title: Effectiveness of cognitive behavior treatment for pediatric obsessive-compulsive disorder: acute outcomes from the Nordic Long-term OCD Treatment Study (NordLOTS).
abstract: OBJECTIVE
  The purpose of this study was to examine the acute effectiveness of manualized exposure-based CBT with a family-based treatment, as an initial treatment for pediatric OCD delivered in regular community child and adolescents outpatient clinics. The report summarizes outcome of the first treatment step in the NordLOTS, which was conducted in Denmark, Sweden and Norway.
  
  
  METHODS
  269 participants, age 7-17, with OCD, received treatment for 14 weekly sessions. Treatment response was defined as CY-BOCS score of ≤15 at post treatment.
  
  
  RESULTS
  241 participants (89.6%) completed all 14 weeks of treatment. Treatment response among the completers was 72.6% (95% CI 66.7%-77.9%). Mixed effects model revealed a statistically significant effect of time F(1,479) = 130.434. Mean symptom reduction on the CY-BOCS was 52.9% (SD = 30.9). The estimated within-group effect size between baseline and post treatment was 1.58 (95% CI: 1.37-1.80).
  
  
  CONCLUSIONS
  This study found that manualized CBT can be applied effectively in community mental health clinics. These findings underscore the feasibility of implementing exposure-based CBT for pediatric OCD in a regular child and adolescent mental health setting.
  
  
  BACKGROUND
  This study was registered in Current Controlled Trials; Nordic Long-term Obsessive-compulsive disorder (OCD) Treatment Study (www.controlled-trials.com ISRCTN66385119).
authors.affiliation: Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway; Department of Child and Adolescent Psychiatry, Division of Mental Health and Addiction, Vestre Viken Hospital, Drammen, Norway. Electronic address: nor.christian.torp@r-bup.no.
authors.forename: Nor Christian
authors.initials: NC
authors.lastname: Torp
authors.affiliation: Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
authors.forename: Kitty
authors.initials: K
authors.lastname: Dahl
authors.affiliation: Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
authors.forename: Gudmundur
authors.initials: G
authors.lastname: Skarphedinsson
authors.affiliation: Aarhus University Hospital, Regional Center for Child and Adolescent Psychiatry, Risskov, Aarhus, Denmark.
authors.forename: Per Hove
authors.initials: PH
authors.lastname: Thomsen
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, NTNU, Trondheim, Norway.
authors.forename: Robert
authors.initials: R
authors.lastname: Valderhaug
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, NTNU, Trondheim, Norway.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Weidle
authors.affiliation: Department of Child and Adolescent Psychiatry, Queen Silva Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Karin Holmgren
authors.initials: KH
authors.lastname: Melin
authors.affiliation: Aarhus University Hospital, Regional Center for Child and Adolescent Psychiatry, Risskov, Aarhus, Denmark.
authors.forename: Katja
authors.initials: K
authors.lastname: Hybel
authors.affiliation: Aarhus University Hospital, Regional Center for Child and Adolescent Psychiatry, Risskov, Aarhus, Denmark.
authors.forename: Judit Becker
authors.initials: JB
authors.lastname: Nissen
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
authors.forename: Fabian
authors.initials: F
authors.lastname: Lenhard
authors.affiliation: Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
authors.forename: Tore
authors.initials: T
authors.lastname: Wentzel-Larsen
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, USA.
authors.forename: Martin E
authors.initials: ME
authors.lastname: Franklin
authors.affiliation: Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
authors.forename: Tord
authors.initials: T
authors.lastname: Ivarsson
mesh_terms: D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003718:Denmark; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009664:Norway; D009771:Obsessive-Compulsive Disorder / Q000523:psychology / Q000628:therapy*; D013548:Sweden; D016896:Treatment Outcome
keywords: Child and adolescent; Cognitive-behavioral therapy; Exposure and response prevention; Obsessive-compulsive disorder; Treatment outcome