Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark.
Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark.
J Am Acad Child Adolesc Psychiatry. 2017 Nov;56(11):940-947.e1. doi: 10.1016/j.jaac.2017.09.002. Epub 2017 Sep 13.
This study describes 1-year treatment outcomes from a large sample of cognitive-behavioral therapy (CBT) responders, investigates age as a possible moderator of these treatment outcomes, and evaluates clinical relapse at the 1-year follow-up.
This study is the planned follow-up to the Nordic Long-term OCD [obsessive-compulsive disorder] Treatment Study (NordLOTS), which included 177 children and adolescents who were rated as treatment responders following CBT for OCD. Participants were assessed with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) at 6- and 12-month follow-up. Treatment response and remission were defined as CY-BOCS total scores ≤15 and ≤10, respectively. Linear mixed-effects models were used to analyze all outcomes.
At 1 year, a total of 155 children and adolescents (87.6%) were available for follow-up assessment, with 142 of these (91.6%) rated below a total score of ≤15 on the CY-BOCS. At 1-year follow-up, 121 (78.1%) were in remission. On average, CY-BOCS total scores dropped by 1.72 points during the first year after terminating treatment (p = .001). A total of 28 participants (15.8%) relapsed (CY-BOCS ≥ 16) at either the 6- or 12-month assessment; only 2 patients required additional CBT.
Results suggest that manualized CBT in a community setting for pediatric OCD has durable effects for those who respond to an initial course of treatment; children and adolescents who respond to such treatment can be expected to maintain their treatment gains for at least 1 year following acute care. Clinical trial registration information- Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.
本研究描述了大量接受认知行为疗法（CBT）治疗的患者在 1 年治疗中的结果，探讨年龄对这些治疗结果的可能影响，并评估在 1 年随访时的临床复发情况。
本研究是北欧长期强迫症（OCD）治疗研究（NordLOTS）的后续研究，纳入了 177 名强迫症患者，他们在接受 CBT 治疗后被评定为治疗反应者。参与者在 6 个月和 12 个月的随访中接受儿童耶鲁布朗强迫症量表（CY-BOCS）评估。治疗反应和缓解定义为 CY-BOCS 总分分别≤15 和≤10。线性混合效应模型用于分析所有结果。
在 1 年时，共有 155 名儿童和青少年（87.6%）可进行随访评估，其中 142 名（91.6%）在 CY-BOCS 总分上评定为≤15。在 1 年随访时，121 名（78.1%）患者缓解。平均而言，在结束治疗后的第一年，CY-BOCS 总分下降了 1.72 分（p=.001）。共有 28 名参与者（15.8%）在 6 个月或 12 个月的评估中复发（CY-BOCS≥16）；仅 2 名患者需要额外的 CBT。
结果表明，在社区环境中对儿科 OCD 采用标准化的 CBT，对初始疗程有反应的患者具有持久的疗效；对这种治疗有反应的儿童和青少年可以预期在急性治疗后至少 1 年内保持治疗效果。临床试验注册信息-北欧长期强迫症（OCD）治疗研究；www.controlled-trials.com；ISRCTN66385119。
