Torp Nor Christian, Højgaard Davið Rma, Aalberg Marianne, Hybel Katja Anna, Skarphéðinsson Guðmundur Ágúst, Thomsen Per Hove, Ivarsson Tord, Weidle Bernhard, Nissen Judith, Melin Karin, Jensen Sanne
Department of Child and Adolescent Psychiatry. Division of Mental Health and Addiction, Vestre Viken Hospital, Drammen, Norway.
Division of Mental Health and Addiction Services, Akershus University Hospital, Oslo, Norway.
Nord J Psychiatry. 2025 Aug;79(6):462-471. doi: 10.1080/08039488.2025.2528075. Epub 2025 Jul 9.
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.
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.
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.
Children and adolescents displaying higher treatment expectancies exhibit milder symptoms of OCD and externalizing symptoms, alongside experiencing more favorable outcomes from EB-CBT.
This study was registered in Current Controlled Trials; Nordic Long-term Obsessive-compulsive disorder (OCD) Treatment Study (www.controlled-trials.com ISRCTN66385119).
本研究的主要目的是调查强迫症青少年患者、其父母及治疗师所报告的治疗期望与基于暴露的认知行为疗法（EB - CBT）的治疗依从性、患者人口统计学特征及治疗结果之间的潜在关系。次要目的是调查这些因素与治疗前后强迫症状的相关性。
本研究是北欧强迫症治疗研究（NordLOTS）的一部分，269名年龄在7至17岁、根据《精神疾病诊断与统计手册》第四版（DSM - IV）诊断为强迫症的儿童和青少年接受了为期14周的EB - CBT治疗项目。患者、父母和治疗师对治疗期望进行评分，治疗师对患者和父母的治疗依从性进行评分。儿童耶鲁 - 布朗强迫量表（CY - BOCS）得分≤15被定义为治疗有效。采用线性混合效应模型评估相关性。
患者评分的较高治疗期望与较低的治疗前CY - BOCS总分以及父母评分的较低外化症状水平显著相关。治疗师评分的较高治疗期望与父母评分的较低外化症状水平显著相关。
表现出较高治疗期望的儿童和青少年强迫症症状及外化症状较轻，同时EB - CBT治疗效果更佳。
本研究已在“当前对照试验”注册；北欧长期强迫症（OCD）治疗研究（www.controlled - trials.com ISRCTN66385119）。
