Per Hove Thomsen

Predictors associated with improved cognitive-behavioral therapy outcome in pediatric obsessive-compulsive disorder

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Nor Christian Torp, Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norge
  • Kitty Dahl, Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norge
  • Gudmundur Skarphedinsson, Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norge
  • Scott Compton, Duke University Medical Center, Durham, NC, USA., Duke University Medical Center, Durham, NC, USA, USA
  • Per Hove Thomsen
  • Bernhard Weidle, Regional Centre for Child and Youth Mental Health and Child Welfare, Trondheim, Norge
  • Katja Anna Hybel
  • Robert Valderhaug, Regional Centre for Child and Youth Mental Health and Child Welfare, Trondheim, Norge
  • Karin Melin, Queen Silvia Children's Hospital, Sverige
  • Judith Becker Nissen
  • Tord Ivarsson, Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norge

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).

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.

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.

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.

OriginalsprogEngelsk
TidsskriftAmerican Academy of Child and Adolescent Psychiatry. Journal
Vol/bind54
Nummer3
Sider (fra-til)200-207
ISSN0890-8567
DOI
StatusUdgivet - mar. 2015

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