Long-term outcome of pediatric obsessive-compulsive disorder: a meta-analysis and qualitative review of the literature.
OBJECTIVE
To review the extant literature on the long-term outcome of child/adolescent-onset obsessive-compulsive disorder (OCD).


METHODS
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.


CONCLUSIONS
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.
Stewart
S E
SE
Pediatric Obsessive-Compulsive Disorder Clinical Research Program, McLean Hospital, Harvard Medical School, MA, USA.
Geller
D A
DA
Jenike
M
M
Pauls
D
D
Shaw
D
D
Mullin
B
B
Faraone
S V
SV
D000293:Adolescent; D017668:Age of Onset; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000523:psychology* / Q000628:therapy*; D011379:Prognosis; D012008:Recurrence; D012044:Regression Analysis; D016896:Treatment Outcome