One-Year Outcome for Responders of Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder

Davíð R.M.A. Højgaard*, Katja A. Hybel, Tord Ivarsson, Gudmundur Skarphedinsson, Judith Becker Nissen, Bernhard Weidle, Karin Melin, Nor Christian Torp, Robert Valderhaug, Kitty Dahl, Erik Lykke Mortensen, Scott Compton, Sanne Jensen, Fabian Lenhard, Per Hove Thomsen

*Corresponding author for this work

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29 Citations (Scopus)

Abstract

Objective: This study describes 1-year treatment outcomes from a large sample of cognitive-behavioral therapy (CBT) responders, investigates age as a possible moderator of these treatment outcomes, and evaluates clinical relapse at the 1-year follow-up. 

Method: This study is the planned follow-up to the Nordic Long-term OCD [obsessive-compulsive disorder] Treatment Study (NordLOTS), which included 177 children and adolescents who were rated as treatment responders following CBT for OCD. Participants were assessed with the Children's Yale−Brown Obsessive-Compulsive Scale (CY-BOCS) at 6- and 12-month follow-up. Treatment response and remission were defined as CY-BOCS total scores ≤15 and ≤10, respectively. Linear mixed-effects models were used to analyze all outcomes. 

Results: At 1 year, a total of 155 children and adolescents (87.6%) were available for follow-up assessment, with 142 of these (91.6%) rated below a total score of ≤15 on the CY-BOCS. At 1-year follow-up, 121 (78.1%) were in remission. On average, CY-BOCS total scores dropped by 1.72 points during the first year after terminating treatment (p =.001). A total of 28 participants (15.8%) relapsed (CY-BOCS ≥ 16) at either the 6- or 12-month assessment; only 2 patients required additional CBT. 

Conclusion: Results suggest that manualized CBT in a community setting for pediatric OCD has durable effects for those who respond to an initial course of treatment; children and adolescents who respond to such treatment can be expected to maintain their treatment gains for at least 1 year following acute care. 

Clinical trial registration information: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.

Original languageEnglish
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume56
Issue number11
Pages (from-to)940-947.e1
Number of pages9
ISSN0890-8567
DOIs
Publication statusPublished - 2017

Keywords

  • cognitive-behavioral therapy
  • follow-up
  • obsessive-compulsive disorder
  • pediatric
  • treatment

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