A significant number of children and adolescents with obsessive compulsive disorder (OCD) demonstrate poor response to the current gold standard treatment, cognitive behaviour therapy (CBT) with exposure and response prevention (ERP). Recent findings suggest that family variables affect treatment response highlighting the need for a meta-analytic review of the precise impact of family variables on OCD-related symptoms and processes. The current review and meta-analysis examined the effect of family-based interventions on OCD symptom and family factor outcomes for children and adolescents with OCD. The moderating effects of the degree of parental involvement and number of family factors targeted in treatment were investigated. An extensive literature search identified 37 eligible studies (1727 OCD participants). Large significant pooled mean effect sizes for OCD symptoms and Family Accommodation (FA), respectively, were obtained at posttest (g = 1.56; g = 1.00) and follow-up (g = 1.69; g = 1.98). Moderator analyses indicated that the number of family factors targeted in treatment significantly moderated outcomes on measures of FA (z = 2.21, p = 0.03), but not on Children’s/Yale-Brown Obsessive Compulsive Scale (C/Y-BOCS) outcomes. FA has been significantly correlated with OCD symptom severity and poorer treatment outcomes, and there is data to suggest that FA may mediate OCD symptom outcomes (e.g., Piacentini et al. in J Am Acad Child Adolesc Psychiatry 50:1149–1161, 2011). Findings show that the greater the number of family factors targeted, the greater the reduction in FA at post, highlighting the importance of addressing a range of family factors in child OCD treatment to optimise outcomes.

中文翻译：

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对儿童和青少年强迫症的基于家庭的心理治疗：荟萃分析和系统评价。

大量强迫症（OCD）的儿童和青少年表现出对目前的黄金标准治疗，认知行为疗法（CBT）和暴露及反应预防（ERP）的不良反应。最近的发现表明，家庭变量会影响治疗反应，这凸显了对家庭变量对强迫症相关症状和过程的确切影响进行荟萃分析的必要性。当前的综述和荟萃分析检查了家庭干预对强迫症儿童和青少年强迫症症状和家庭因素结局的影响。研究了父母参与程度和针对治疗的家庭因素数量的调节作用。大量文献检索确定了37项合格研究（1727名OCD参与者）。g  = 1.56；g  = 1.00）和随访（g  = 1.69；g  = 1.98）。主持人的分析表明，针对治疗的家庭因素数量显着降低了FA的预后（z  = 2.21，p = 0.03），但不包括儿童/耶鲁布朗强迫症量表（C / Y-BOCS）结局。FA已与OCD症状严重程度和较差的治疗结果显着相关，并且有数据表明FA可能介导OCD症状结果（例如，Piacentini等人，《 J Am Acad Child Adolesc Psychiatry 50：1149–1161，2011》）。研究结果表明，靶向的家庭因素越多，术后FA的减少越大，这突出了在儿童强迫症治疗中解决一系列家庭因素以优化结果的重要性。