Effectiveness of cognitive behavior treatment for pediatric obsessive-compulsive disorder: acute outcomes from the Nordic Long-term OCD Treatment Study (NordLOTS)

Objective: The purpose of this study was to examine the acute effectiveness of manualized exposure-based CBT with a family-based treatment, as an initial treatment for pediatric OCD delivered in regular community child and adolescents outpatient clinics. The report summarizes outcome of the first treatment step in the NordLOTS, which was conducted in Denmark, Sweden and Norway.

Method: 269 participants, age 7-17, with OCD, received treatment for 14 weekly sessions. Treatment response was defined as CY-BOCS score of ≤15 at post treatment.

Results: 241 participants (89.6%) completed all 14 weeks of treatment. Treatment response among the completers was 72.6% (95% CI 66.7%-77.9%). Mixed effects model revealed a statistically significant effect of time F(1,479) = 130.434. Mean symptom reduction on the CY-BOCS was 52.9% (SD = 30.9). The estimated within-group effect size between baseline and post treatment was 1.58 (95% CI: 1.37-1.80).

Conclusion: This study found that manualized CBT can be applied effectively in community mental health clinics. These findings underscore the feasibility of implementing exposure-based CBT for pediatric OCD in a regular child and adolescent mental health setting.

Clinical trials registration information: This study was registered in Current Controlled Trials; Nordic Long-term Obsessive-compulsive disorder (OCD) Treatment Study (www.controlled-trials.com ISRCTN66385119).