Long-term course of pediatric obsessive–compulsive disorder: 3 years of prospective follow-up

Abstract

ObjectiveThis study assesses the long-term course of treatment-seeking youth with a primary diagnosis of DSM-IV OCD. MethodSixty youth and their parents completed intake interviews and annual follow-up interviews for 3years using the youth version of the Longitudinal Interval Follow-up Evaluation (Y-LIFE) and Children's Yale–Brown Obsessive Compulsive Scale (CY-BOCS). Remission was defined as no longer meeting DSM-IV criteria for OCD for 8weeks or more, and recurrence was defined as meeting full criteria for OCD for 4 consecutive weeks after having achieved symptom remission. Remission rates for youth were compared to rates of adults participating in the same study. ResultsThe probability of achieving partial remission of OCD was 0.53 and the probability of achieving full remission was 0.27. Among the 24 youth participants who achieved remission, 79% stayed in remission throughout the study (mean of 88weeks of follow-up) and 21% experienced a recurrence of symptoms. Better functioning at intake and a shorter latency to initial OCD treatment were associated with faster onset of remission (P<.001). ConclusionsRemission is more likely among youth versus adults with OCD. Treatment early in the course of illness and before substantial impact on functioning predicted a better course.