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- Holmgren Melin, Karin, et al.
(författare)
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Treatment and 12-month outcome of children and adolescents with obsessive-compulsive disorder: A naturalistic study
- 2015
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - Amsterdam : Elsevier BV. - 2211-3649 .- 2211-3657. ; 6, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Pediatric obsessive-compulsive disorder (OCD) is a disorder associated with distress and impairment in many domains. Moreover, there is a high risk of relapse and developing a chronic illness. Randomized-controlled trails (RCT), the gold-standard for evaluating treatments, show treatments to be efficacious, yet little is known about their generalizability and long-term durability in "usual-care" settings. The aim of the present study is to evaluate the feasibility and effectiveness of evidence-based pediatric OCD-treatments in regular practice. Participants were 109 children (aged 7-17 years) with a primary diagnosis of OCD, recruited from a specialized OCD-clinic in Sweden. Few exclusion criteria were applied. The youths were assessed at baseline, 6 and 12 months following the first assessment, using Children's Yale-Brown Obsessive Compulsive Scale and Children's OCD Impact Scale. They were treated with Cognitive Behavior Therapy, augmented with SSRI when indicated. The majority responded well to treatment i.e. were free from OCD or in remission at 12 month evaluation. Moreover, the participants psychosocial functioning significantly improved from baseline to evaluation at 6 and 12 months. (C) 2015 Elsevier Inc. All rights reserved.
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| 2. |
- Melin, Karin, 1964, et al.
(författare)
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A solid majority remit following evidence-based OCD treatments: a 3-year naturalistic outcome study in pediatric OCD
- 2018
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Ingår i: European Child & Adolescent Psychiatry. - Heidelberg : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; 27:10, s. 1373-1381
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Tidskriftsartikel (refereegranskat)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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