Table A Predictors of Pediatric OCD Treatment Response in CBT Only Studies
Author (s)
Study Design &
Intervention
N; Age
OCD Outcome
Measure; Timing of
Assessments
Predictors
Examined
Statistically
Predictor Findings
ADIS-P
CY-BOCS
NIMH GOCS
Child Age
Age was not related to treatment response
Randomized Controlled Trials:
Barrett et
al., 2004 12
Randomized trial:
77; 7-17
individual cognitivebehavioral family therapy
(CBFT), group CBFT or
waitlist control. 14
weekly sessions and 2
booster sessions
- Post-treatment, 3
and 6 month followup
Uncontrolled Trials:
Bolton et
al., 1995 13
Long term follow up
study of adolescents
treated 9 – 14 years prior
(see Bolton et al., 1983)
*5 patients were treated
with clomipramine in
addition to behavior
therapy
Benazon et
al., 2002 26
Open trial: E/RP, 12
weekly sessions
14; 23-31 Medical records
PSE
Youth
PHS
were 1218 at
- 9 to 14 years posttime of
treatment
treatment
Duration of
illness
Severity
Parental
psychopathology
No variable (duration of illness, severity, or
parental psychopathology) was associated with
treatment response
16; 8-17
Gender
Comorbid
anxiety
disorder
Neither gender nor comorbid anxiety disorder
were associated with treatment response
CY-BOCS
NIMH GOCS
CGI-I
- Post-treatment
Table A Continued
Author (s)
Study Design &
Intervention
N; Age
OCD Outcome
Measure; Timing of
Assessments
Predictors
Examined
Statistically
Predictor Findings
Piacentini
et al., 2002
Open trial: E/RP, weekly
sessions, mean of 12.5
sessions attended
42; 5-17
CY-BOCS
NIMH GOCS
CGI-I
Child age
Gender
Duration of
OCD
BL OCD
severity
Comorbidity
Age, gender, duration of OCD, and comorbid
tics were not associated with treatment
response
Tic disorder
Comorbid tic disorder was not associated with
treatment response
BL OCD
severity
Comorbid
depression,
anxiety
Family
functioning
More severe obsessions/compulsions, and
higher level of family dysfunction at
pretreatment predicted poorer outcome at 18
month follow-up
16
- Post-treatment
Himle et
al., 2003 28
Open trial: group E/RP, 7
weekly sessions
19; 1217
CY-BOCS
BL CY-BOCS Obsessions score, greater OCDrelated academic impairment, higher level of
anxiety symptoms were associated with poorer
outcome
- Post-treatment
Barrett et
al., 2005 17
Long-term follow-up
study using subsample
from Barrett et al. (2004)
study
48; 8-19
ADIS-P
CY-BOCS
NIMH GOCS
- 12 and 18 month
follow-up
Comorbid depression and anxiety were not
associated with treatment response
Note: LOI-CV = ADIS-P = Anxiety Disorders Interview Schedule – Parent Version, CY-BOCS = Children’s Yale-Brown Obsessive Compulsive Scale, NIMH
GOCS = NIMH Global Scale for OCD, PSE = Present State Examination, PHS = Past History Schedule, CGI-I = Clinical Global Impression of Improvement.
References (includes all references from original article)
1.
Heyman I, Fombonne E, Simmons H, Ford T, Meltzer H, Goodman R. Prevalence of
obsessive-compulsive disorder in the British nationwide survey of child mental health. Br J Psychiatry. 2001; 179:324-329.
2.
Zohar AH. The epidemiology of obsessive-compulsive disorder in children and
adolescents. Child Adolesc Psychiatr Clin N Am. 1999; 8:445-460.
3.
POTS. Cognitive-behavior therapy, sertraline, and their combination for children and
adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment Study (POTS) randomized controlled trial. JAMA.
2004; 292:1969-1976
4.
Kraemer HC, Stice E, Kazdin A, Offord D, Kupfer D. How do risk factors work together? Mediators, moderators, and
independent, overlapping, and proxy risk factors. Am J Psychiatry. 2001; 158:848-856.
5.
O'Kearney RT, Anstey KJ, von Sanden C. Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in
children and adolescents. Cochrane Database Syst Rev. 2006; CD004856.
6.
Abramowitz JS. Effectiveness of psychological and pharmacological treatments for obsessive-compulsive disorder: a quantitative
review. J Consult Clin Psychol. 1997; 65:44-52.
7.
