Impact of comorbidity on cognitive-behavioral therapy response in pediatric obsessive-compulsive disorder.

Full Abstract

OBJECTIVE:
To examine the impact of psychiatric comorbidity on cognitive-behavioral therapy response in children and adolescents with obsessive-compulsive disorder.

METHOD:
Ninety-six youths with obsessive-compulsive disorder (range 7-19 years) received 14 sessions of weekly or intensive family-based cognitive-behavioral therapy. Assessments were conducted before and after treatment. Primary outcomes included scores on the Children's Yale-Brown Obsessive-Compulsive Scale, response rates, and remission status.

RESULTS:
Seventy-four percent of participants met criteria for at least one comorbid diagnosis. In general, participants with one or more comorbid diagnoses had lower treatment response and remission rates relative to those without a comorbid diagnosis. The number of comorbid conditions was negatively related to outcome. The presence of attention-deficit/hyperactivity disorder and disruptive behavior disorders was related to lower treatment response rates, and the presence of disruptive behavior disorders and major depressive disorder were related to lower remission rates.

CONCLUSIONS:
The presence of a comorbid disorder, particularly disruptive behavior, major depressive, and attention-deficit/hyperactivity disorders, has a negative impact on treatment response. Assessing for psychiatric disorders before treatment entry and treating these comorbid conditions before or during cognitive-behavioral therapy may improve final outcome. Comorbid anxiety or tic disorders do not seem to negatively affect response.

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Author information

Author/s: Storch, Eric A (EA); Merlo, Lisa J (LJ); Larson, Michael J (MJ); Geffken, Gary R (GR); Lehmkuhl, Heather D (HD); Jacob, Marni L (ML); Murphy, Tanya K (TK); Goodman, Wayne K (WK);

Affiliation: Department of Psychiatry, University of Florida, Gainesville, FL 32610, USA. estorch(-atsign-)psychiatry.ufl.edu.

Journal and publication information

Publication Type: Journal Article

Journal: Journal of the American Academy of Child and Adolescent Psychiatry (J Am Acad Child Adolesc Psychiatry), published in United States. (Language: eng)

Reference: 2008-May; vol 47 (issue 5) : pp 583-92

Dates: Created 2008/04/29; Completed 2008/06/11;

PMID: 18356759, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: J Am Acad Child Adolesc Psychiatry. 2008 May;47(5):481-2. (PMID: 18438183)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Attention Deficit Disorder with Hyperactivity - diagnosis; psychology; therapy
Attention Deficit and Disruptive Behavior Disorders - diagnosis; psychology; therapy
Child
Cognitive Therapy
Comorbidity
Depressive Disorder, Major - diagnosis; psychology; therapy

Depressive Disorder, Major - diagnosis; psychology; therapy
Female
Humans
Male
Obsessive-Compulsive Disorder - diagnosis; epidemiology; therapy
Prognosis
Treatment Outcome

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