Has the first-line management of paediatric OCD improved following the introduction of NICE guidelines?

INTRODUCTION Obsessive–compulsive disorder (OCD) is a distressing and impairing condition that affects between 0.25% and 4% of children and adolescents. In 2005, the National Institute of Health and Care Excellence (NICE) introduced guidelines for the management of paediatric OCD in the UK. Based on robust evidence, NICE recommended cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) as first-line psychological and pharmacological treatments. However, the extent to which patients are able to access these evidence-based interventions in routine clinical practice remains unclear. To assess the impact of these guidelines, we conducted an audit of the previous treatment received by children with OCD referred to the National and Specialist Paediatric (N&S) OCD clinic at the Maudsley Hospital, London. We hypothesised that publication of NICE guidelines, in 2005, would increase the use of SSRIs and CBT in this group of patients.