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Excellent long-term stability of treatment gains of stepwise treatment for pediatric OCD

Cognitive behavior therapy as a single treatment works well for most children and adolescents with OCD and the improvement continues even after the treatment was discontinued

Washington, DC – WEBWIRE

A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports that the long-term stability of treatment gains for children and adolescents diagnosed with obsessive-compulsive disorder (OCD), participating in a stepwise manualized treatment, is excellent.

“OCD is a persistent and highly disabling psychiatric disorder and affects 0.25 to 4 percent of children and adolescents. Untreated, pediatric OCD can become chronic and disrupts the child’s normal development, contributing to poor quality of life and functional impairment,” said first author Karin Melin, PhD and Head Nurse at the Department of Child and Adolescent Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden. Early diagnosis and treatment are crucial for the prevention of possible lifelong impairment, and these findings suggest that most participants respond well to treatment for pediatric OCD, and the long-term outcome is correspondingly good.”

Immediate improvements in child and adolescent OCD symptoms following treatment in the study that included a first step of manualized cognitive-behavioral therapy (CBT). If needed, extended treatment with CBT, or a switch to pharmacotherapy with sertraline, was sustained and further improved over a three-year period after treatment.

Additional long-term improvements were also found in psychosocial functioning and a reduction in depressive symptoms associated with treatment.

“Single treatment with manualized CBT, seems to be the most beneficial and safest treatment to offer children and adolescents who initially present with OCD,” added Dr. Melin.

These findings are based on results from The Nordic Long-term OCD Treatment Study (NordLOTS).
The study population consisted of 269 participants in the age 7-to-17 years of age who were diagnosed with OCD. All participants received individualized CBT for 14 weeks; non-responders to initial CBT were randomized to continue CBT or pharmacotherapy with sertraline for 16 weeks. Three years after initial CBT, 90 percent of participants were rated as responders and 73 percent were in clinical remission.


The article is "Treatment Gains Are Sustainable in Pediatric Obsessive-Compulsive Disorder: Three-Year Follow-Up From the NordLOTS,” by Karin Melin, RN, PhD, Gudmundur Skarphedinsson, PhD, Per Hove Thomsen, DrMedSci, Bernhard Weidle, PhD, Nor Christian Torp, PhD, Robert Valderhaug, PhD, Davíð R.M.A. Højgaard, PhD, Katja. A. Hybel, PhD, Judith Becker Nissen, PhD, Sanne Jensen, PhD, Fellow, Kitty Dahl, PhD, Ingela Skärsäter, RN, PhD, Bente Storm Haugland, PhD, Tord Ivarsson, MD, PhD ( It appears in the Journal of the American Academy of Child and Adolescent Psychiatry, volume 59, issue 2 (February 2020), published by Elsevier.

Dr. Melin is Head Nurse at CAP Specialized Clinic, Department of Child and Adolescent Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.

Copies of this paper are available to credentialed journalists upon request, please contact Mary Billingsley at or +1 202 587 9672. Journalists wishing to interview the study authors can contact Karin Melin, RN, PhD, CAP Specialized Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden at or +46 707 487087.

Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today’s psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The Journal’s purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.

About Elsevier
Elsevier is a global information analytics business that helps scientists and clinicians to find new answers, reshape human knowledge, and tackle the most urgent human crises. For 140 years, we have partnered with the research world to curate and verify scientific knowledge. Today, we’re committed to bringing that rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirectScopusSciValClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, 39,000 e-book titles and many iconic reference works, including Gray’s Anatomy. Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers.

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