Obsessive-compulsive (OC) symptoms are often present among youth with Prader-Willi Syndrome (PWS). They are also associated with considerable problems in the daily functioning of the child and his/her family. Although medication and behavioral treatments exist that target OC symptoms among youth without PWS, these treatments have not been thoroughly adapted for this population nor scientifically tested. Although medication has been helpful in addressing OC symptoms in several published case reports, the associated efficacy is modest and the potential for side effects is a realistic concern. Given that behavioral treatment for OC symptoms has superior efficacy to pharmacotherapy in youth without PWS without the accompanying risk for adverse side effects, it follows that an adapted version of behavioral therapy may hold promise in treating clinically problematic OC symptoms in youth with PWS. Thus, the purpose of the proposed grant is to develop and pilot-test a behavioral treatment for OC symptoms for use in youth with PWS. This study will allow us to develop and test a treatment protocol aimed at reducing OC symptoms that are clinically problematic and negatively impact functioning and quality of life in the child and his/her family.
We published a case series of behavioral treatment for obsessive-compulsive symptoms in three youth with PWS. Diagnostic and symptom severity assessments were conducted at screening, pre-treatment, and post-treatment by a trained independent evaluator. All youth were considered treatment responders and exhibited meaningful reductions in compulsion severity, overall obsessive-compulsive severity, and obsessive-compulsive related impairment. These data provide preliminary evidence for the utility of behavioral therapy in treating obsessive-compulsive symptoms in youth with PWS. In addition, we are very pleased that we have published related findings on skinpicking, and presented our research findings at top psychiatry meetings.
Case series of behavioral psychotherapy for obsessive-compulsive symptoms in youth with Prader-Willi syndrome. Storch EA, Rahman O, Morgan J Brauer L, Miller J & Murphy T. Journal of Development and Physical Disabilites, 2011, 23(4): 359-368.
A preliminary analysis of the phenomenology of skin-picking in Prader-Willi syndrome. Morgan JR, Storch EA, Woods DW, Bodzin D, Lewin AB, Murphy TK. Child Psychiatry and Human Development. 41:448-63, 2010.