One-Year Outcome for Responders of Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder

Davíð R.M.A. Højgaard; Katja A. Hybel; Tord Ivarsson; Gudmundur Skarphedinsson; Judith Becker Nissen; Bernhard Weidle; Karin Melin; Nor Christian Torp; Robert Valderhaug; Kitty Dahl; Erik Lykke Mortensen; Scott Compton; Sanne Jensen; Fabian Lenhard; Per Hove Thomsen

doi:10.1016/j.jaac.2017.09.002

One-Year Outcome for Responders of Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder

Davíð R.M.A. Højgaard^*, Katja A. Hybel, Tord Ivarsson, Gudmundur Skarphedinsson, Judith Becker Nissen, Bernhard Weidle, Karin Melin, Nor Christian Torp, Robert Valderhaug, Kitty Dahl, Erik Lykke Mortensen, Scott Compton, Sanne Jensen, Fabian Lenhard, Per Hove Thomsen

^*Corresponding author af dette arbejde

11 Citationer (Scopus)

Abstract

Objective: This study describes 1-year treatment outcomes from a large sample of cognitive-behavioral therapy (CBT) responders, investigates age as a possible moderator of these treatment outcomes, and evaluates clinical relapse at the 1-year follow-up.

Method: This study is the planned follow-up to the Nordic Long-term OCD [obsessive-compulsive disorder] Treatment Study (NordLOTS), which included 177 children and adolescents who were rated as treatment responders following CBT for OCD. Participants were assessed with the Children's Yale−Brown Obsessive-Compulsive Scale (CY-BOCS) at 6- and 12-month follow-up. Treatment response and remission were defined as CY-BOCS total scores ≤15 and ≤10, respectively. Linear mixed-effects models were used to analyze all outcomes.

Results: At 1 year, a total of 155 children and adolescents (87.6%) were available for follow-up assessment, with 142 of these (91.6%) rated below a total score of ≤15 on the CY-BOCS. At 1-year follow-up, 121 (78.1%) were in remission. On average, CY-BOCS total scores dropped by 1.72 points during the first year after terminating treatment (p =.001). A total of 28 participants (15.8%) relapsed (CY-BOCS ≥ 16) at either the 6- or 12-month assessment; only 2 patients required additional CBT.

Conclusion: Results suggest that manualized CBT in a community setting for pediatric OCD has durable effects for those who respond to an initial course of treatment; children and adolescents who respond to such treatment can be expected to maintain their treatment gains for at least 1 year following acute care.

Clinical trial registration information: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.

Originalsprog	Engelsk
Tidsskrift	Journal of the American Academy of Child and Adolescent Psychiatry
Vol/bind	56
Udgave nummer	11
Sider (fra-til)	940-947.e1
Antal sider	9
ISSN	0890-8567
DOI	https://doi.org/10.1016/j.jaac.2017.09.002
Status	Udgivet - 2017

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10.1016/j.jaac.2017.09.002

Citationsformater

Højgaard, D. R. M. A., Hybel, K. A., Ivarsson, T., Skarphedinsson, G., Becker Nissen, J., Weidle, B., Melin, K., Torp, N. C., Valderhaug, R., Dahl, K., Mortensen, E. L., Compton, S., Jensen, S., Lenhard, F., & Hove Thomsen, P. (2017). One-Year Outcome for Responders of Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 56(11), 940-947.e1. https://doi.org/10.1016/j.jaac.2017.09.002

One-Year Outcome for Responders of Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder. / Højgaard, Davíð R.M.A.; Hybel, Katja A.; Ivarsson, Tord et al.

I: Journal of the American Academy of Child and Adolescent Psychiatry, Bind 56, Nr. 11, 2017, s. 940-947.e1.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Højgaard, DRMA, Hybel, KA, Ivarsson, T, Skarphedinsson, G, Becker Nissen, J, Weidle, B, Melin, K, Torp, NC, Valderhaug, R, Dahl, K, Mortensen, EL, Compton, S, Jensen, S, Lenhard, F & Hove Thomsen, P 2017, 'One-Year Outcome for Responders of Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder', Journal of the American Academy of Child and Adolescent Psychiatry, bind 56, nr. 11, s. 940-947.e1. https://doi.org/10.1016/j.jaac.2017.09.002

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abstract = "Objective: This study describes 1-year treatment outcomes from a large sample of cognitive-behavioral therapy (CBT) responders, investigates age as a possible moderator of these treatment outcomes, and evaluates clinical relapse at the 1-year follow-up. Method: This study is the planned follow-up to the Nordic Long-term OCD [obsessive-compulsive disorder] Treatment Study (NordLOTS), which included 177 children and adolescents who were rated as treatment responders following CBT for OCD. Participants were assessed with the Children's Yale−Brown Obsessive-Compulsive Scale (CY-BOCS) at 6- and 12-month follow-up. Treatment response and remission were defined as CY-BOCS total scores ≤15 and ≤10, respectively. Linear mixed-effects models were used to analyze all outcomes. Results: At 1 year, a total of 155 children and adolescents (87.6%) were available for follow-up assessment, with 142 of these (91.6%) rated below a total score of ≤15 on the CY-BOCS. At 1-year follow-up, 121 (78.1%) were in remission. On average, CY-BOCS total scores dropped by 1.72 points during the first year after terminating treatment (p =.001). A total of 28 participants (15.8%) relapsed (CY-BOCS ≥ 16) at either the 6- or 12-month assessment; only 2 patients required additional CBT. Conclusion: Results suggest that manualized CBT in a community setting for pediatric OCD has durable effects for those who respond to an initial course of treatment; children and adolescents who respond to such treatment can be expected to maintain their treatment gains for at least 1 year following acute care. Clinical trial registration information: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.",

