Faro Alyssa L, Wolenski Rebecca A, Lee Chun W, Guvenek-Cokol Perihan Esra, Dickstein Daniel P, Fraire Maria G
McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
Children (Basel). 2025 Apr 15;12(4):505. doi: 10.3390/children12040505.
BACKGROUND/OBJECTIVES: Residential treatment represents an important level of care for adolescents with severe and/or treatment-refractory obsessive-compulsive disorder (OCD). Despite accumulating evidence supporting the treatment efficacy and cost-effectiveness of insurance-based intensive OCD treatment in residential settings, few data exist that characterize the population of adolescent patients utilizing this level of care. As a result, residential treatment may be poorly understood by patients, their families, and referring providers, which may delay appropriate treatment for adolescents with OCD. Here, we characterize the patient population at an intensive residential treatment center (RTC) and partial hospitalization program (PHP) for adolescents ( = 15.23) with a primary diagnosis of OCD.
We examine quantitative data collected from 168 adolescents admitted to the McLean OCD Institute for Children and Adolescents for the treatment of primary OCD or a related disorder over a three-year period. We also conduct analyses on a subset of patients ( = 120) who participated in the Child and Adolescent Routine Evaluation (CARE) Initiative (McLean Child Division-Wide Measurement-Based Care Program) to further characterize this patient population with a lens toward additional comorbidities and factors impacting prognosis.
The current paper describes the severity of symptom presentation, comorbidities, psychotropic medication profiles, and disruption to personal and family functioning. Analyses also include the prevalence of OCD subtypes and co-occurrence among varied presentations.
In addition to identifying common clinical presentations in an RTC/PHP, this paper further aims to detail best practices and clinical rationale guiding a specialty RTC/PHP to inform families, providers, and payors about the individuals that most benefit from this level of care.
背景/目的：住院治疗是重度和/或难治性强迫症（OCD）青少年重要的护理级别。尽管越来越多的证据支持在住院环境中基于保险的强化强迫症治疗的疗效和成本效益，但关于使用这种护理级别的青少年患者群体的特征的数据却很少。因此，患者、其家人和转诊提供者可能对住院治疗了解不足，这可能会延迟强迫症青少年的适当治疗。在此，我们描述了一家针对以强迫症为主要诊断的青少年（平均年龄 = 15.23岁）的强化住院治疗中心（RTC）和部分住院计划（PHP）的患者群体。
我们检查了在三年期间从168名入住麦克莱恩儿童与青少年强迫症研究所接受原发性强迫症或相关疾病治疗的青少年收集的定量数据。我们还对一部分患者（n = 120）进行了分析，这些患者参与了儿童和青少年常规评估（CARE）倡议（麦克莱恩儿童部门全范围基于测量的护理计划），以便从其他共病情况和影响预后的因素方面进一步描述该患者群体的特征。
本文描述了症状表现的严重程度、共病情况、精神药物使用情况以及对个人和家庭功能的干扰。分析还包括强迫症亚型的患病率以及不同表现形式之间的共现情况。
除了确定RTC/PHP中的常见临床表现外，本文还旨在详细阐述指导专科RTC/PHP的最佳实践和临床原理，以便向家庭、提供者和付款人通报最能从这种护理级别中受益的个体情况。