Freeman JB, Choate-Summers ML, Moore PS, et al. Cognitive behavioral treatment for young children with obsessivecompulsive disorder. Biol Psychiatry. 2007; 61:337-343.
8.
Geller DA, Biederman J, Stewart SE, et al. Impact of comorbidity on treatment response to paroxetine in pediatric obsessivecompulsive disorder: is the use of exclusion criteria empirically supported in randomized clinical trials? J Child Adolesc
Psychopharmacol. 2003; 13 Suppl 1:S19-S29.
9.
March JS, Franklin M, Nelson A, Foa E. Cognitive-behavioral psychotherapy for pediatric obsessive-compulsive disorder. J Clin
Child Psychol. 2001; 30:8-18.
10.
Thomsen PH. Obsessive-complusive disorder: pharmacological treatment. Eur Child Adolesc Psychiatry. 2000; 9 Suppl 1:I76I84.
11.
Turner CM. Cognitive-behavioural theory and therapy for obsessive-compulsive disorder in children and adolescents: current
status and future directions. Clin Psychol Rev. 2006; 26:912-938.
12.
Barrett P, Healy-Farrell L, March JS. Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: a
controlled trial. J Am Acad Child Adolesc Psychiatry. 2004; 43:46-62.
13.
Bolton D, Luckie M, Steinberg D. Long-term course of obsessive-compulsive disorder treated in adolescence. J Am Acad Child
Adolesc Psychiatry. 1995; 34:1441-1450.
14.
Flament MF, Rapoport JL, Berg CJ, et al. Clomipramine treatment of childhood obsessive-compulsive disorder. A double-blind
controlled study. Arch Gen Psychiatry. 1985; 42:977-983.
15.
Riddle MA, Reeve EA, Yaryura-Tobias JA, et al. Fluvoxamine for children and adolescents with obsessive-compulsive disorder:
a randomized, controlled, multicenter trial. J Am Acad Child Adolesc Psychiatry. 2001; 40:222-229.
16.
Piacentini J, Bergman RL, Jacobs C, McCracken JT, Kretchman J. Open trial of cognitive behavior therapy for childhood
obsessive-compulsive disorder. J Anxiety Disord. 2002; 16:207-219.
17.
Barrett P, Farrell L, Dadds M, Boulter N. Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder:
long-term follow-up and predictors of outcome. J Am Acad Child Adolesc Psychiatry. 2005; 44:1005-1014.
18.
Leonard HL, Swedo SE, Rapoport JL, et al. Treatment of obsessive-compulsive disorder with clomipramine and desipramine in
children and adolescents. A double-blind crossover comparison. Arch Gen Psychiatry. 1989; 46:1088-1092.
19.
March JS, Biederman J, Wolkow R, et al. Sertraline in children and adolescents with obsessive-compulsive disorder: a
multicenter randomized controlled trial. JAMA. 1998; 280:1752-1756.
20.
Thomsen PH, Ebbesen C, Persson C. Long-term experience with citalopram in the treatment of adolescent OCD. J Am Acad
Child Adolesc Psychiatry. 2001; 40:895-902.
21.
Geller DA, Wagner KD, Emslie G, et al. Paroxetine treatment in children and adolescents with obsessive-compulsive disorder: a
randomized, multicenter, double-blind, placebo-controlled trial. J Am Acad Child Adolesc Psychiatry. 2004; 43:1387-1396.
22.
Leonard HL, Swedo SE, Lenane MC, et al. A 2- to 7-year follow-up study of 54 obsessive-compulsive children and adolescents.
Arch Gen Psychiatry. 1993; 50:429-439.
23.
Wever C, Rey JM. Juvenile obsessive-compulsive disorder. Aust N Z J Psychiatry. 1997; 31:105-113.
24.
Wagner KD, Cook EH, Chung H, Messig M. Remission status after long-term sertraline treatment of pediatric obsessivecompulsive disorder. J Child Adolesc Psychopharmacol. 2003; 13 Suppl 1:S53-S60.
25.
Masi G, Millepiedi S, Mucci M, Bertini N, Milantoni L, Arcangeli F. A naturalistic study of referred children and adolescents
with obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry. 2005; 44:673-681.
26.
Benazon NR, Ager J, Rosenberg DR. Cognitive behavior therapy in treatment-naive children and adolescents with obsessivecompulsive disorder: an open trial. Behav Res Ther. 2002; 40:529-539.
27.
