Nordic Network for Studies in Pediatric Obsessive- Compulsive Disorder (OCD) Neurobiology, Genetics and Treatment

OCD a serious often chronic condition with onset mostly in childhood and adolescence entails considerable suffering and impairment. Adult OCD is the 10:th most common reason for disability from illness and most adults with OCD report onset in childhood or adolescence. The etiology involves interaction of genetic, neurobiological and environmental factors. Treatment (Cognitive Behavioural Therapy (CBT) and Serotonin Re-uptake Inhibitors (SSRI) have proven efficacy over 3 months, but less is known about t he long-term benefits nor the necessary dose of CBT. However, optimal treatment in CBT non- or partial responders (about 30% in most studies), is unknown. Salient research questions in paediatric OCD can only be answered in co-ooperative networks ensurin g that a large enough number of patients are included in studies. In such networks an exchange of ideas, knowledge, research methods and expertise can occur. Three main strands are included in the application: (1) Organising researcher nwetwork meetings a nd (2) by building an infrastructure for data capture through a common electronic data capture application; and (3) implementing studies based on all patients, or in subgroups, within the network. The network's research strategy is based on (1) using CBT in a large group (n>=300) children and adolescents with moderate severe OCD; (2) to identify a group of non-, or partially responding patients (n>=100) and randomize them to either continued intensive CBT or to Sertraline (a SSRI) and CBT support; (3) st udy genetic aspects particularly centered on the role of the glutamate system; (4) neurochemical aspects using Magnet Resonance Spectroscopy; (5) neuropsychological aspects; and (6) predictors, mediators and moderators of treatment response through short- and long term (3 year) outcome studies - including the feasibility of treatment termination in responders. Also treatment refractory (CBT and SSRI) patients will be treated in a third step using Aripiprazol.