title: The Nordic long-term OCD treatment study (NordLOTS): rationale, design, and methods.
abstract: BACKGROUND
  This 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  This 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.
authors.affiliation: Department of Child and Adolescent Psychiatry, Aarhus University Hospital Risskov, Risskov, Denmark. Per.hove.thomsen@ps.rm.dk.
authors.forename: Per Hove
authors.initials: PH
authors.lastname: Thomsen
authors.forename: Nor C
authors.initials: NC
authors.lastname: Torp
authors.forename: Kitty
authors.initials: K
authors.lastname: Dahl
authors.forename: Karin
authors.initials: K
authors.lastname: Christensen
authors.forename: Inger
authors.initials: I
authors.lastname: Englyst
authors.forename: Karin H
authors.initials: KH
authors.lastname: Melin
authors.forename: Judith B
authors.initials: JB
authors.lastname: Nissen
authors.forename: Katja A
authors.initials: KA
authors.lastname: Hybel
authors.forename: Robert
authors.initials: R
authors.lastname: Valderhaug
authors.forename: Bernhard
authors.initials: B
authors.lastname: Weidle
authors.forename: Gudmundur
authors.initials: G
authors.lastname: Skarphedinsson
authors.forename: Petra Lindheim
authors.initials: PL
authors.lastname: von Bahr
authors.forename: Tord
authors.initials: T
authors.lastname: Ivarsson