Defining treatment response and remission in obsessive-compulsive disorder: a signal detection analysis of the Children's Yale-Brown Obsessive Compulsive Scale.
OBJECTIVE
To examine the optimal Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) percent reduction cutoffs for predicting treatment response and clinical remission among children and adolescents with obsessive-compulsive disorder (OCD).


METHODS
Youth with OCD (N = 109; range 7 to 19 years) received 14 sessions of weekly or intensive family-based CBT as part of previously published studies or through the standard clinical flow at our facility. Assessments were conducted before and after treatment and included the CY-BOCS, response and remission status on the Clinical Global Impressions Scale, and the Child Obsessive-Compulsive Impact Scale.


RESULTS
Maximally efficient CY-BOCS cutoffs were observed at a 25% reduction for treatment response, a 45% to 50% reduction for symptom remission, and a CY-BOCS score of 14 when considering raw scores. OCD-related impairment improved as a function of treatment response and symptom remission.


CONCLUSIONS
These data indicate that a CY-BOCS reduction of 25% appears to be optimal for determining treatment response, a reduction of 45% to 50% appears to be optimal for detecting symptom remission, and a CY-BOCS raw score of 14 best reflects remission after treatment. Clinical trials should employ a consistent definition of treatment response for cross-study comparability. Clinicians can use these values for treatment planning decisions.
Storch
Eric A
EA
Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, 800 6th Street South, 4th Floor, St. Petersburg, FL 33701, USA. estorch@health.usf.edu
Lewin
Adam B
AB
De Nadai
Alessandro S
AS
Murphy
Tanya K
TK
D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D004493:Education; D005196:Family Therapy; D005260:Female; D006801:Humans; D007171:Implosive Therapy; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D010552:Personality Assessment / Q000706:statistics & numerical data*; D011379:Prognosis; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D017603:Signal Detection, Psychological; D016896:Treatment Outcome