Cognitive Behavior Treatment for Child and Adolescent Obsessive-Compulsive Disorder (OCD): One Year Treatment Responder Outcomes from the Nordic Long-term OCD Treatment Study (NordLOTS)

Background: Obsessive-compulsive Disorder (OCD) affects between 0.25% and 4% of children and adolescents.<br/>Around 40% of youth with OCD continue to meet criteria for OCD well into adulthood. Cognitive behavioral<br/>therapy (CBT) is the recommended first line treatment for pediatric OCD. Consistent with the available followup<br/>research on pediatric OCD, we expected treatment effects, for initial treatment responders, to last<br/>throughout the first year following acute treatment. Methods: This prospective follow-up study was a part of<br/>the Nordic Long-term OCD Treatment Study (NordLOTS) in which 177 responders to 14 weeks of manualized<br/>CBT in an open trial program were assessed six and twelve months after treatment termination. Treatment<br/>response was defined as a Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) total score &lt; 16, and<br/>remission was defined as a CY-BOCS total score ≤10. Results: At one-year follow-up 155 (87.6%) of the original<br/>sample were available for assessment and 142 (91.6%) were still rated as responders. Of these 121 (78.1%)<br/>were in remission. Mixed effects analysis revealed that patients continued to show symptom reduction over<br/>the one year follow-up period (F[2, 313.15] = 11.230, p &lt; 0.001). Twenty-eight patients relapsed (CY-BOCS ≥16)<br/>during the one-year follow-up where of 11 returned to responder status by the 12-month assessment point.<br/>Conclusion: Results of this follow-up study suggest that manualized CBT applied in community settings has<br/>durable effects for initial responders to treatment, and that patients continue to improve during the first year<br/>following acute treatment. Clinical trials registration information: Nordic Long-term Obsessive-Compulsive<br/>Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.<br/>Long-Term Effectiveness of Cognitive Behavioral Treatment (CBT) and Sertraline