Symptom dimensions and cognitive-behavioural therapy outcome for pediatric obsessive-compulsive disorder

• Published in: Acta psychiatrica Scandinavica Vol. 117; no. 1; pp. 67 - 75
• Main Authors: Storch, E. A., Merlo, L. J., Larson, M. J., Bloss, C. S., Geffken, G. R., Jacob, M. L., Murphy, T. K., Goodman, W. K.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-01-2008; Blackwell
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Age Factors; Aggression - psychology; Anxiety disorders. Neuroses; Behavior therapy. Cognitive therapy; Biological and medical sciences; Child; Child psychology; children; Clinical outcomes; Cognitive therapy; Cognitive Therapy - methods; cognitive-behavioural therapy; factor analysis; Family Therapy - methods; Female; Humans; Male; Medical sciences; Neuroses; obsessive-compulsive disorder; Obsessive-Compulsive Disorder - diagnosis; Obsessive-Compulsive Disorder - psychology; Obsessive-Compulsive Disorder - therapy; Obsessive-compulsive disorders; Predictive Value of Tests; Psychiatry; Psychological tests; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regression analysis; Severity of Illness Index; Surveys and Questionnaires; symptom dimensions; treatment; Treatment Outcome; Treatments; Human; Obsessive compulsive disorder; Pediatrics; Cognitive therapy; cognitive-behavioural therapy; Factor analysis; symptom dimensions; obsessive-compulsive disorder; Anxiety disorder; Symptomatology; Treatment; children; Behavior therapy; Child
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/j.1600-0447.2007.01113.x

Objective:  To examine whether obsessive‐compulsive disorder (OCD) symptom subtypes are associated with response rates to cognitive‐behavioural therapy (CBT) among pediatric patients.
Method:  Ninety‐two children and adolescents with OCD (range = 7–19 years) received 14 sessions of weekly or intensive (daily psychotherapy sessions) family‐based CBT. Assessments were conducted at baseline and post‐treatment. Primary outcomes included scores on the Children’s Yale‐Brown Obsessive‐Compulsive Scale (CY‐BOCS), remission status, and ratings on the Clinical Global Improvement (CGI) and Clinical Global Impression – Severity (CGI‐Severity) scales.
Results:  Seventy‐six per cent of study participants (n = 70) were classified as treatment responders. Patients with aggressive/checking symptoms at baseline showed a trend (P = 0.06) toward improved treatment response and exhibited greater pre/post‐treatment CGI‐Severity change than those who endorsed only non‐aggressive/checking symptoms. Step‐wise linear regression analysis indicated higher scores on the aggressive/checking dimension were predictive of treatment‐related change in the CGI‐Severity index. Regression analysis with CY‐BOCS score as the dependent variable showed no difference between OCD subtypes.
Conclusion:  Response to CBT in pediatric OCD patients does not differ substantially across subtypes.