keywords = "cognitive-behavioral therapy, follow-up, obsessive-compulsive disorder, pediatric, treatment",

author = "H{\o}jgaard, {Dav{\'i}{\dh} R.M.A.} and Hybel, {Katja A.} and Tord Ivarsson and Gudmundur Skarphedinsson and {Becker Nissen}, Judith and Bernhard Weidle and Karin Melin and Torp, {Nor Christian} and Robert Valderhaug and Kitty Dahl and Mortensen, {Erik Lykke} and Scott Compton and Sanne Jensen and Fabian Lenhard and {Hove Thomsen}, Per",

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T1 - One-Year Outcome for Responders of Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder

AU - Højgaard, Davíð R.M.A.

AU - Hybel, Katja A.

AU - Ivarsson, Tord

AU - Skarphedinsson, Gudmundur

AU - Becker Nissen, Judith

AU - Weidle, Bernhard

AU - Melin, Karin

AU - Torp, Nor Christian

AU - Valderhaug, Robert

AU - Dahl, Kitty

AU - Mortensen, Erik Lykke

AU - Compton, Scott

AU - Jensen, Sanne

AU - Lenhard, Fabian

AU - Hove Thomsen, Per

PY - 2017

Y1 - 2017

N2 - Objective: This study describes 1-year treatment outcomes from a large sample of cognitive-behavioral therapy (CBT) responders, investigates age as a possible moderator of these treatment outcomes, and evaluates clinical relapse at the 1-year follow-up. Method: This study is the planned follow-up to the Nordic Long-term OCD [obsessive-compulsive disorder] Treatment Study (NordLOTS), which included 177 children and adolescents who were rated as treatment responders following CBT for OCD. Participants were assessed with the Children's Yale−Brown Obsessive-Compulsive Scale (CY-BOCS) at 6- and 12-month follow-up. Treatment response and remission were defined as CY-BOCS total scores ≤15 and ≤10, respectively. Linear mixed-effects models were used to analyze all outcomes. Results: At 1 year, a total of 155 children and adolescents (87.6%) were available for follow-up assessment, with 142 of these (91.6%) rated below a total score of ≤15 on the CY-BOCS. At 1-year follow-up, 121 (78.1%) were in remission. On average, CY-BOCS total scores dropped by 1.72 points during the first year after terminating treatment (p =.001). A total of 28 participants (15.8%) relapsed (CY-BOCS ≥ 16) at either the 6- or 12-month assessment; only 2 patients required additional CBT. Conclusion: Results suggest that manualized CBT in a community setting for pediatric OCD has durable effects for those who respond to an initial course of treatment; children and adolescents who respond to such treatment can be expected to maintain their treatment gains for at least 1 year following acute care. Clinical trial registration information: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.

AB - Objective: This study describes 1-year treatment outcomes from a large sample of cognitive-behavioral therapy (CBT) responders, investigates age as a possible moderator of these treatment outcomes, and evaluates clinical relapse at the 1-year follow-up. Method: This study is the planned follow-up to the Nordic Long-term OCD [obsessive-compulsive disorder] Treatment Study (NordLOTS), which included 177 children and adolescents who were rated as treatment responders following CBT for OCD. Participants were assessed with the Children's Yale−Brown Obsessive-Compulsive Scale (CY-BOCS) at 6- and 12-month follow-up. Treatment response and remission were defined as CY-BOCS total scores ≤15 and ≤10, respectively. Linear mixed-effects models were used to analyze all outcomes. Results: At 1 year, a total of 155 children and adolescents (87.6%) were available for follow-up assessment, with 142 of these (91.6%) rated below a total score of ≤15 on the CY-BOCS. At 1-year follow-up, 121 (78.1%) were in remission. On average, CY-BOCS total scores dropped by 1.72 points during the first year after terminating treatment (p =.001). A total of 28 participants (15.8%) relapsed (CY-BOCS ≥ 16) at either the 6- or 12-month assessment; only 2 patients required additional CBT. Conclusion: Results suggest that manualized CBT in a community setting for pediatric OCD has durable effects for those who respond to an initial course of treatment; children and adolescents who respond to such treatment can be expected to maintain their treatment gains for at least 1 year following acute care. Clinical trial registration information: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.

KW - cognitive-behavioral therapy

KW - follow-up

KW - obsessive-compulsive disorder

KW - pediatric

KW - treatment

U2 - 10.1016/j.jaac.2017.09.002

DO - 10.1016/j.jaac.2017.09.002

M3 - Journal article

C2 - 29096776

AN - SCOPUS:85032443084

SN - 0890-8567

VL - 56

SP - 940-947.e1

JO - American Academy of Child and Adolescent Psychiatry. Journal

JF - American Academy of Child and Adolescent Psychiatry. Journal

IS - 11

ER -

One-Year Outcome for Responders of Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder

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