trial registration number and date of registration: clinical trials.gov NCT03595098, 07-23-2018. [ABSTRACT FROM AUTHOR]
Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Family-based cognitive behavioral therapy versus family-based psychoeducation and relaxation training for obsessive-compulsive disorder in children and adolescents: a randomized clinical trial (TECTO).
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  Data: <searchLink fieldCode="AR" term="%22Pagsberg%2C+Anne+Katrine%22">Pagsberg, Anne Katrine</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lønfeldt%2C+Nicole+Nadine%22">Lønfeldt, Nicole Nadine</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Thoustrup%2C+Christine+Lykke%22">Thoustrup, Christine Lykke</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Korsbjerg%2C+Nicoline+Løcke+Jepsen%22">Korsbjerg, Nicoline Løcke Jepsen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Uhre%2C+Camilla+Funch%22">Uhre, Camilla Funch</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Christensen%2C+Sofie+Heidenheim%22">Christensen, Sofie Heidenheim</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Uhre%2C+Valdemar+Funch%22">Uhre, Valdemar Funch</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mora-Jensen%2C+Anna-Rosa+Cecilie%22">Mora-Jensen, Anna-Rosa Cecilie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ritter%2C+Melanie%22">Ritter, Melanie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pretzmann%2C+Linea%22">Pretzmann, Linea</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ingstrup%2C+Helga+Kristensen%22">Ingstrup, Helga Kristensen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Moltke%2C+Birgitte+Borgbjerg%22">Moltke, Birgitte Borgbjerg</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Harboe%2C+Gitte+Sommer%22">Harboe, Gitte Sommer</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Thorsen%2C+Emilie+Damløv%22">Thorsen, Emilie Damløv</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Clemmensen%2C+Line+Katrine+Harder%22">Clemmensen, Line Katrine Harder</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lindschou%2C+Jane%22">Lindschou, Jane</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Engstrøm%2C+Janus%22">Engstrøm, Janus</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gluud%2C+Christian%22">Gluud, Christian</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Siebner%2C+Hartwig+Roman%22">Siebner, Hartwig Roman</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Thomsen%2C+Per+Hove%22">Thomsen, Per Hove</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Child+%26+Adolescent+Psychiatry%22">European Child & Adolescent Psychiatry</searchLink>. Dec2025, Vol. 34 Issue 12, p3955-3971. 17p.
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  Data: Few randomized clinical trials (RCTs) have compared cognitive behavioral therapy (CBT) versus active control interventions for pediatric obsessive-compulsive disorder (OCD), and the range of investigated outcomes has been limited. We investigated benefits and harms of family-based CBT with exposure and response prevention (FCBT) versus family-based psychoeducation and relaxation training (FPRT) in pediatric OCD. This single-center RCT was investigator-initiated, independently funded, including participants with OCD aged 8–17 years with a Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) entry score ≥ 16. We randomized participants 1:1 to 14 sessions of FCBT versus FPRT. Allocation was masked to assessors and statisticians. The primary outcome was CY-BOCS end-of-treatment-score (week-16) analyzed by intention-to-treat. Adverse events were reported by the Negative Effects Questionnaire (NEQ-20). One-hundred-and-thirty participants were randomized, 52.3% females; mean age 13.3 (SD = 2.9) years; mean CY-BOCS total score 25.8 (SD = 4.9); n = 64 to FCBT versus n = 66 to FPRT. Sixteen participants dropped out (four from FCBT, 12 from FPRT). The mean CY-BOCS total score at end-of-treatment was significantly lower for FCBT (15.9, SD = 8.7) versus FPRT (19.9, SD = 8.1), estimate − 3.89, 95%CI [–6.83, − 0.96), p = 0.01, effect size = 0.47, 95% CI [0.09, 0.85]. This difference was below our predefined minimal clinically important difference of four points. The average weekly NEQ frequency score showed no significant group differences. FCBT was associated with significantly larger symptom reduction than FPRT, but with a modest effect. FCBT and FPRT appeared comparably tolerable. A rigorous methodology enabled the counteraction of several biases. Limitations included missing self-reported data and inability of masking participants and treatment providers. Trial registration number and date of registration: clinical trials.gov NCT03595098, 07-23-2018. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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