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

Nor Christian Torp*, Kitty Dahl, Gudmundur Skarphedinsson, Scott Compton, Per Hove Thomsen, Bernhard Weidle, Katja Hybel, Robert Valderhaug, Karin Melin, Judit Becker Nissen, Tord Ivarsson

*Corresponding author for this work

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60 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)200-207.e1
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume54
Issue number3
DOIs
Publication statusPublished - 1 Mar 2015

Bibliographical note

Funding Information:
Financial support for this article came from the Norwegian Research Council (Helse og Rehabilitering, Norge) and the Danish Council for Strategic Research (Pulje til styrkelse af psykiatrisk Forskning i Region Midtjylland).

Funding Information:
Disclosure: Dr. Compton has received funding from the National Institutes of Health and Shire for clinical trials. He is an editor of Journal of Consulting and Clinical Psychology, Journal of Child and Adolescent Psychopharmacology, and BMC Psychiatry. Drs. Dahl, Thomsen, Weidle, Valderhaug, Nissen, Ivarsson, Mr. Torp, Mr. Skarphedinsson, Ms. Hybel, and Ms. Melin report no biomedical financial interests or potential conflicts of interest.

Publisher Copyright:
© 2015 American Academy of Child & Adolescent Psychaitry.

Other keywords

  • cognitive-behavioral therapy
  • pediatric OCD
  • predictors

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