Do Children with OCD Fare Better in the Long Term with Therapy or Medication After an Initial Failure?
Obsessive-compulsive disorder in children and adolescents can cause significant distress and severely disrupt their daily lives. When cognitive behavioral therapy, considered the first recommended treatment, does not yield the expected results, what should be done next? Recent research followed fifty young people aged 7 to 17 for three years who had not responded to an initial series of therapy sessions. These young individuals were randomly assigned to either continue therapy or receive medication with sertraline, an antidepressant often used in such cases.
The results show that both approaches lead to lasting improvement. After three years, 92% of participants showed a significant reduction in their symptoms. Among them, 77% were in complete remission, meaning they showed almost no signs of the disorder, and 15% had only mild symptoms. No significant difference was observed between those who continued therapy and those who took the medication. This means that both options are effective in the long term for children and adolescents who do not respond well to the initial phase of treatment.
Cognitive behavioral therapy helps patients modify their thoughts and behaviors by gradually exposing them to their fears while preventing them from repeating their compulsive rituals. Sertraline, on the other hand, works by increasing serotonin levels in the brain, a substance that influences mood and anxiety. During the study, some young participants experienced moderate side effects such as restlessness or sleep disturbances, but no serious effects were reported. Most tolerated the treatment well, whether it was therapy or medication.
These findings confirm the value of tailoring treatment to each patient’s needs. Rather than viewing an initial failure as a dead end, it is possible to offer an alternative that can lead to significant improvement. Families and caregivers can therefore consider these two solutions with confidence, knowing that each offers real chances of long-term well-being. The key is not to give up after an unsuccessful first attempt and to continue searching for the most suitable method for each situation.
Our References
Original Reference
DOI: https://doi.org/10.1007/s00787-026-03009-3
Title: Three-Year Follow-Up of children and adolescents with OCD Who Did Not Respond to Initial Cognitive-Behavioral Therapy (CBT): Outcomes of Continued CBT vs. Sertraline
Journal: European Child & Adolescent Psychiatry
Publisher: Springer Science and Business Media LLC
Authors: Gudmundur Skarphedinsson; Bernhard Weidle; Nor Christian Torp; Davíð R. M. A. Højgaard; Sanne Jensen; Karin Melin; Katja Anna Hybel; Per Hove Thomsen; Judith B. Nissen; Tord Ivarsson