TY - JOUR
T1 - Symptom trajectories of early responders and remitters among youth with OCD
AU - Rech, Megan
AU - Weinzimmer, Saira
AU - Geller, Daniel
AU - McGuire, Joseph F.
AU - Schneider, Sophie C.
AU - Patyk, Kevin C.
AU - De Nadai, Alessandro S.
AU - Cepeda, Sandra C.
AU - Small, Brent J.
AU - Murphy, Tanya K.
AU - Wilhelm, Sabine
AU - Storch, Eric A.
N1 - Funding Information:
This work was supported by grants from the National Institute of Mental Health ( NIMH ) to Drs. Storch (1R01MH093381) and Geller (5R01MH093402). The funding organization was not involved in the design or conduct of the study; collection, management, analysis, and interpretation of the data or preparation, review, and approval of the manuscript.
Funding Information:
Dr. Storch reports receiving royalties from Elsevier, Wiley, Springer, American Psychological Association , Jessica Kingsley, Lawrence Erlbaum, Oxford, grants from Greater Houston Community Foundation , ReBuild Texas, NIH , Texas Higher Education Coordinating Board . He receives consultant fees from Levo Therapeutics, and personal fees for training from International OCD Foundation .
Funding Information:
This work was supported by grants from the National Institute of Mental Health (NIMH) to Drs. Storch (1R01MH093381) and Geller (5R01MH093402). The funding organization was not involved in the design or conduct of the study; collection, management, analysis, and interpretation of the data or preparation, review, and approval of the manuscript.Dr. Storch reports receiving royalties from Elsevier, Wiley, Springer, American Psychological Association, Jessica Kingsley, Lawrence Erlbaum, Oxford, grants from Greater Houston Community Foundation, ReBuild Texas, NIH, Texas Higher Education Coordinating Board. He receives consultant fees from Levo Therapeutics, and personal fees for training from International OCD Foundation.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/10
Y1 - 2020/10
N2 - Objectives: This study examined the phenomenology and predictors of early response and remission among youth with obsessive-compulsive disorder (OCD) receiving cognitive-behavioral therapy (CBT). Methods: One hundred and thirty-nine youth with a current primary diagnosis of OCD participated in this study. Participants received 10 sessions of CBT augmented by either placebo or D-cycloserine (DCS) as part of a randomized double-blind multi-site clinical trial. Early response and remission status were determined by clinician-rated global symptom improvement (CGI-I) and severity (CGI-S), respectively. Results: At the mid-treatment assessment, 45.3% of youth were early responders, and 28.1% were early remitters. At post-treatment assessment, 79.1% of youth were responders and 67.6% were remitters. Early response predicted a higher likelihood of post-treatment response and remission; early remission significantly predicted a higher likelihood of post-treatment remission. Bivariate logistic regressions showed that early response was predicted by lower baseline clinician-rated global severity (CGI-S) and lower depression severity; however, only depression severity remained a significant predictor in the multivariable logistic regression model. Furthermore, bivariate logistic regressions showed that early remission was predicted by lower baseline clinician-rated global severity (CGI-S), lower depression severity, and lower obsessive-compulsive symptom severity (CY-BOCS); however, only global severity remained a significant predictor in the multivariable logistic regression model. Conclusions: Lower OCD and depression symptom severity predicted a greater likelihood of early treatment response and remission to CBT. Findings suggest that low OCD and depression symptom severity could serve as baseline characteristics to identify potential candidates for lower-intensity initial interventions in a stepped care approach. The modest predictive value of the variables examined suggests that additional factors could add to prediction of treatment response and remission. Trial registration: clinicaltrials.gov Identifier: NCT00864123.
AB - Objectives: This study examined the phenomenology and predictors of early response and remission among youth with obsessive-compulsive disorder (OCD) receiving cognitive-behavioral therapy (CBT). Methods: One hundred and thirty-nine youth with a current primary diagnosis of OCD participated in this study. Participants received 10 sessions of CBT augmented by either placebo or D-cycloserine (DCS) as part of a randomized double-blind multi-site clinical trial. Early response and remission status were determined by clinician-rated global symptom improvement (CGI-I) and severity (CGI-S), respectively. Results: At the mid-treatment assessment, 45.3% of youth were early responders, and 28.1% were early remitters. At post-treatment assessment, 79.1% of youth were responders and 67.6% were remitters. Early response predicted a higher likelihood of post-treatment response and remission; early remission significantly predicted a higher likelihood of post-treatment remission. Bivariate logistic regressions showed that early response was predicted by lower baseline clinician-rated global severity (CGI-S) and lower depression severity; however, only depression severity remained a significant predictor in the multivariable logistic regression model. Furthermore, bivariate logistic regressions showed that early remission was predicted by lower baseline clinician-rated global severity (CGI-S), lower depression severity, and lower obsessive-compulsive symptom severity (CY-BOCS); however, only global severity remained a significant predictor in the multivariable logistic regression model. Conclusions: Lower OCD and depression symptom severity predicted a greater likelihood of early treatment response and remission to CBT. Findings suggest that low OCD and depression symptom severity could serve as baseline characteristics to identify potential candidates for lower-intensity initial interventions in a stepped care approach. The modest predictive value of the variables examined suggests that additional factors could add to prediction of treatment response and remission. Trial registration: clinicaltrials.gov Identifier: NCT00864123.
KW - Cognitive-behavioral therapy
KW - Early response and remission
KW - Pediatric OCD
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U2 - 10.1016/j.jocrd.2020.100580
DO - 10.1016/j.jocrd.2020.100580
M3 - Article
AN - SCOPUS:85090741460
SN - 2211-3649
VL - 27
JO - Journal of Obsessive-Compulsive and Related Disorders
JF - Journal of Obsessive-Compulsive and Related Disorders
M1 - 100580
ER -