Long-term outcome of pediatric obsessive-compulsive disorder: a meta-analysis and qualitative review of the literature
Journal Title
Acta Psychiatrica Scandinavica
Readers/Advisors
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Term and Year
Publication Date
2004-07
Book Title
Publication Volume
110
Publication Issue
1
Publication Begin
4
Publication End
13
Number of pages
Research Projects
Organizational Units
Journal Issue
Abstract
Objective: To review the extant literature on the long-term outcome of
child/adolescent-onset obsessive–compulsive disorder (OCD).
Method: Medline and Psychlit databases were systematically searched
for articles regarding long-term outcomes of child/adolescent-onset
OCD. Meta-analysis regression was applied to evaluate predictors and
persistence of OCD.
Results: Sixteen study samples (n ¼ 6–132; total ¼ 521 participants) in
22 studies had follow-up periods ranging between 1 and 15.6 years.
Pooled mean persistence rates were 41% for full OCD and 60% for full
or subthreshold OCD. Earlier age of OCD onset (z ¼ )3.26,
P ¼ 0.001), increased OCD duration (z ¼ 2.22, P ¼ 0.027) and inpatient vs. out-patient status (z ¼ 2.94, P ¼ 0.003) predicted greater
persistence. Comorbid psychiatric illness and poor initial treatment
response were poor prognostic factors. Although psychosocial function
was frequently compromised, most studies lacked comprehensive
outcome measures.
Conclusion: Long-term persistence of pediatric OCD may be lower
than believed. Future studies should include broader measures of
outcome including symptomatic persistence and functional impairment
in multiple domains.