Defining Treatment Outcomes in Pediatric Obsessive-Compulsive Disorder Using a Self-Report Scale. Issue 2 (March 2019)

• Record Type: Journal Article
• Authors: McGuire, Joseph F.; Geller, Daniel A.; Murphy, Tanya K.; Small, Brent J.; Unger, Arianna; Wilhelm, Sabine; Storch, Eric A.
• Is Part Of: Behavior therapy. Volume 50:Issue 2(2019)
• Page Start: 314
• Page End: 324
• Publication Date: 2019-03
• Subjects: children -- adolescents -- obsessive-compulsive disorder -- cognitive-behavior therapy -- evidence-based assessment; Behavior therapy -- Periodicals; 616.8914205
• DOI: 10.1016/j.beth.2018.06.003
• Languages: English
• ISSNs: 0005-7894

Abstract

Abstract: This study examined benchmarks of treatment response and clinical remission on the Obsessive Compulsive Inventory–Child Version (OCI-CV) for youth with obsessive-compulsive disorder (OCD). Participants were 91 youth who enrolled in a randomized controlled trial that examined the benefit of augmenting cognitive behavior therapy (CBT) with either d-cycloserine or placebo. Youth completed the OCI-CV at baseline, Week 4 (prior to initiating exposure therapy), and posttreatment. Receiver operator curve (ROC) analyses examined optimal benchmarks for treatment response and clinical remission as identified by independent evaluators at the posttreatment assessment using the Clinical Global Impression (CGI) scales of Improvement (CGI-Improvement), Severity (CGI-Severity), and Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Optimal benchmarks for treatment response were a 20%–25% reduction in the OCI-CV total score. Meanwhile, optimal benchmarks for remission were a 55%–65% reduction in the OCI-CV total score and a posttreatment total score ≤ 6-8. OCI-CV benchmarks exhibited moderate agreement with the CY-BOCS for treatment response and clinical remission. Meanwhile, fair agreement was observed for response and remission with CGI scales. A lower pretreatment OCI-CV total score was associated with less agreement between classification approaches. Findings provide benchmarks for classifying treatment response and clinical remission in an efficient manner. Given the moderate agreement between the CY-BOCS and OCI-CV benchmarks, the OCI-CV may serve as a useful alternative when clinician-rated scales cannot be administered due to limited resources (e.g., time, training). Thus, evidence-based measurement can be incorporated to monitor therapeutic response and remission in clinical practice. Highlights: Evidence-based assessment is an important feature of evidence-based treatments. Self-report scales are efficient tools to identify and quantify OCD symptom severity. The OCI-CV is a psychometrically validated and commonly used measure in youth. Benchmarks for treatment response and remission were identified on the OCI-CV. The OCI-CV can be integrated into therapy to monitor clinical outcomes.