The role of treatment expectations in predicting treatment outcomes: examining clinical and demographic influences.

OBJECTIVE

The primary aim of this study was to investigate the potential relationship between treatment expectancy and treatment compliance with patient demographic and treatment outcome of exposure-based CBT (EB-CBT), as reported by youth with OCD, their parents, and therapists. The secondary aim is to investigate the correlation of these factors with obsessive-compulsive symptoms before and after treatment.

METHOD

This study is a part of the NordLOTS, in which 269 children and adolescents, aged 7-17 years, with a DSM-IV diagnosis of OCD, were treated with a 14-week EB-CBT program. Patients, parents, and therapists rated their expectancy of the treatment, and therapists rated patients' and parents' compliance with treatment. A Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) score ≤15 was defined as treatment response. Linear mixed effects models were used to assess associations.

RESULTS

Higher patient-rated treatment expectancy was significantly associated with lower pre-treatment CY-BOCS total score, as well as lower levels of parent-rated externalizing symptoms. Higher therapist-rated treatment expectancy was significantly associated with lower levels of parent-rated externalizing symptoms.

CONCLUSIONS

Children and adolescents displaying higher treatment expectancies exhibit milder symptoms of OCD and externalizing symptoms, alongside experiencing more favorable outcomes from EB-CBT.

CLINICAL TRIALS REGISTRATION INFORMATION

This study was registered in Current Controlled Trials; Nordic Long-term Obsessive-compulsive disorder (OCD) Treatment Study (www.controlled-trials.com ISRCTN66385119).