A study by the Bellvitge University Hospital, the Bellvitge Biomedical Research Institute (IDIBELL), the University of Barcelona, and CIBERSAM observes that children with increased volume of two prefrontal cortex structures respond better to cognitive behavioral therapy.
Predicting the patients that may benefit from the therapy would avoid costly trial and error processes and would permit correct those factors responsible for the therapy failure.
A new study has found that the size of two brain structures is associated with the response to cognitive behavioral therapy in children with obsessive-compulsive disorder (OCD). The work is led by researchers from the Bellvitge University Hospital, the Bellvitge Biomedical Research Institute (IDIBELL), the University of Barcelona, and the CIBER for Mental Health (CIBERSAM) and published in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), the most important international journal in the field.
Brain MRI analysis of 168 children and adolescents from international centers showed that those with increased volume of two prefrontal cortex regions had more significant reduction of obsessive-compulsive symptoms after behavior therapy intervention. The results could mean that those patients with these prefrontal structures (related to the anxiety response) more developed, could take advantage of the emotional regulation strategies provided by behavior therapy.
Greater Dr. Carles Soriano, principal investigator at IDIBELL and the Psychology School at University of Barcelona, and member of CIBERSAM indicates that “the identification of these structures can mean a great improvement in the clinical management of children with OCD“. And he adds, “even though behavioral therapy is effective in more than 60% of cases, its action mechanisms are still largely unknown". This prevents us from predicting which patients may benefit from the therapy to avoiding costly trial and error processes and/or modifying those factors responsible for the therapy failure”.
The project also studies a large adult sample. However, no correlation was observed between the size of the brain structures and the efficacy of the therapy. Thus, even though behavior therapy is equally effective, the results seem to indicate that the mechanisms of action of this intervention may differ from those of children.
Cognitive behavioral therapy in obsessive compulsive disorder
In children, Obsessive-compulsive disorder manifests with anxiety in facing situations perceived as annoying or uncontrollable, which results in the need to, for example, organize things in a certain way, repeat words or behaviors several times, or repeatedly check an action, such as turning off the light. These symptoms interfere with the normal development of family, social, and academic activities and significantly affect their well-being.
The treatment of choice for these cases is cognitive behavioral therapy, a form of psychological intervention based on exposing the patient, in a controlled manner, to situations that generate anxiety and let extinguish this anxiety. In addition, cognitive strategies or modulation of thought are frequently used.