Author Affiliation: Department of Epidemiology, University of Florida, Gainesville (firstname.lastname@example.org).
To the Editor: Dr Franklin and colleagues reported that the addition of cognitive behavior therapy (CBT) to serotonin reuptake inhibitor (SRI) treatment was efficacious among participants aged 7 through 17 years who had a primary diagnosis of obsessive-compulsive disorder (OCD) and partial response to SRI medication.1 However, this study did not address the effect of comorbidity on CBT or SRI treatment. In this study, 59.7% of the participants had 1 or more comorbidities, 21.8% had attention-deficit/hyperactivity disorder (ADHD), and 15.3% had tic disorder. The authors reported no difference in comorbidities or SRI medications in the 3 treatment groups (SRI only, SRI plus instructions in CBT, and SRI plus CBT); however, the P value for Pearson χ2 test for tic disorder was .06, which was not statistically significant but still worth consideration. The authors did not do pairwise comparisons to show whether there was a difference in having tic disorder between the SRI-only group (21.4%) and the SRI plus CBT group (4.8%).
Wang Y. Cognitive Behavior Therapy for Pediatric Obsessive-Compulsive Disorder. JAMA. 2012;307(6):560–561. doi:10.1001/jama.2012.108