TY - JOUR

T1 - Long- term remission status in pediatric obsessive-compulsive disorder

T2 - Evaluating the predictive value of symptom severity after treatment

AU - Jensen, Sanne

AU - Mortensen, Erik L.

AU - Skarphedinsson, Gudmundur

AU - Hojgaard, David R. M. A.

AU - Hybel, Katja A.

AU - Nissen, Judith B.

AU - Ivarsson, Tord

AU - Weidle, Bernhard

AU - Torp, Nor C.

AU - Thomsen, Per H.

PY - 2022

Y1 - 2022

N2 - It is unknown if long-term remission for pediatric obsessive-compulsive disorder (OCD) patients is associated with post-treatment OCD symptom severity. The aim of the present study was to evaluate if post-treatment symptom severity cut-offs can discriminate remitters from non-remitters in pediatric OCD patients during three years of follow-up. All participants (N = 269) from the Nordic Long-term OCD Treatment Study (Nor-dLOTS) undergoing stepped-care treatment were included. Patients were rated with the Clinical Global Impression - Severity Scale (CGI-S) one (n = 186), two (n = 167), and three years (n = 166) after first-line cognitive-behavioral therapy. Post-treatment symptom severity scores as well as percentage reductions during treatment evaluated with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) were analyzed using receiver operating characteristics according to the CGI-S remission scores (< 2) at follow-up. Post-treatment CY-BOCS severity scores acceptably discriminated remitters from non-remitters at one-year follow-up, but poorly for the two-and three-year follow-up. Severity percentage reduction during treatment did not discriminate remis-sion status acceptably at any follow-up point. Post-treatment OCD symptom severity status seems to have little discriminative value for long-term remission status in pediatric patients. Further research is warranted to detect post-treatment factors of prognostic value.

AB - It is unknown if long-term remission for pediatric obsessive-compulsive disorder (OCD) patients is associated with post-treatment OCD symptom severity. The aim of the present study was to evaluate if post-treatment symptom severity cut-offs can discriminate remitters from non-remitters in pediatric OCD patients during three years of follow-up. All participants (N = 269) from the Nordic Long-term OCD Treatment Study (Nor-dLOTS) undergoing stepped-care treatment were included. Patients were rated with the Clinical Global Impression - Severity Scale (CGI-S) one (n = 186), two (n = 167), and three years (n = 166) after first-line cognitive-behavioral therapy. Post-treatment symptom severity scores as well as percentage reductions during treatment evaluated with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) were analyzed using receiver operating characteristics according to the CGI-S remission scores (< 2) at follow-up. Post-treatment CY-BOCS severity scores acceptably discriminated remitters from non-remitters at one-year follow-up, but poorly for the two-and three-year follow-up. Severity percentage reduction during treatment did not discriminate remis-sion status acceptably at any follow-up point. Post-treatment OCD symptom severity status seems to have little discriminative value for long-term remission status in pediatric patients. Further research is warranted to detect post-treatment factors of prognostic value.

KW - Stepped -care treatment

KW - Long-term study

KW - Clinical assessment

KW - Remission

KW - Children and adolescents

KW - Children?s Yale-brown obsessive-compulsive

KW - Clinical global impression scale

KW - COGNITIVE-BEHAVIOR THERAPY

KW - SIGNAL-DETECTION ANALYSIS

KW - DEFINING TREATMENT RESPONSE

KW - FOLLOW-UP

KW - PSYCHOMETRIC EVALUATION

KW - CHILDREN

KW - OCD

KW - NONRESPONDERS

KW - RELIABILITY

KW - ADOLESCENTS

U2 - 10.1016/j.psychres.2022.114906

DO - 10.1016/j.psychres.2022.114906

M3 - Journal article

C2 - 36265194

VL - 317

JO - Psychiatry Research

JF - Psychiatry Research

SN - 0165-1781

M1 - 114906

ER -