Per Hove Thomsen

Treatment Gains Are Sustainable in Pediatric Obsessive-Compulsive Disorder: Three-Year Follow-Up From the NordLOTS

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

DOI

  • Karin Melin, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden. Electronic address: karin.a.melin@vgregion.se.
  • ,
  • Gudmundur Skarphedinsson, Faculty of Psychology, University of Iceland, Reykjavík, Iceland.
  • ,
  • Per Hove Thomsen
  • Bernhard Weidle, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway; St. Olav's University Hospital, Trondheim, Norway.
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  • Nor Christian Torp, 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.
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  • Robert Valderhaug, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway; Hospital of Aalesund, Norway.
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  • Davíð R M A Højgaard
  • Katja A Hybel
  • Judith Becker Nissen
  • Sanne Jensen
  • Kitty Dahl, Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo
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  • Ingela Skärsäter, School of Health and Social Sciences, Halmstad University, Sweden.
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  • Bente Storm Haugland, Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.
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  • Tord Ivarsson, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway.

OBJECTIVE: This study evaluates the long-term outcomes of a stepped care treatment for pediatric obsessive-compulsive disorder (OCD) and investigates whether response to first-step cognitive-behavioral therapy (CBT) is an important indicator of three-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. Non-responders to CBT were randomized to an extended treatment with continued CBT or pharmacotherapy with sertraline. Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) scores of ≤15 and ≤10 were defined as treatment response and remission, respectively. Participants were assessed two and three years after first-step CBT. Linear mixed-effects (LME) models were used to analyze the outcomes.

RESULTS: Intent-to-treat analyses showed a significant reduction in the CY-BOCS total score from baseline (24.6) to the three-year follow-up (5.0) (p=.001), with a mean reduction of 5.9 from posttreatment to the three-year follow-up. Three years after treatment, 90% (n=242) of the participants were rated as responders and 73% were in clinical remission. The duration of treatment did not influence the symptom level at the three-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 manualized CBT or extended treatment with CBT or sertraline. The improvements were maintained, and the symptoms decreased further during follow-up and were, after three years, similarly independent of the treatment duration and form of extended treatment.

OriginalsprogEngelsk
TidsskriftJournal of the American Academy of Child and Adolescent Psychiatry
ISSN0890-8567
DOI
StatusE-pub ahead of print - 14 feb. 2019

Bibliografisk note

Copyright © 2019 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

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