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Treatment Gains Are Sustainable in Pediatric Obsessive-Compulsive Disorder: Three-Year Follow-Up From the NordLOTS
- Source :
- Melin, K, Skarphedinsson, G, Thomsen, P H, Weidle, B, Torp, N C, Valderhaug, R, Højgaard, D R M A, Hybel, K A, Nissen, J B, Jensen, S, Dahl, K, Skärsäter, I, Haugland, B S & Ivarsson, T 2019, ' Treatment Gains Are Sustainable in Pediatric Obsessive-Compulsive Disorder : Three-Year Follow-Up From the NordLOTS ' Journal of the American Academy of Child and Adolescent Psychiatry . https://doi.org/10.1016/j.jaac.2019.01.010, Melin, K, Skarphedinsson, G, Thomsen, P H, Weidle, B, Torp, N C, Valderhaug, R, Højgaard, D R M A, Hybel, K A, Nissen, J B, Jensen, S, Dahl, K, Skärsäter, I, Haugland, B S & Ivarsson, T 2020, ' Treatment Gains Are Sustainable in Pediatric Obsessive-Compulsive Disorder: Three-Year Follow-Up From the NordLOTS ', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 59, no. 2, pp. 244-253 . https://doi.org/10.1016/j.jaac.2019.01.010
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Objective This study evaluated the long-term outcomes of a stepped care treatment for pediatric obsessive-compulsive disorder (OCD) and investigated whether response to first-step cognitive-behavioral therapy (CBT) is an important indicator of 3-year outcomes. Method This study is a part of the Nordic Long-term OCD Treatment Study (NordLOTS), in which 269 children and adolescents were treated with CBT. Nonresponders to CBT were randomized to extended treatment with continued CBT or pharmacotherapy with sertraline. Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) scores no higher than 15 and no higher than 10 were defined as treatment response and remission, respectively. Participants were assessed 2 and 3 years after first-step CBT. Linear mixed-effects models were used to analyze the outcomes. Results Intent-to-treat analyses showed a significant decrease in CY-BOCS total score from baseline (24.6) to 3-year follow-up (5.0; p = .001), with a mean decrease of 5.9 from after treatment to 3-year follow-up. Three years after treatment, 90% (n = 242) of participants were rated as responders and 73% were in clinical remission. The duration of treatment did not influence the symptom level at 3-year follow-up (p = .998) and no significant difference was found (p = .169) between the extended treatment conditions. Conclusion The results suggest that evidence-based treatment for pediatric OCD has long-term positive effects, whether a first step of manual-based CBT or extended treatment with CBT or sertraline. The improvements were maintained, and the symptoms decreased further during follow-up and were, after 3 years, similarly independent of treatment duration and form of extended treatment. Clinical trial registration information Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.
- Subjects :
- Obsessive-Compulsive Disorder
Pediatrics
medicine.medical_specialty
Adolescent
cognitive-behavioral therapy
medicine.medical_treatment
behavioral disciplines and activities
Pharmacotherapy
Obsessive compulsive
Sertraline
mental disorders
follow-up
Developmental and Educational Psychology
medicine
Humans
0501 psychology and cognitive sciences
Child
Cognitive Behavioral Therapy
sertraline
business.industry
05 social sciences
Significant difference
obsessive-compulsive disorder
Cognitive behavioral therapy
Clinical trial
Psychiatry and Mental health
Treatment Outcome
pediatric
Treatment study
business
After treatment
Follow-Up Studies
050104 developmental & child psychology
medicine.drug
Subjects
Details
- ISSN :
- 08908567
- Volume :
- 59
- Database :
- OpenAIRE
- Journal :
- Journal of the American Academy of Child & Adolescent Psychiatry
- Accession number :
- edsair.doi.dedup.....7ab3d49f2267f197f30e0f920b639dc5