Abstract
BackgroundThis paper describes and discusses the methodology of the Nordic long-term OCD-treatment study (NordLOTS). The purpose of this effectiveness study was to study treatment outcome of CBT, to identify CBT non- or partial responders and to investigate whether an increased number of CBT-sessions or sertraline treatment gives the best outcome; to identify treatment refractory patients and to investigate the outcome of aripiprazole augmentation; to study the outcome over a three year period for each responder including the risk of relapse, and finally to study predictors, moderators and mediators of treatment response.MethodsStep 1 was an open and uncontrolled clinical trial with CBT, step 2 was a controlled, randomised non-blinded study of CBT non-responders from step 1. Patients were randomized to receive either sertraline plus CBT-support or continued and modified CBT. In step 3 patients who did not respond to either CBT or sertraline were treated with aripiprazole augmentation to sertraline.ConclusionsThis multicenter trial covering three Scandinavian countries is going to be the largest CBT-study for paediatric OCD to date. It is not funded by industry and tries in the short and long-term to answer the question whether further CBT or SSRI is better in CBT non-responders.
Highlights
This paper describes and discusses the methodology of the Nordic long-term Obsessive-compulsive disorder (OCD)-treatment study (NordLOTS)
Valderhaug et al showed this to be the case in one study, this needs to be replicated in studies with more clinics in both specialized OCD clinics and general child psychiatric outpatient clinics [17]
1) primary diagnosis of OCD according to the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision [18], 2) Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) entry score equal to or above 16, 3) ages 7 through 17, 4) patients with attention deficit hyperactivity disorder (ADHD) were included if they had been stable on medication for at least 3 months
Summary
Step 1 was an open and uncontrolled clinical trial with CBT, step 2 was a controlled, randomised non-blinded study of CBT non-responders from step 1. Patients were randomized to receive either sertraline plus CBT-support or continued and modified CBT. In step 3 patients who did not respond to either CBT or sertraline were treated with aripiprazole augmentation to sertraline
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