The impact of neuropsychological functioning on treatment outcome in pediatric obsessive-compulsive disorder.
BACKGROUND
Scant research has examined the effect of neuropsychological (NP) functioning on treatment outcome in pediatric obsessive-compulsive disorder (OCD). This study sought to address this gap in existing research.


METHODS
A total of 63 youths were included in this study and asked to complete the Rey-Osterrieth Complex Figure (ROCF) and specific subtests of the Wechsler Intelligence Scale for Children, Third Edition (WISC-III).


RESULTS
Analyses suggest that 5 min recall accuracy (raw score) and percent recall from the ROCF, assessed before treatment may be predictors of treatment response among children with OCD. What is more, exploratory post hoc analyses indicated that performance on these ROCF tasks is particularly relevant among youths receiving cognitive-behavior therapy (CBT) alone. These results may be driven by executive functioning ability. Additional analyses suggest a relationship between age, symptom severity, and NP functioning on select tasks from both the ROCF and WISC-III.


CONCLUSIONS
Although alternative explanations exist, these findings suggest that poorer performance on the ROCF and, in turn, poorer response to treatment, particularly among those youths receiving CBT alone, may be due to executive functioning difficulties. Clinicians and researchers should be sensitive to this fact and may warrant modification(s) to existing treatment protocols. Limitations to this study, however, suggest the need for replication and extension of these findings in the future.
Rhode Island Hospital, Department of Child and Adolescent Psychiatry, Bradley/Hasbro Children's Research Center, Providence, Rhode Island 02903, USA. cflessner@lifespan.org
Christopher A
CA
Flessner
Amy
A
Allgair
Abbe
A
Garcia
Jennifer
J
Freeman
Jeffrey
J
Sapyta
Martin E
ME
Franklin
Edna
E
Foa
John
J
March
D000293:Adolescent; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D056344:Executive Function / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000187:drug effects; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000628:therapy*; D011597:Psychomotor Performance / Q000187:drug effects; D020280:Sertraline / Q000627:therapeutic use*; D014888:Wechsler Scales
D018687:Antidepressive Agents, Second-Generation; D020280:Sertraline