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Long‐term outcome of pediatric obsessive–compulsive disorder: a meta‐analysis and qualitative review of the literature
Author(s) -
Stewart S. E.,
Geller D. A.,
Jenike M.,
Pauls D.,
Shaw D.,
Mullin B.,
Faraone S. V.
Publication year - 2004
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/j.1600-0447.2004.00302.x
Subject(s) - persistence (discontinuity) , psychosocial , meta analysis , obsessive compulsive , psychology , clinical psychology , psychiatry , medline , extant taxon , medicine , pediatrics , geotechnical engineering , evolutionary biology , political science , law , engineering , biology
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 = 6–132; total = 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 = −3.26, P = 0.001), increased OCD duration ( z = 2.22, P = 0.027) and in‐patient vs. out‐patient status ( z = 2.94, P = 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.