To examine relapse rates following remission in a 3-year follow-up study in pediatric patients with obsessive-compulsive disorder (OCD) treated with cognitive\u2013behavioral therapy (CBT) in a first step, and either continued CBT or sertraline (randomized selection) in a second step.<\/p>\n\n\n\n
Participants (N = 269) fulfilled DSM-IV<\/em> OCD criteria with a mean severity on the Children\u2019s Yale\u2013Brown Obsessive Compulsive Scale (CY-BOCS) of 24.6 (SD = 5.1) and were included in analyses according to intent-to-treat principles. CBT used manualized exposure and response prevention (ERP) during both steps 1 and 2, and step 2 sertraline medication used flexible dosing. The follow-up schedules were timed to 6, 12, 24, and 36 months following step 1 CBT. Remission was defined as a CY-BOCS score \u226410 and relapse as an elevated CY-BOCS score \u226516 in those who had remitted.<\/p>\n\n\n\n A good third of our patients were in stable and full remission at all examinations (n = 98, 36.4%). Further, some in remission following treatment (n = 36, 13.4%) had mild OCD at some examinations. Relapses during follow-up were not uncommon (n = 28, 10.4%), but in many patients these improved again (n = 10, 3.7%) and were in remission at the final 3-year follow-up. Furthermore, a considerable proportion (n = 50, 18.6%) of the patients were initial non-remitters to the treatment but achieved remission at some point during the follow-up. In addition, 11.5% (n = 31) had persistent OCD but reached remission by the last follow-up. Finally, a smaller segment of our sample (9.7%, n = 26), did not attain remission at any point during the study.<\/p>\n\n\n\n Our outcome paints a more promising picture of pediatric OCD long-term outcome than previous studies have done. However, both relapse rates and the presence of\u00a0initial non-remitters and\u00a0persistent OCD show that treatments need improvement, particularly for those who respond slowly, partially, or not at all. The lack of a general psychiatric interview at follow-up is a marked limitation.<\/p>\n\n\n\n <\/p>\n\n\n\nResults<\/h3>\n\n\n\n
Conclusion<\/h3>\n\n\n\n