Predictors of Treatment Response in Pediatric Obsessive-Compulsive Disorder

doi:10.1097/CHI.0b013e3181799ebd

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 47, Issue 8, August 2008, Pages 868-878

https://doi.org/10.1097/CHI.0b013e3181799ebd Get rights and content

Abstract

Objective

To examine predictors of treatment response in pediatric obsessive-compulsive disorder (OCD).

Method

A literature review of psychotherapy (i.e., cognitive-behavioral therapy) and medication studies for pediatric OCD published from 1985 to 2007 was conducted using several databases.

Results

The literature search produced a total of 21 studies (6 cognitive-behavioral therapy, 13 medication, and 2 combination studies) that met specific methodological criteria. Across studies, the following nine predictors were examined: child sex, child age, duration of illness/age at onset, baseline severity of obsessive-compulsive symptoms, type of obsessive-compulsive symptoms, comorbid disorders/symptoms, psychophysiological factors, neuropsychological factors, and family factors. Among all of the studies, there was little evidence that sex, age, or duration of illness (age at onset) was associated with treatment response. Baseline severity of obsessive-compulsive symptoms and family dysfunction were associated with poorer response to cognitive-behavioral therapy, whereas comorbid tics and extermalizing disorders were associated with poorer response in medication-only studies.

Conclusions

Overall, there are limited data on predictors of treatment response for pediatric OCD. The majority of studies are plagued with methodological limitations and post hoc approaches. Additional research is needed to better delineate the predictors of treatment response in pediatric OCD with the goal of developing individualized treatment approaches. J. Am. Acad. Child Adolesc. Psychiatry, 2008;47(8):868-878.

Section snippets

Method

To identify relevant published studies for inclusion in this review, literature searches were completed using the PsycINFO, PubMed, Cochrane, and Lilacs databases. For the PsycINFO and PubMed literature searches, two key terms related to diagnosis (i.e., “obsessive-compulsive disorder” and “OCD”) were paired with each of eight key terms related to treatment (i.e., “cognitive-behavioral therapy,” “CBT,” “cognitive-behavioral treatment,” “cognitive-behavioral family treatment,” “behavioral

Summary of Studies

Using the above inclusion criteria, a total of 21 published papers were identified. Six of the studies evaluated CBT only, 13 evaluated medications only, and two examined a combination of CBT and medication treatments. Key characteristics of each study are included in Tables A-C, which are available on the Journal's Web site at www.jaacap.com through the ArticlePlus feature. Across these studies, a total of nine predictors were examined statistically in these studies. We have included only

Discussion

The present review examined predictors of pediatric OCD treatment response in both psychosocial and medication trials. Literature searches of databases and review articles revealed that nine predictors were statistically examined in a minimum of two studies. These predictors were child sex, child age, duration of illness/age at on set, baseline severity of OC symptoms, type of OC symptoms, comorbid disorders/symptoms, psychophysiological factors, neuropsychological factors, and family factors.

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: ArticlePlus (online-only) materials for this article appear on the Journal's Web site:www.jaacap.com.

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ReviewPredictors of Treatment Response in Pediatric Obsessive-Compulsive Disorder

Abstract

Objective

Method

Results

Conclusions

Section snippets

Method

Summary of Studies

Discussion

Child Adolesc Psychiatr Clin N Am

Biol Psychiatry

Clin Psychol Rev

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Anxiety Disord

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Behav Res Ther

J Am Acad Child Adolesc Psychiatry

Biol Psychiatry

Biol Psychiatry

Clin Psychol Rev

Child Adolesc Psychiatr Clin N Am

J Psychiatr Res

J Anxiety Disord

Behav Ther

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Prevalence of obsessive-compulsive disorder in the British nationwide survey of child mental health

Br J Psychiatry

Review
Predictors of Treatment Response in Pediatric Obsessive-Compulsive Disorder