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A solid majority remit following evidence-based OCD treatments : a 3-year naturalistic outcome study in pediatric OCD

Melin, Karin, Skarphedinsson, Gudmundur, Skärsäter, Ingela, Storm Mowatt Haugland, Bente, Ivarsson, Tord
2018

Artikel i tidskrift (Refereegranskat)

Abstract:

This study reports follow-up 2 and 3 years after the initial assessment of a sample of youth with a primary diagnosis of OCD. Participants were 109 children and adolescents, aged 5-17 years, recruited from a specialized, outpatient OCD clinic in Sweden. Patients were treated with cognitive behavioral therapy (CBT), augmented when indicated by selective serotonin reuptake inhibitor (SSRI). In cases where SSRIs were insufficient, augmentation with a second-generation antipsychotic (SGA) was applied. Participants were assessed with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Children's OCD Impact Scale (COIS), and Children's Depressive Inventory (CDI) at follow-ups 2 and 3 years after baseline assessment. Treatment response was defined as CY-BOCS total score ≤ 15, and remission was defined as CY-BOCS total score ≤ 10. Analyzing the outcomes with linear mixed-effects models (LME) showed a decrease in OCD symptom load from 23 to 6.9 at the 3-year follow-up. Moreover, two of three (66.1%) participants were in remission, and another 19.2% had responded to treatment at the 3-year follow-up. Thus, 85.3% of participants responded to treatment. Moreover, during the follow-up period, participants' psychosocial functioning had significantly improved, and depressive symptoms had significantly decreased. The results suggest that evidence-based treatment for pediatric OCD, following expert consensus guidelines, has long-term positive effects for most children and adolescents diagnosed with OCD. The results also indicate that improvements are maintained over a 3-year period, at least, and that improvement is also found with regard to psychosocial functioning and depressive symptoms. © 2018 Springer International Publishing AG

Nyckelord: Cognitive behavioral therapy; Follow-up; Long term; Obsessive–compulsive disorder; Pediatric; Serotonin uptake inhibitors; Treatment outcome

Citera: Melin, Karin, Skarphedinsson, Gudmundur, Skärsäter, Ingela, Storm Mowatt Haugland, Bente, Ivarsson, Tord, Skarsater, I. & Haugland, B. S. M., A solid majority remit following evidence-based OCD treatments: a 3-year naturalistic outcome study in pediatric OCD, European Child & Adolescent Psychiatry., 27:10, s. 1373-1381, 2018