Effectiveness of cognitive behavior treatment for pediatric obsessive-compulsive disorder: Acute outcomes from the Nordic Long-term OCD Treatment Study (NordLOTS)

Torp, Nor Christian; Dahl, Kitty; Skarphéðinsson, Guðmundur; Thomsen, Per Hove; Valderhaug, Robert; Weidle, Bernhard; Melin, Karin; Hybel, Katja Anna; Nissen, Judith Becker; Lenhard, Fabian; Wentzel‐Larsen, Tore; Franklin, Martin E.; Ivarsson, Tord

doi:10.1016/j.brat.2014.11.005

Cited by 122 publications

(69 citation statements)

References 52 publications

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“…In the remaining sessions, children and adolescents were treated individually for 45 minutes, and then the parents were seen with or without the child for the remaining 30 minutes. 21 Assessments were conducted at baseline, midtreatment (week 7), and posttreatment (week 14) by certified independent evaluators (IEs). At the end of the 14 weeks of treatment, participants were rated as either responders or nonresponders, based on the CY-BOCS total score.…”

Section: Methods Participantsmentioning

confidence: 99%

“…A detailed description of the demographic and clinical characteristics of the NordLOTS study sample has been reported elsewhere. 21 To be eligible to participate in the study, participants had to be between 7 and 17 years of age, to receive a primary DSM-IV diagnosis of OCD, and to have a baseline CY-BOCS score of !16. Exclusion criteria were the presence of psychiatric disorder(s) with a higher treatment priority (e.g., psychosis or major depression disorder), or a pervasive developmental disorder (i.e., PDD, Asperger's disorder, or autism spectrum disorder).…”

Section: Methods Participantsmentioning

confidence: 99%

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Predictors Associated With Improved Cognitive-Behavioral Therapy Outcome in Pediatric Obsessive-Compulsive Disorder

Torp

Dahl

Skarphéðinsson

et al. 2015

Journal of the American Academy of Child & Adolescent Psych

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In the multivariate analysis, only age predicted better treatment outcome. Using univariate analysis, a variety of predictors of poorer treatment outcome after CBT was identified. The high impact of comorbid symptoms on outcome in pediatric OCD suggests that treatment should address comorbidity issues. The lack of a family predictor may be related to high family involvement in this study. Future research strategies should focus on optimizing intervention in the presence of these characteristics to achieve greater benefits for patients with OCD. Clinical trial registration information-Nordic Long-term Obsessive compulsive disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.

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Section: Methods Participantsmentioning

confidence: 99%

Section: Methods Participantsmentioning

confidence: 99%

Predictors Associated With Improved Cognitive-Behavioral Therapy Outcome in Pediatric Obsessive-Compulsive Disorder

Torp

Dahl

Skarphéðinsson

et al. 2015

Journal of the American Academy of Child & Adolescent Psych

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“…30 The first 60 minutes of each session were devoted to exposure and response prevention (ERP) and cognitive restructuring with the child; the remaining 30 minutes were family-focused. Following an approach validated in previous work, 19,31 each week covered a different topic including causes and prevalence of OCD; the rationale for ERP; the importance of disengaging from symptoms; and the range of emotional responses to OCD. In addition to psychoeducation, parents received a detailed review of the child session and what was assigned for homework, and they had an opportunity to ask questions.…”

Section: Methodsmentioning

confidence: 99%

Targeted Family Intervention for Complex Cases of Pediatric Obsessive-Compulsive Disorder: A Randomized Controlled Trial

Peris¹,

Rozenman²,

Sugar

et al. 2017

Journal of the American Academy of Child & Adolescent Psych

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Objective Although evidence-based treatments for pediatric obsessive-compulsive disorder (OCD) exist, many youth fail to respond, and interventions tailored to the needs of specific subsets of patients are lacking. This study examines the efficacy of a family intervention module designed for cases of OCD complicated by poor family functioning. Method Participants were 62 youngsters ages 8–17 (mean age = 12.71 years; 57% male; 65% Caucasian) with a primary diagnosis of OCD and at least two indicators of poor family functioning. They were randomized to receive 12 sessions of individual child cognitive-behavioral therapy (CBT) plus weekly parent psychoeducation and session review (standard treatment; ST) or the same 12 child sessions plus six sessions of family therapy aimed at improving OCD-related emotion regulation and problem-solving (Positive Family Interaction Therapy; PFIT). Blind raters evaluated outcomes and tracked responders to three-month follow-up. Results Compared to ST, PFIT demonstrated better overall response rates on the Clinician Global Impression-Improvement scale (CGI-I; 68% versus 40%, p = .03, phi = 0.28) and rates of remission (58% PFIT versus 27% ST, p = .01, phi = 0.32). PFIT also produced significantly greater reductions in functional impairment, symptom accommodation, and family conflict, and improvements in family cohesion. As expected, these shifts in family functioning constitute an important treatment mechanism, with changes in accommodation mediating treatment response. Conclusion PFIT is efficacious for reducing OCD symptom severity and impairment and for improving family functioning. Findings are discussed in terms of personalized medicine and mechanisms of change in pediatric OCD treatment. Clinical trial registration information Family Focused Treatment of Pediatric Obsessive Compulsive Disorder; http://clinicaltrials.gov/; NCT01409642.

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“…High rates of comorbidity ranging from 25 to 65% have been reported in both clinical and epidemiological studies [19][20][21][22]. Common comorbid conditions include major depression (10-73%) and anxiety disorders (26-76%) [6,7,10,14].…”

Section: Introductionmentioning

confidence: 99%

An epidemological study of obsessive compulsive disorder in adolescents from India

Jaisoorya

Reddy

Thennarasu

et al. 2015

Comprehensive Psychiatry

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Effectiveness of cognitive behavior treatment for pediatric obsessive-compulsive disorder: Acute outcomes from the Nordic Long-term OCD Treatment Study (NordLOTS)

Abstract: This study was registered in Current Controlled Trials; Nordic Long-term Obsessive-compulsive disorder (OCD) Treatment Study (www.controlled-trials.com ISRCTN66385119).

Cited by 122 publications

References 52 publications

Predictors Associated With Improved Cognitive-Behavioral Therapy Outcome in Pediatric Obsessive-Compulsive Disorder

Predictors Associated With Improved Cognitive-Behavioral Therapy Outcome in Pediatric Obsessive-Compulsive Disorder

Targeted Family Intervention for Complex Cases of Pediatric Obsessive-Compulsive Disorder: A Randomized Controlled Trial

An epidemological study of obsessive compulsive disorder in adolescents from India

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