Efficacy of Exposure and Response Prevention Therapy in Combination with Selective Serotonin Reuptake Inhibitors for Obsessive-Compulsive Disorder in Adolescents: A Real-Life Experience from Bangladesh.

The objective of this study was to evaluate the efficacy of Exposure and response prevention (ERP) therapy in combination with Selective Serotonin Reuptake Inhibitors (SSRIs) in adolescents with Obsessive-Compulsive Disorder (OCD). This parallel arm interventional study was conducted among 40 adolescents with OCD in the Outpatient Clinic of the Department of Psychiatry of Bangladesh Medical University (BMU) Hospital, Dhaka, Bangladesh from May 2018 to September 2020. The participants were randomly selected either for SSRI in combination with ERP therapy (n=21) or SSRI only (n=19). The change in severity of OCD symptoms measured by Children Yale-Brown Obsessive Compulsive Scale (CY-BOCS) and rate of response (≥25.0% reduction in OCD severity from baseline) and remission (final CY-BOCS score ≤12) were considered as the outcome measures. Combination of ERP therapy with SSRIs resulted in more reduction of OCD symptom severity in adolescents compared to SSRI only therapy (reduction in CY-BOCS score was 43.8% and 28.2% respectively at week 12, p-value <0.001). Besides, rate of 60 response at week 6 and rate of remission at week 12 were higher in adolescents who received ERP therapy in combination with SSRIs (response rate 85.7% vs. 26.3%, p-value <0.001 and remission rate 42.9% vs. 28.6%, p-value 0.001). Combination of ERP therapy and SSRI had a better efficacy compared to SSRI only in symptom reduction in adolescents with OCD.