Comorbidity and treatment response in pediatric obsessive-compulsive disorder: a pilot study of group cognitive-behavioral treatment

Abstract

This pilot study evaluated the effectiveness of group cognitive-behavioral treatment (CBT) on treatment outcomes for children and adolescents who presented with obsessive-compulsive disorder (OCD) and complex comorbid conditions, including depression, attention deficit/hyperactivity disorder and pervasive developmental disorders (PDD). Specifically, the impact of comorbidity on treatment response rates and remission rates was examined. Forty-three youth (aged 7-17) with OCD participated in group family-based CBT. Assessments were conducted at pre- and post-treatment and 6 months. Eighty-six percent of youth presented with a secondary psychiatric disorder, and 74% presented with a tertiary psychiatric condition. Contrary to the expected, comorbidity was not associated with poorer treatment outcomes at post-assessment. At longer term follow-up (6 months), however, treatment outcomes were poorer for youth with multiple comorbid conditions and for those with attention deficit/hyperactivity disorder. The finding that group CBT is largely effective for youth with comorbid conditions is of clinical and practical significance. Group delivery of CBT provides an efficient and cost-effective approach, and alleviates strain on services and service providers. Continued efforts are needed to improve long-term outcomes for youth with multiple comorbid conditions and attention deficit/hyperactivity disorder. Examining treatment response as a function of comorbidity with larger clinical samples is important to extend this research.