3.92 Specific Contamination Symptoms Are Associated With Experiencing a Limited Response From CBT in Pediatric OCD Patients

TY - ABST

T1 - 3.92 Specific Contamination Symptoms Are Associated With Experiencing a Limited Response From CBT in Pediatric OCD Patients

AU - Duholm, Charlotte Steen

AU - Jensen, Sanne

AU - Rask, Charlotte Ulrikka

AU - Thomsen, Per Hove

AU - Ivarsson, Tord

AU - Skarphedinsson, Gudmundur

AU - Weidle, Bernhard

AU - Torp, Nor Christian

AU - Nissen, Judith Becker

AU - Højgaard, David R.M.A.

N1 - New Research Poster 3.92:

PY - 2022/10

Y1 - 2022/10

N2 - ObjectivesThe first-line treatment for pediatric OCD is CBT. A recent study identified 3 distinct treatment-response trajectories during and after treatment in a large group of children with OCD and found that higher levels of contamination symptoms predicted being a limited responder to CBT. This study is an extension of this, examining what characterizes this group of limited responders to CBT regarding contamination symptoms from baseline to 3-year follow-up compared to acute and slow responders to CBT.MethodsThe study sample comprised 269 children and adolescents with OCD, aged 7 to 17 years, from Denmark, Norway and Sweden, all included in the Nordic Long-term OCD Treatment Study (NordLOTS). OCD symptoms and severity were assessed with Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). All participants received stepped-care treatment starting with 14 weekly sessions of manualized CBT whereafter nonresponders were randomized to further treatment with CBT or SSRIs. Linear mixed-effect modeling (LME) was used to examine differences in the sum of contamination items and group differences in single-item occurrences at baseline, posttreatment, and 3-year follow-up.ResultsThe limited responders to the initial CBT were characterized by a higher symptom load across all OCD symptom categories at the 3-year follow-up, with contamination as the most dominant. The LME analysis showed a significant difference in reduction of the sum of contamination items from baseline to the 3-year follow-up between the limited responders and the 2 other groups (limited vs acute: p = .0046; limited vs slow: p < .001), with the limited responders showing a smaller reduction. Five out of 16 items from the contamination category showed persistence from baseline to 3-year follow-up in this group: 1) obsessions about dirt and germs; 2) obsessions about bodily waste or secretions; 3) no concern about contamination other than how it might feel; 4) handwashing compulsions; and 5) ritualized showering, toothbrushing, grooming.ConclusionsThe results indicate that specific contamination symptoms may play an important role for a group of young OCD patients and their response to CBT; however, further studies on the interrelationship with other predictors of treatment response are encouraged.

AB - ObjectivesThe first-line treatment for pediatric OCD is CBT. A recent study identified 3 distinct treatment-response trajectories during and after treatment in a large group of children with OCD and found that higher levels of contamination symptoms predicted being a limited responder to CBT. This study is an extension of this, examining what characterizes this group of limited responders to CBT regarding contamination symptoms from baseline to 3-year follow-up compared to acute and slow responders to CBT.MethodsThe study sample comprised 269 children and adolescents with OCD, aged 7 to 17 years, from Denmark, Norway and Sweden, all included in the Nordic Long-term OCD Treatment Study (NordLOTS). OCD symptoms and severity were assessed with Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). All participants received stepped-care treatment starting with 14 weekly sessions of manualized CBT whereafter nonresponders were randomized to further treatment with CBT or SSRIs. Linear mixed-effect modeling (LME) was used to examine differences in the sum of contamination items and group differences in single-item occurrences at baseline, posttreatment, and 3-year follow-up.ResultsThe limited responders to the initial CBT were characterized by a higher symptom load across all OCD symptom categories at the 3-year follow-up, with contamination as the most dominant. The LME analysis showed a significant difference in reduction of the sum of contamination items from baseline to the 3-year follow-up between the limited responders and the 2 other groups (limited vs acute: p = .0046; limited vs slow: p < .001), with the limited responders showing a smaller reduction. Five out of 16 items from the contamination category showed persistence from baseline to 3-year follow-up in this group: 1) obsessions about dirt and germs; 2) obsessions about bodily waste or secretions; 3) no concern about contamination other than how it might feel; 4) handwashing compulsions; and 5) ritualized showering, toothbrushing, grooming.ConclusionsThe results indicate that specific contamination symptoms may play an important role for a group of young OCD patients and their response to CBT; however, further studies on the interrelationship with other predictors of treatment response are encouraged.

U2 - 10.1016/j.jaac.2022.09.370

DO - 10.1016/j.jaac.2022.09.370

M3 - Conference abstract in journal

SN - 0890-8567

VL - 61

SP - S258

JO - Journal of the American Academy of Child and Adolescent Psychiatry

JF - Journal of the American Academy of Child and Adolescent Psychiatry

IS - 10

T2 - AACAP/CACAP 2022 Annual Meeting

Y2 - 17 October 2022 through 23 October 2022

ER -