Obsessive-compulsive (OC) symptoms are common in both children and adults with Prader-Willi Syndrome (PWS), to the degree that they are considered central to the syndrome's behavioral phenotype and constitute diagnostic criteria for the disorder. Although efficacious behavioral treatments (e.g., exposure and response prevention) exist for OC symptoms in typically developing youth, these treatments are not tailored to meet the specific needs of youth with PWS and their families. The purpose of the current study is to report on a modified CBT protocol that addresses obsessive-compulsive symptoms in youth with PWS.

Three children received a modified version of cognitive-behavioral therapy targeting obsessive-compulsive symptoms in PWS. Measures were administered at screening, baseline, and post-treatment and included the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Children's Yale-Brown Obsessive Compulsive Scale (CYBOCS), Family Accommodation Scale, Clinical Global Impression - Severity (CGI-S), Clinical Global Improvement (CGI), and measures of impairment and adaptive functioning. Treatment consisted for 12 family-based CBT sessions that included exposure and response prevention; cognitive restructuring; and other operant treatment elements.

Participants experienced reduced CYBOCS scores at baseline to post-treatment, 25 to 15.3. All three youth were considered treatment responders on the CGI-Improvement scale. Similar reductions on secondary variables such as OCD impairment were reported.

Although these results are preliminary, initial results suggest that behavioral treatment of OC symptoms may be effective in the PWS population. This treatment holds promise for being a safe and tolerable method for reducing compulsive symptoms in youth with PWS.