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Specific Contamination Symptoms are Associated with Experiencing a Limited Response of Cognitive-Behavioral Therapy in Pediatric Patients with OCD

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Abstract

A recent study identified three distinct treatment-response trajectories in pediatric OCD where higher levels of contamination symptoms predicted a limited response to cognitive-behavioral therapy (CBT). This study extends these findings by examining which specific symptoms characterize limited CBT response from baseline to 3-year follow-up, with an emphasis on contamination symptoms. The study sample comprised 269 pediatric patients with OCD, all receiving stepped-care treatment with manualized CBT. Differences in single item-reporting between the three trajectory groups were examined using linear mixed-effect modeling. Limited responders displayed a higher symptom load across all OCD symptom categories at 3-year follow-up, dominated by contamination symptoms. Five of these (obsessions about dirt and germs, about bodily fluids, about the feeling of contamination and compulsions regarding handwashing and showering) showed persistence from baseline to 3-year follow-up. The results indicate that presence of specific contamination symptoms may influence long-term symptom severity trajectories in young patients with OCD.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Denmark

    Charlotte Steen Duholm, Sanne Jensen, Charlotte Ulrikka Rask, Per Hove Thomsen, Judith Becker Nissen & Davíð R. M. A. Højgaard

  2. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

    Charlotte Steen Duholm, Sanne Jensen, Charlotte Ulrikka Rask, Per Hove Thomsen, Judith Becker Nissen & Davíð R. M. A. Højgaard

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

    Tord Ivarsson

  4. Faculty of Psychology, University of Iceland, Reykjavík, Iceland

    Gudmundur Skarphedinsson

  5. Division of Mental Health and Addiction, Vestre Viken Hospital, Drammen, Norway

    Nor Christian Torp

  6. Akershus University Hospital, Oslo, Norway

    Nor Christian Torp

  7. Regional Centre for Child and Youth Mental Health and Child Welfare Central Norway, Norwegian University of Science and Technology, Trondheim, Norway

    Bernhard Weidle

  8. Aarhus University Hospital, Psychiatry, Palle Juul-Jensens Boulevard 175, Entrance K, 8200, Aarhus, Denmark

    Charlotte Steen Duholm

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  1. Charlotte Steen Duholm
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Duholm, C.S., Jensen, S., Rask, C.U. et al. Specific Contamination Symptoms are Associated with Experiencing a Limited Response of Cognitive-Behavioral Therapy in Pediatric Patients with OCD. Child Psychiatry Hum Dev (2022). https://doi.org/10.1007/s10578-022-01480-y

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