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Psychiatry Res. 2018 Dec;270:317-323. doi: 10.1016/j.psychres.2018.09.054. Epub 2018 Sep 22.

Obsessive-compulsive symptom dimensions: Association with comorbidity profiles and cognitive-behavioral therapy outcome in pediatric obsessive-compulsive disorder.

Author information

1
Center for Child and Adolescent Psychiatry, Aarhus University Hospital Risskov, Risskov, Denmark. Electronic address: davmar@rm.dk.
2
Center for Child and Adolescent Psychiatry, Aarhus University Hospital Risskov, Risskov, Denmark.
3
Department of Public Health and Center for Healthy Aging, University of Copenhagen.
4
The Center for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP).
5
Regional Center for Child and Youth Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.
6
Department of Child and Adolescent Psychiatry, Queen Silvia's Children's Hospital, Sahlgrenska. University Hospital, Gothenburg, Sweden; Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden.
7
The Center for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP); Department of Child and Adolescent Psychiatry, 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; Department of Child and Adolescent Psychiatry, Hospital of Aalesund, Norway.
9
University of Iceland, Reykjavik.
10
Menninger Department of Psychiatry, Baylor College of Medicine, USA; Rogers Behavioral Health-Tampa Bay, Tampa, FL, USA; Johns Hopkins All Children's Hospital, St. Petersburg FL, USA.

Abstract

Our aims were to examine: (1) classes of comorbid disorders in a sample of children and adolescents with Obsessive-Compulsive Disorder (OCD), (2) how these classes relate to obsessive-compulsive symptom dimensions, and (3) the extent to which obsessive-compulsive symptom dimensions predict Cognitive-Behavioral Therapy (CBT) outcome. Participants (N = 269) were assessed with the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL) and the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Latent Class Analysis (LCA) was used to identify comorbidity classes. Regression analyses were used to evaluate symptom dimensions as predictors of treatment outcome and their relation to comorbidity classes. Comorbidity was included in the treatment outcome analyses as it can affect outcome. Comorbidity was best categorized by a three-class model and each class was distinctively correlated with the OCD symptom dimensions. Higher scores on the symmetry/hoarding factor increased the chance of responding to CBT by an odds ratio of 1.56 (p = 0.020) when controlled for age, gender, and comorbidity class. The harm/sexual factor (p = 0.675) and contamination/cleaning factor (p = 0.122) did not predict CBT outcome. Three clinically relevant comorbidity subgroups in pediatric OCD were identified. Patients who exhibited higher levels of symmetry/hoarding dimension were more prone to respond to CBT.

KEYWORDS:

CBT; Comorbidity; OCD; Pediatric; Predictor; Treatment outcome

PMID:
30290317
DOI:
10.1016/j.psychres.2018.09.054
[Indexed for MEDLINE]

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