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Remission and Relap...
Remission and Relapse Across Three Years in Pediatric Obsessive-Compulsive Disorder Following Evidence-Based Treatments
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- Ivarsson, Tord, 1946 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology
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Jensen, Sanne (författare)
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Højgaard, Davíð R.M.A. (författare)
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Hybel, Katja Anna (författare)
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Torp, Nor Christian (författare)
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- Melin, Karin, 1964 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för vårdvetenskap och hälsa,Institute of Health and Care Sciences
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Nissen, Judith Becker (författare)
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Weidle, Bernhard (författare)
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Thomsen, Per Hove (författare)
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Dahl, Kitty (författare)
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Skarphedinsson, Gudmundur (författare)
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(creator_code:org_t)
- 2024
- 2024
- Engelska.
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Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry. - 0890-8567 .- 1527-5418. ; 63:5, s. 519-527
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objective: To examine relapse rates following remission in a 3-year follow-up study in pediatric patients with obsessive-compulsive disorder (OCD) treated with cognitive–behavioral therapy (CBT) in a first step, and either continued CBT or sertraline (randomized selection) in a second step. Method: Participants (N = 269) fulfilled DSM-IV OCD criteria with a mean severity on the Children's Yale–Brown Obsessive Compulsive Scale (CY-BOCS) of 24.6 (SD = 5.1) and were included in analyses according to intent-to-treat principles. CBT used manualized exposure and response prevention (ERP) during both steps 1 and 2, and step 2 sertraline medication used flexible dosing. The follow-up schedules were timed to 6, 12, 24, and 36 months following step 1 CBT. Remission was defined as a CY-BOCS score ≤10 and relapse as an elevated CY-BOCS score ≥16 in those who had remitted. Results: A good third of our patients were in stable and full remission at all examinations (n = 98, 36.4%). Further, some in remission following treatment (n = 36, 13.4%) had mild OCD at some examinations. Relapses during follow-up were not uncommon (n = 28, 10.4%), but in many patients these improved again (n = 10, 3.7%) and were in remission at the final 3-year follow-up. Furthermore, a considerable proportion (n = 50, 18.6%) of the patients were initial non-remitters to the treatment but achieved remission at some point during the follow-up. In addition, 11.5% (n = 31) had persistent OCD but reached remission by the last follow-up. Finally, a smaller segment of our sample (9.7%, n = 26), did not attain remission at any point during the study. Conclusion: Our outcome paints a more promising picture of pediatric OCD long-term outcome than previous studies have done. However, both relapse rates and the presence of initial non-remitters and persistent OCD show that treatments need improvement, particularly for those who respond slowly, partially, or not at all. The lack of a general psychiatric interview at follow-up is a marked limitation. Clinical trial registration information: Nordic Long-term Obsessive compulsive disorder (OCD) Treatment Study; https://www.isrctn.com; ISRCTN66385119
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences (hsv//eng)
Nyckelord
- cognitive-behavioral therapy
- obsessive-compulsive disorder
- relapse
- serotonin re-uptake inhibitor
- stepped care
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Ivarsson, Tord, ...
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Jensen, Sanne
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Højgaard, Davíð ...
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Hybel, Katja Ann ...
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Torp, Nor Christ ...
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Melin, Karin, 19 ...
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Nissen, Judith B ...
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Weidle, Bernhard
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Thomsen, Per Hov ...
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Dahl, Kitty
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Skarphedinsson, ...
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