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J Am Acad Child Adolesc Psychiatry. 2017 Nov;56(11):940-947.e1. doi: 10.1016/j.jaac.2017.09.002. Epub 2017 Sep 13.

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

Author information

1
Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark. Electronic address: davmar@rm.dk.
2
Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark.
3
Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo.
4
University of Iceland, Reykjavik.
5
Regional Center for Child and Youth Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.
6
Queen Silvia's Children's Hospital, Sahlgrenska, University Hospital, Gothenburg, Sweden.
7
Division of Mental Health and Addiction, Vestre Viken Hospital, Drammen, Norway.
8
Regional Center for Child and Youth Mental Health, Norwegian University of Science and Technology, Trondheim, Norway; Hospital of Aalesund, Norway.
9
Center for Healthy Aging, University of Copenhagen, Denmark.
10
Duke University Medical Center, Durham, NC.
11
Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden and the Stockholm Health Care Services, Stockholm County Council, Sweden.

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.

KEYWORDS:

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

PMID:
29096776
DOI:
10.1016/j.jaac.2017.09.002
[Indexed for MEDLINE]

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