Nor Christian Torp1, Kitty Dahl2, Gudmundur Skarphedinsson2, Scott Compton3, Per Hove Thomsen4, Bernhard Weidle5, Katja Hybel4, Robert Valderhaug5, Karin Melin6, Judit Becker Nissen4, Tord Ivarsson2. 1. Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo; Division of Mental Health and Addiction, Vestre Viken Hospital, Drammen, Norway. Electronic address: nor.christian.torp@r-bup.no. 2. Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo. 3. Duke University Medical Center, Durham, NC. 4. Aarhus University Hospital, Regional Center for Child and Adolescent Psychiatry, Risskov, Aarhus, Denmark. 5. Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, NTNU, Trondheim, Norway. 6. Specialmottagningen, Queen Silvia Children's Hospital, Gothenburg, Sweden.
Abstract
OBJECTIVE: To identify predictors of treatment response in a large sample of pediatric participants with obsessive-compulsive disorder (OCD). The Nordic Long-term Obsessive compulsive disorder (OCD) Treatment Study (NordLOTS) included 269 children and adolescents, 7 to 17 years of age, with a DSM-IV diagnosis of OCD. Outcomes were evaluated after 14 weekly sessions of exposure-based cognitive-behavioral therapy (CBT). METHOD: The association of 20 potential predictors, identified by literature review, along with their outcomes, was evaluated using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) posttreatment. A CY-BOCS total score of ≤15 was the primary outcome measure. RESULTS: The univariate analyses showed that children and adolescents who were older had more severe OCD, greater functional impairment, higher rates of internalizing and externalizing symptoms, and higher levels of anxiety and depression symptoms before treatment had significantly poorer outcomes after 14 weeks of treatment. However, only age was a significant predictor in the multivariate model. CONCLUSION: In the multivariate analysis, only age predicted better treatment outcome. Using univariate analysis, a variety of predictors of poorer treatment outcome after CBT was identified. The high impact of comorbid symptoms on outcome in pediatric OCD suggests that treatment should address comorbidity issues. The lack of a family predictor may be related to high family involvement in this study. Future research strategies should focus on optimizing intervention in the presence of these characteristics to achieve greater benefits for patients with OCD. Clinical trial registration information-Nordic Long-term Obsessive compulsive disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.
OBJECTIVE: To identify predictors of treatment response in a large sample of pediatric participants with obsessive-compulsive disorder (OCD). The Nordic Long-term Obsessive compulsive disorder (OCD) Treatment Study (NordLOTS) included 269 children and adolescents, 7 to 17 years of age, with a DSM-IV diagnosis of OCD. Outcomes were evaluated after 14 weekly sessions of exposure-based cognitive-behavioral therapy (CBT). METHOD: The association of 20 potential predictors, identified by literature review, along with their outcomes, was evaluated using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) posttreatment. A CY-BOCS total score of ≤15 was the primary outcome measure. RESULTS: The univariate analyses showed that children and adolescents who were older had more severe OCD, greater functional impairment, higher rates of internalizing and externalizing symptoms, and higher levels of anxiety and depression symptoms before treatment had significantly poorer outcomes after 14 weeks of treatment. However, only age was a significant predictor in the multivariate model. CONCLUSION: In the multivariate analysis, only age predicted better treatment outcome. Using univariate analysis, a variety of predictors of poorer treatment outcome after CBT was identified. The high impact of comorbid symptoms on outcome in pediatric OCD suggests that treatment should address comorbidity issues. The lack of a family predictor may be related to high family involvement in this study. Future research strategies should focus on optimizing intervention in the presence of these characteristics to achieve greater benefits for patients with OCD. Clinical trial registration information-Nordic Long-term Obsessive compulsive disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.
Authors: Joseph O'Neill; John Piacentini; Susanna Chang; Ronald Ly; Tsz M Lai; Casey C Armstrong; Lindsey Bergman; Michelle Rozenman; Tara Peris; Allison Vreeland; Ross Mudgway; Jennifer G Levitt; Noriko Salamon; Stefan Posse; Gerhard S Hellemann; Jeffry R Alger; James T McCracken; Erika L Nurmi Journal: Neuropsychopharmacology Date: 2017-04-04 Impact factor: 7.853
Authors: Robert R Selles; Davið R M A Højgaard; Tord Ivarsson; Per Hove Thomsen; Nicole Michelle McBride; Eric A Storch; Daniel Geller; Sabine Wilhelm; Lara J Farrell; Allison M Waters; Sharna Mathieu; S Evelyn Stewart Journal: J Am Acad Child Adolesc Psychiatry Date: 2019-06-20 Impact factor: 8.829
Authors: Fabian Lenhard; Sebastian Sauer; Erik Andersson; Kristoffer Nt Månsson; David Mataix-Cols; Christian Rück; Eva Serlachius Journal: Int J Methods Psychiatr Res Date: 2017-07-28 Impact factor: 4.035
Authors: Eric A Storch; Brent J Small; Joseph F McGuire; Tanya K Murphy; Sabine Wilhelm; Daniel A Geller Journal: J Child Adolesc Psychopharmacol Date: 2017-09-14 Impact factor: 2.576
Authors: Mary Kathryn Cancilliere; Jennifer Freeman; Abbe Garcia; Kristen Benito; Jeffrey Sapyta; Martin Franklin Journal: Child Psychiatry Hum Dev Date: 2018-10
Authors: Michelle Rozenman; John Piacentini; Joseph O'Neill; R Lindsey Bergman; Susanna Chang; Tara S Peris Journal: Psychiatry Res Date: 2019-04-19 Impact factor: 3.222
Authors: Gudmundur Skarphedinsson; Alessandro S De Nadai; Eric A Storch; Adam B Lewin; Tord Ivarsson Journal: Eur Child Adolesc Psychiatry Date: 2016-05-21 Impact factor: 4.785