Rosenberg DR, Stewart CM, Fitzgerald KD, Tawile V, Carroll E. Paroxetine open-label treatment of pediatric outpatients with
obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry. 1999; 38:1180-1185.
28.
Himle JA, Fischer DJ, Van Etten ML, Janeck AS, Hanna GL. Group behavioral therapy for adolescents with tic-related and nontic-related obsessive-compulsive disorder. Depress Anxiety. 2003; 17:73-77.
29.
March JS, Franklin ME, Leonard H, et al. Tics moderate treatment outcome with sertraline but not cognitive-behavior therapy in
pediatric obsessive-compulsive disorder. Biol Psychiatry. 2007; 61:344-347.
30.
Graeff FG, Parente A, Del Ben CM, Guimaraes FS. Pharmacology of human experimental anxiety. Braz J Med Biol Res. 2003;
36:421-432.
31.
Andres S, Boget T, Lazaro L, et al. Neuropsychological performance in children and adolescents with obsessive-compulsive
disorder and influence of clinical variables. Biol Psychiatry. 2007; 61:946-951.
32.
Greisberg S, McKay D. Neuropsychology of obsessive-compulsive disorder: a review and treatment implications. Clin Psychol
Rev. 2003; 23:95-117.
33.
Schultz RT, Evans DW, Wolff M. Neuropsychological models of childhood obsessive-compulsive disorder. Child Adolesc
Psychiatr Clin N Am. 1999; 8:513-31.
34.
Andres S, Lazaro L, Salamero M, Boget T, Penades R, Castro-Fornieles J. Changes in cognitive dysfunction in children and
adolescents with obsessive-compulsive disorder after treatment. J Psychiatr Res. 2008; 42:507-514.
35.
Barrett PM, Dadds MR, Rapee RM. Family treatment of childhood anxiety: a controlled trial. J Consult Clin Psychol. 1996;
64:333-342.
36.
Yaryura-Tobias JA, Grunes MS, Walz J, Neziroglu F. Parental obsessive-compulsive disorder as a prognostic factor in a year
long fluvoxamine treatment in childhood and adolescent obsessive-compulsive disorder. Int Clin Psychopharmacol. 2000; 15:163168.
37.
Silverman WK, Kurtines WM, Ginsburg GS, Weems CF, Rabian B, Serafini LT. Contingency management, self-control, and
education support in the treatment of childhood phobic disorders: a randomized clinical trial. J Consult Clin Psychol. 1999;
67:675-687.
38.
Treadwell KR, Flannery EC, Kendall PC. Ethnicity and gender in relation to adaptive functioning, diagnostic status, and
treatment outcome in children from an anxiety clinic. J Anxiety Disord. 1995; 9:373-384.
39.
Silverman WK, Kurtines WM, Ginsburg GS, Weems CF, Lumpkin PW, Carmichael DH. Treating anxiety disorders in children
with group cognitive-behaviorial therapy: a randomized clinical trial. J Consult Clin Psychol. 1999; 67:995-1003.
40.
Beidel DC, Turner SM, Morris TL. Behavioral treatment of childhood social phobia. J Consult Clin Psychol. 2000; 68:1072-1080.
41.
Berman S, Weems CF, Silverman WK. Predictors of outcome in exposure-based cognitive and behavioral treatments for phobic
and anxiety disorders in children. Behavior Therapy. 2000; 31:713-731.
42.
Cobham VE, Dadds MR, Spence SH. The role of parental anxiety in the treatment of childhood anxiety. J Consult Clin Psychol.
1998; 66:893-905.
43.
Mendlowitz SL, Manassis K, Bradley S, Scapillato D, Miezitis S, Shaw BF. Cognitive-behavioral group treatments in childhood
anxiety disorders: the role of parental involvement. J Am Acad Child Adolesc Psychiatry. 1999; 38:1223-1229.
44.
Walkup JT, Labellarte MJ, Riddle MA, et al. Searching for moderators and mediators of pharmacological treatment effects in
children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2003; 42:13-21.
45.
Geller DA, Hoog SL, Heiligenstein JH, et al. Fluoxetine treatment for obsessive-compulsive disorder in children and adolescents:
a placebo-controlled clinical trial. J Am Acad Child Adolesc Psychiatry. 2001; 40:773-779.
46.
Thomsen PH. Child and adolescent obsessive-compulsive disorder treated with citalopram: findings from an open trial of 23
cases. J Child Adolesc Psychopharmacol. 1997; 7:157-166.