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Defining cognitive-behavior therapy response and remission in pediatric OCD: a signal detection analysis of the Children’s Yale-Brown Obsessive Compulsive Scale

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Abstract

The objective of the study was to examine the optimal Children’s Yale-Brown Obsessive–Compulsive Scale (CY-BOCS) percent reduction and raw cutoffs for predicting cognitive-behavioral treatment (CBT) response among children and adolescents with obsessive–compulsive disorder (OCD). The sample consisted of children and adolescents with OCD (N = 241) participating in the first step of the Nordic long-term OCD treatment study and receiving 14 weekly sessions of CBT in the form of exposure and response prevention. Evaluations were conducted pre- and post-treatment, included the CY-BOCS, Clinical Global Impressions—severity/improvement. The results showed that the most efficient CY-BOCS cutoffs were 35 % reduction for treatment response, 55 % reduction for remission, and a post-treatment CY-BOCS raw total score of 11 for treatment remission. Overall, our results diverge from previous research on pediatric OCD with more conservative cutoffs (higher cutoff reduction for response and remission, and lower raw score for remission). Further research on optimal cutoffs is needed.

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Acknowledgments

The authors would like to thank the patients and their parents that participated in the Nordic long-term OCD treatment study (NordLOTS) and the NordLOTS researcher group. Funding was applied to each national site as well as some central funding. We thank the following for their contributions: Trygfonden, The Danish Council for Strategic Research, Pulje til styrkelse af psykiatrisk forskning i Region Midtjylland, The Center for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Stiftelsen Clas Groschinskys Minnesfond, Norwegian Research Council, Norwegian ExtraFoundation, and (De Nadai) National Institutes of Health under Ruth L. Kirschstein National Research Service Award number F31MH094095 from the National Institute of Mental Health.

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Authors and Affiliations

  1. Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Nydalen, Postbox 4623, 0405, Oslo, Norway

    Gudmundur Skarphedinsson & Tord Ivarsson

  2. Department of Pediatrics, Psychology and Psychiatry, University of South Florida, St. Petersburg, FL, USA

    Alessandro S. De Nadai, Eric A. Storch & Adam B. Lewin

  3. Department of Health Policy and Management, University of South Florida, Tampa, FL, USA

    Eric A. Storch

  4. Rogers Behavioral Health–Tampa Bay, Tampa, FL, USA

    Eric A. Storch

  5. All Children’s Hospital, Johns Hopkins Medicine, St. Petersburg, FL, USA

    Eric A. Storch

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  1. Gudmundur Skarphedinsson
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Correspondence to Gudmundur Skarphedinsson.

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Conflicts of interest

Tord Ivarsson is involved in Speakers Bureau for Shire, Sweden. Dr. Storch has received grant funding from NIH, the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, the International OCD Foundation, and Ortho-McNeil Scientific Affairs Pharmaceuticals. He has received textbook honorarium from Springer, the American Psychological Association, Wiley Publishers, and Lawrence Erlbaum Associates. He is an educational consultant for Rogers Memorial Hospital. He serves as a consultant for Prophase, Inc. and CroNos, Inc., and serves on the Speaker’s Bureau and Scientific Advisory Board of the International OCD Foundation. He has received research support from the All Children’s Hospital Guild Endowed Chair. Dr. Adam Lewin Research support from the International OCD Foundation and All Children's Hospital. Honorarium from Oxford Press, Springer, and Children's Tumor Foundation. Travel Support from the Tourette Syndrome Association, American Psychological Association, Society for Clinical Child and Adolescent Psychology. Scientific Advisory Board for International OCD Foundation.

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Skarphedinsson, G., De Nadai, A.S., Storch, E.A. et al. Defining cognitive-behavior therapy response and remission in pediatric OCD: a signal detection analysis of the Children’s Yale-Brown Obsessive Compulsive Scale. Eur Child Adolesc Psychiatry 26, 47–55 (2017). https://doi.org/10.1007/s00787-016-0863-0

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