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Predictors associated with improved cognitive-behavioral therapy outcome in pediatric obsessive-compulsive disorder.
- Source :
-
Journal of the American Academy of Child and Adolescent Psychiatry [J Am Acad Child Adolesc Psychiatry] 2015 Mar; Vol. 54 (3), pp. 200-207.e1. Date of Electronic Publication: 2014 Dec 20. - Publication Year :
- 2015
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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).<br />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.<br />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.<br />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.<br /> (Copyright © 2015 American Academy of Child & Adolescent Psychaitry. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Child
Cognition
Combined Modality Therapy
Comorbidity
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Male
Multivariate Analysis
Psychiatric Status Rating Scales
Scandinavian and Nordic Countries
Severity of Illness Index
Treatment Outcome
Cognitive Behavioral Therapy
Obsessive-Compulsive Disorder therapy
Selective Serotonin Reuptake Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1527-5418
- Volume :
- 54
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of the American Academy of Child and Adolescent Psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 25721185
- Full Text :
- https://doi.org/10.1016/j.jaac.2014.12.007