1. 3.89 Distinct Trajectories of Long-Term Functional Impairment in Pediatric OCD During and After Stepped-Care Treatment
- Author
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Orri Smarason, David R.M.A. Hojgaard, Sanne Jensen, Gudmundur B. Arnkelsson, Eric A. Storch, Lidewij H. Wolters, Nor Christian Torp, Karin Melin, Katja Anna Hybel, Bernhard Weidle, Judith Becker Nissen, Tord Ivarsson, Per Hove Thomsen, and Gudmundur Skarphedinsson
- Subjects
Psychiatry and Mental health ,Developmental and Educational Psychology - Abstract
ObjectivesThe present study aimed to: 1) identify possible latent class trajectories of OCD-related functional impairment over 3 years after stepped-care treatment in children and adolescents with OCD; 2) describe these classes according to pretreatment characteristics; and 3) identify predictors of trajectory class membership.MethodsThe sample consisted of 246 children and adolescents (aged 7-17 years) with OCD participating in the Nordic long-term OCD treatment study (NordLOTS). Latent class growth analysis (LCGA) was conducted using Children’s Obsessive-Compulsive Impact Scale-Revised (COIS-R) data from children and parents on 7 points of assessment: pretreatment, week 7, week 14, 6-month follow-up, 12-month follow-up, 24-month follow-up, and 36-month follow-up.ResultsFor both the parent and child versions of the COIS-R, a 5-cluster quadratic solution had the best fit as determined by the Bayesian information criterion (BIC). For children and parents, the 2 largest clusters were comprised of participants who steadily declined in their levels of functional impairment throughout treatment and follow-up but had different levels of severity at baseline. For both parents and children, the 3 smaller clusters were comprised of participants who showed no or limited improvement in functional impairment as well as a class that improved initially and then relapsed during follow-up. Higher levels of contamination and cleaning symptoms, somatic and illness symptoms, and comorbid ADHD predicted membership for the nonresponse and relapse clusters.ConclusionsMost children and adolescents undergoing stepped-care treatment for OCD show improvements in functional impairment continuously throughout a 3-year follow-up period. However, distinct subgroups do not respond to treatment or relapse after treatment. These subgroups can be distinguished by symptom and comorbidity profiles.
- Published
- 2022