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- Title
Quality of life in pediatric patients with obsessive–compulsive disorder during and 3 years after stepped-care treatment.
- Authors
Jensen, Sanne; Hybel, Katja A.; Højgaard, Davíð R. M. A.; Nissen, Judith Becker; Weidle, Bernhard; Ivarsson, Tord; Skarphedinsson, Gudmundur; Melin, Karin; Torp, Nor Christian; Carlsen, Anders Helles; Mortensen, Erik Lykke; Lenhard, Fabian; Compton, Scott; Thomsen, Per Hove
- Abstract
The present study aimed to investigate the long-term quality of life (QoL) in a large sample of pediatric obsessive–compulsive disorder (OCD) patients. The study included 220 pediatric OCD patients from the Nordic Long-term OCD Treatment Study (NordLOTS) who were evaluated at seven time points before, during, and after stepped-care treatment over a 3-year follow-up period. Data from three symptom severity trajectory classes formed the basis of the QoL evaluation: acute (n = 127, N = 147), slow (n = 46, N = 63), and limited responders (n = 47, N = 59). Patients' QoL was assessed using parent and child ratings of the revised Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R). QoL was analyzed by trajectory class using a random mixed effects model. The association between pre-treatment factors and long-term QoL was investigated across classes in a multivariate model. Three years after treatment, the acute responder class had reached QoL levels from a general population, whereas the limited responder class had not. The slow responder class reached norm levels for the child-rated QoL only. Higher levels of co-occurring externalizing symptoms before treatment were associated with lower parent-rated QoL during follow-up, while adolescence and higher levels of co-occurring internalizing symptoms were associated with lower child-rated QoL during follow-up. For some patients, residual OCD symptoms in the years after treatment, even at levels below assumed clinical significance, are associated with compromised QoL. Co-occurring symptoms could be part of the explanation. Assessing QoL after OCD treatment, beyond the clinician-rated symptom severity, could detect patients in need of further treatment and/or assessment. Trial registry: Nordic Long-term Obsessive–Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119.
- Subjects
MULTIVARIATE analysis; MEDICAL care; TREATMENT effectiveness; PRE-tests &; post-tests; BEHAVIOR disorders; QUALITY of life; QUESTIONNAIRES; OBSESSIVE-compulsive disorder; COMORBIDITY; CHILDREN
- Publication
European Child & Adolescent Psychiatry, 2022, Vol 31, Issue 9, p1377
- ISSN
1018-8827
- Publication type
Article
- DOI
10.1007/s00787-021-01775-w