Evidence map›Paper›PMID 30877851›Full record

Trial reportJournal of behavior therapy and experimental psychiatry2019

Sudden gains in cognitive behavioral therapy among children and adolescents with obsessive compulsive disorder.

Eric A Storch, Joseph F McGuire, Sophie C Schneider, Brent J Small, Tanya K Murphy, Sabine Wilhelm, Daniel A Geller

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of behavior therapy and experimental psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00864123 (D-Cycloserine Augmentation of Therapy for Pediatric Obsessive-Compulsive Disorder), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00864123 phase2completednot on this map

D-Cycloserine Augmentation of Therapy for Pediatric Obsessive-Compulsive Disorder

TypeinterventionalSponsorUniversity of South FloridaRan2008 to 2009Enrolled30ConditionsObsessive-compulsive DisorderArmsCognitive-behavioral therapy, D-cycloserine, Placebo pill
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Sudden gains in modular CBT for mental health disorders in children and young people with epilepsy.Journal of child psychology and psychiatry, and allied disciplines · 2025
    Trial
  2. Symptom Trajectories of Early Responders and Remitters among Youth with OCD.Journal of obsessive-compulsive and related disorders · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Eric A StorchMenninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA. Electronic address: eric.storch@bcm.edu.
Joseph F McGuireDivision of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, USA.
Sophie C SchneiderMenninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA.
Brent J SmallSchool of Aging Studies, University of South Florida, USA.
Tanya K MurphyDepartment of Pediatrics, University of South Florida, USA.
Sabine WilhelmMassachusetts General Hospital and Harvard Medical School, USA.
Daniel A GellerMassachusetts General Hospital and Harvard Medical School, USA.

Funding

2/2-D-Cycloserine Augmentation of CBT for Pediatric OCDR01MH093402 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI GELLER, DANIEL A · 2011 to 2014
$1.7M
1/2-D-Cycloserine Augmentation of CBT for Pediatric OCDR01MH093381 · NIMH · UNIVERSITY OF SOUTH FLORIDA · PI STORCH, ERIC A. · 2011 to 2014
$1.2M
D-Cycloserine Augmentation of Therapy for Pediatric Obsessive-Compulsive DisorderR03MH076775 · NIMH · UNIVERSITY OF FLORIDA · PI STORCH, ERIC A · 2007 to 2007
$73k
NIMH NIH HHS R01 MH093381NIMH NIH HHS R01 MH093402NIMH NIH HHS R03 MH076775
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThis study examined the occurrence of sudden gains (or reversal of gains) among children with obsessive-compulsive disorder (OCD) during the course of cognitive-behavioral therapy (CBT), as well as the association of sudden gains with treatment response, treatment group, and pre-treatment clinical characteristics.

methodsThe sample consisted of 136 youth (ages 7-17) with a primary diagnosis of OCD who were randomized in a double-blinded fashion to 10 sessions of CBT with augmentation of either d-cycloserine or placebo. Sudden gain status was determined based on clinician-rated obsessive-compulsive symptom severity, which was collected on 9 occasions across the study period.

results42.6% of youth experienced at least one sudden gain, which tended to occur either after starting exposure and response prevention or towards the end of treatment. After applying the Benjamini-Hochberg procedure for multiple comparisons, there were no significant pre-treatment predictors of sudden gains and only reduced insight predicted the reversal of gains. Individuals with at least one sudden gain had improved overall treatment outcomes, measured both by reduction in OCD symptom severity, and by global illness severity. LIMITATIONS: Several clinical constructs were not examined. Symptomatology was not assessed at every treatment session. Differences in those who achieved sudden gains and those who did not may be obscured. There is the possibility that a sudden gain reflected a scoring error generated by an optimistic or inaccurate report. Finally, a relatively homogenous sample may limit the generalizability of results.

conclusionsThe course of CBT for pediatric OCD is variable with many children experiencing sudden gains, but a sizable percentage experience a reversal of gains which was related to reduced insight. Sudden gains tended to occur after starting exposure and response prevention and towards the end of treatment. TRIALSREGISTRATION: ClinicaltrialsgovRegistry:NCT00864123. https://www.clinicaltrials.gov/ct2/show/NCT00864123.

Indexed as

Cognitive Behavioral TherapyOutcome Assessment, Health CareAdolescentChildCombined Modality TherapyCycloserineDouble-Blind MethodFemaleHumansMaleNeurotransmitter AgentsObsessive-Compulsive DisorderCycloserineNeurotransmitter AgentsChildrenCognitive-behavioral therapyObsessive-compulsive disorderSudden gains

Identifiers

PMID30877851
PMCPMC6520195

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.