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A solid majority remit following evidence-based OCD treatments: a 3-year naturalistic outcome study in pediatric OCD

Journal article
Authors Karin Melin
G. Skarphedinsson
I. Skarsater
B. S. M. Haugland
Tord Ivarsson
Published in European Child & Adolescent Psychiatry
Volume 27
Issue 10
Pages 1373-1381
ISSN 1018-8827
Publication year 2018
Published at Institute of Neuroscience and Physiology
Pages 1373-1381
Language en
Links dx.doi.org/10.1007/s00787-018-1137-...
Keywords Obsessive-compulsive disorder, Long term, Follow-up, Pediatric, Cognitive behavioral therapy, obsessive-compulsive disorder, cognitive-behavior therapy, functional, impairment, children, adolescents, validity, metaanalysis, scale, reliability, convergent, Psychology, Pediatrics, Psychiatry
Subject categories Psychology

Abstract

This study reports follow-up 2 and 3 years after the initial assessment of a sample of youth with a primary diagnosis of OCD. Participants were 109 children and adolescents, aged 5-17 years, recruited from a specialized, outpatient OCD clinic in Sweden. Patients were treated with cognitive behavioral therapy (CBT), augmented when indicated by selective serotonin reuptake inhibitor (SSRI). In cases where SSRIs were insufficient, augmentation with a second-generation antipsychotic (SGA) was applied. Participants were assessed with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Children's OCD Impact Scale (COIS), and Children's Depressive Inventory (CDI) at follow-ups 2 and 3 years after baseline assessment. Treatment response was defined as CY-BOCS total score <= 15, and remission was defined as CY-BOCS total score <= 10. Analyzing the outcomes with linear mixed-effects models (LME) showed a decrease in OCD symptom load from 23 to 6.9 at the 3-year follow-up. Moreover, two of three (66.1%) participants were in remission, and another 19.2% had responded to treatment at the 3-year follow-up. Thus, 85.3% of participants responded to treatment. Moreover, during the follow-up period, participants' psychosocial functioning had significantly improved, and depressive symptoms had significantly decreased. The results suggest that evidence-based treatment for pediatric OCD, following expert consensus guidelines, has long-term positive effects for most children and adolescents diagnosed with OCD. The results also indicate that improvements are maintained over a 3-year period, at least, and that improvement is also found with regard to psychosocial functioning and depressive symptoms.

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