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

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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.

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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.

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Authors and Affiliations

  1. Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Karin Melin & Tord Ivarsson

  2. Department of Child and Adolescent Psychiatry, CAP Specialized unit, Sahlgrenska University Hospital, 416 85, Gothenburg, Sweden

    Karin Melin

  3. Faculty of Psychology, University of Iceland, Gimli, Saemundgata 101, Reykjavik, Iceland

    Gudmundur Skarphedinsson

  4. School of Social and Health and Sciences, Halmstad University, Box 823, 301 18, Halmstad, Sweden

    Ingela Skärsäter

  5. Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Postboks 7810, 5008, Bergen, Norway

    Bente Storm Mowatt Haugland

  6. Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Postboks 4623, Nydalen, 0405, Oslo, Norway

    Tord Ivarsson

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  1. Karin Melin
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  2. Gudmundur Skarphedinsson
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Correspondence to Karin Melin.

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Melin, K., Skarphedinsson, G., Skärsäter, I. et al. A solid majority remit following evidence-based OCD treatments: a 3-year naturalistic outcome study in pediatric OCD. Eur Child Adolesc Psychiatry 27, 1373–1381 (2018). https://doi.org/10.1007/s00787-018-1137-9

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