Many people with obsessive-compulsive disorder develop it in childhood or adolescence. Several antidepressants have been shown to work on pediatric obsessive-compulsive disorder; for a new study, researchers tried out therapy.

What the researchers wanted to know: What is the best way to treat obsessive-compulsive disorder (OCD) in children—cognitive-behavior therapy, sertraline (Zoloft), or both?

What they did: One hundred and twelve children with OCD joined the study and were randomly assigned to 12 weeks of the antidepressant by itself, cognitive behavioral therapy alone, therapy plus the drug, or a placebo pill. Except for the drug-only and placebo-only kids, everyone knew what treatment they were getting. After 4, 8, and 12 weeks, an evaluator who didn't know the treatments scored the kids' obsessions and compulsions.

What they found: Kids getting therapy alone or therapy plus Zoloft improved the most. Kids getting the drug alone improved more than kids on placebo but less than those getting therapy. None of the kids taking drugs had serious side effects or became depressed or suicidal.

What the study means to you: The researchers conclude that children and adolescents with obsessive-compulsive disorder should start with just cognitive-behavior therapy or therapy with an antidepressant of the selective serotonin reuptake inhibitor class (which includes Zoloft, the drug tested here).

Caveats: This doesn't say which treatment might be best suited to which children; the researchers say they'll be answering that question in future articles. Pfizer, which makes Zoloft, provided the drug and placebo, and the lead author of the paper has received speaker fees, consulting fees, and research support from several drug companies. However, this study was funded by the National Institute for Mental Health, and neither NIMH nor Pfizer had any hand in the study design or analysis.

Find out more: The National Library of Medicine has a long list of links to information on children's mental health, such as this list of questions for parents to ask about their children's meds, from the American Academy of Child & Adolescent Psychiatry.

Read the article: The Pediatric OCD Treatment Study (POTS) Team. "Cognitive-Behavior Therapy, Sertraline, and Their Combination for Children and Adolescents With Obsessive-Compulsive Disorder." Journal of the American Medical Association. Oct. 27, 2004, Vol. 292, No. 16, pp. 1969–1976.

Abstract online: http://jama.ama-assn.org