IngentaConnect Long-term outcome of pediatric obsessive-compulsive disorder: a m...

Authors: Stewart S.E.; Geller D.A.; Jenike M.; Pauls D.; Shaw D.¹; Mullin B.¹; Faraone S.V.

Source: Acta Psychiatrica Scandinavica, Volume 110, Number 1, July 2004 , pp. 4-13(10)

Abstract:

Stewart SE, Geller DA, Jenike M, Pauls D, Shaw D, Mullin B, Faraone SV. Long-term outcome of pediatric obsessive–compulsive disorder: a meta-analysis and qualitative review of the literature.

Acta Psychiatr Scand 2004: 110: 4–13. © Blackwell Munksgaard 2004. Objective:

To review the extant literature on the long-term outcome of child/adolescent-onset obsessive–compulsive disorder (OCD). Method:

Medline and Psychlit databases were systematically searched for articles regarding long-term outcomes of child/adolescent-onset OCD. Meta-analysis regression was applied to evaluate predictors and persistence of OCD. Results:

Sixteen study samples (n = 6–132; total = 521 participants) in 22 studies had follow-up periods ranging between 1 and 15.6 years. Pooled mean persistence rates were 41% for full OCD and 60% for full or subthreshold OCD. Earlier age of OCD onset (z = -3.26, P = 0.001), increased OCD duration (z = 2.22, P = 0.027) and in-patient vs. out-patient status (z = 2.94, P = 0.003) predicted greater persistence. Comorbid psychiatric illness and poor initial treatment response were poor prognostic factors. Although psychosocial function was frequently compromised, most studies lacked comprehensive outcome measures. Conclusion:

Long-term persistence of pediatric OCD may be lower than believed. Future studies should include broader measures of outcome including symptomatic persistence and functional impairment in multiple domains.

Keywords: obsessive–compulsive disorder; meta-analysis; prognosis; child; adolescent; pediatrics outcome assessment

Document Type: Review article

DOI: 10.1111/j.1600-0447.2004.00302.x

Affiliations: 1: Pediatric Psychopharmacology Clinic, Massachusetts General Hospital, MA, USA

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