Predictors of treatment response in pediatric obsessive-compulsive disorder.
OBJECTIVE
To examine predictors of treatment response in pediatric obsessive-compulsive disorder (OCD).


METHODS
A literature review of psychotherapy (i.e., cognitive-behavioral therapy) and medication studies for pediatric OCD published from 1985 to 2007 was conducted using several databases.


RESULTS
The literature search produced a total of 21 studies (6 cognitive-behavioral therapy, 13 medication, and 2 combination studies) that met specific methodological criteria. Across studies, the following nine predictors were examined: child sex, child age, duration of illness/age at onset, baseline severity of obsessive-compulsive symptoms, type of obsessive-compulsive symptoms, comorbid disorders/symptoms, psychophysiological factors, neuropsychological factors, and family factors. Among all of the studies, there was little evidence that sex, age, or duration of illness (age at onset) was associated with treatment response. Baseline severity of obsessive-compulsive symptoms and family dysfunction were associated with poorer response to cognitive-behavioral therapy, whereas comorbid tics and externalizing disorders were associated with poorer response in medication-only studies.


CONCLUSIONS
Overall, there are limited data on predictors of treatment response for pediatric OCD. The majority of studies are plagued with methodological limitations and post hoc approaches. Additional research is needed to better delineate the predictors of treatment response in pediatric OCD with the goal of developing individualized treatment approaches.
Ginsburg
Golda S
GS
Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, 600 North Wolfe Street/CMSC 340, Baltimore, MD 21287-3325, USA. gginsbu@jhmi.edu
Kingery
Julie Newman
JN
Drake
Kelly L
KL
Grados
Marco A
MA
D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D017367:Selective Serotonin Reuptake Inhibitors