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

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

doi:10.1007/s00787-018-1137-9

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

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

Faculty of Psychology

University of Iceland

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	1373-1381
Number of pages	9
Journal	European Child and Adolescent Psychiatry
Volume	27
Issue number	10
DOIs	https://doi.org/10.1007/s00787-018-1137-9
Publication status	Published - 1 Oct 2018

Bibliographical note

Funding Information: Acknowledgements For funding this study, we thank “Agreement concerning research and education of doctors: Region Västra Götaland”, Claes Groschinskys Memorial Fund, and Iris Jonzén-Sandblom and Greta Jonzén’s Foundation. We also thank children and parents who participated in this study, completed the questionnaires and answered a lot of questions. Finally, we are grateful for the efforts made by the clinic staff. Funding Information: For funding this study, we thank ?Agreement concerning research and education of doctors: Region V?stra G?taland?, Claes Groschinskys Memorial Fund, and Iris Jonz?n-Sandblom and Greta Jonz?n?s Foundation. We also thank children and parents who participated in this study, completed the questionnaires and answered a lot of questions. Finally, we are grateful for the efforts made by the clinic staff. Publisher Copyright: © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

Other keywords

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

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10.1007/s00787-018-1137-9

Cite this

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

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{\textquoteright}s Yale–Brown Obsessive–Compulsive Scale (CY-BOCS), Children{\textquoteright}s OCD Impact Scale (COIS), and Children{\textquoteright}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{\textquoteright} 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.",

keywords = "Cognitive behavioral therapy, Follow-up, Long term, Obsessive–compulsive disorder, Pediatric, Serotonin uptake inhibitors, Treatment outcome",

author = "Karin Melin and Gudmundur Skarphedinsson and Ingela Sk{\"a}rs{\"a}ter and Haugland, \{Bente Storm Mowatt\} and Tord Ivarsson",

note = "Funding Information: Acknowledgements For funding this study, we thank “Agreement concerning research and education of doctors: Region V{\"a}stra G{\"o}taland”, Claes Groschinskys Memorial Fund, and Iris Jonz{\'e}n-Sandblom and Greta Jonz{\'e}n{\textquoteright}s Foundation. We also thank children and parents who participated in this study, completed the questionnaires and answered a lot of questions. Finally, we are grateful for the efforts made by the clinic staff. Funding Information: For funding this study, we thank ?Agreement concerning research and education of doctors: Region V?stra G?taland?, Claes Groschinskys Memorial Fund, and Iris Jonz?n-Sandblom and Greta Jonz?n?s Foundation. We also thank children and parents who participated in this study, completed the questionnaires and answered a lot of questions. Finally, we are grateful for the efforts made by the clinic staff. Publisher Copyright: {\textcopyright} 2018, Springer-Verlag GmbH Germany, part of Springer Nature.",

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doi = "10.1007/s00787-018-1137-9",

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T1 - A solid majority remit following evidence-based OCD treatments

T2 - a 3-year naturalistic outcome study in pediatric OCD

AU - Melin, Karin

AU - Skarphedinsson, Gudmundur

AU - Skärsäter, Ingela

AU - Haugland, Bente Storm Mowatt

AU - Ivarsson, Tord

N1 - Funding Information: Acknowledgements For funding this study, we thank “Agreement concerning research and education of doctors: Region Västra Götaland”, Claes Groschinskys Memorial Fund, and Iris Jonzén-Sandblom and Greta Jonzén’s Foundation. We also thank children and parents who participated in this study, completed the questionnaires and answered a lot of questions. Finally, we are grateful for the efforts made by the clinic staff. Funding Information: For funding this study, we thank ?Agreement concerning research and education of doctors: Region V?stra G?taland?, Claes Groschinskys Memorial Fund, and Iris Jonz?n-Sandblom and Greta Jonz?n?s Foundation. We also thank children and parents who participated in this study, completed the questionnaires and answered a lot of questions. Finally, we are grateful for the efforts made by the clinic staff. Publisher Copyright: © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - 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.

AB - 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.

KW - Cognitive behavioral therapy

KW - Follow-up

KW - Long term

KW - Obsessive–compulsive disorder

KW - Pediatric

KW - Serotonin uptake inhibitors

KW - Treatment outcome

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U2 - 10.1007/s00787-018-1137-9

DO - 10.1007/s00787-018-1137-9

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SN - 1018-8827

VL - 27

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JO - European Child and Adolescent Psychiatry

JF - European Child and Adolescent Psychiatry

IS - 10

ER -

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

Abstract

Bibliographical note

Other keywords

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