Quality of life in pediatric patients with obsessive-compulsive disorder during and 3 years after stepped-care treatment

Research output: Contribution to journalJournal articleResearchpeer-review

  • Sanne Jensen
  • Katja A. Hybel
  • David R. M. A. Hojgaard
  • Judith Becker Nissen
  • Bernhard Weidle
  • Tord Ivarsson
  • Gudmundur Skarphedinsson
  • Karin Melin
  • Nor Christian Torp
  • Anders Helles Carlsen
  • Mortensen, Erik Lykke
  • Fabian Lenhard
  • Scott Compton
  • Per Hove Thomsen

The present study aimed to investigate the long-term quality of life (QoL) in a large sample of pediatric obsessive-compulsive disorder (OCD) patients. The study included 220 pediatric OCD patients from the Nordic Long-term OCD Treatment Study (NordLOTS) who were evaluated at seven time points before, during, and after stepped-care treatment over a 3-year follow-up period. Data from three symptom severity trajectory classes formed the basis of the QoL evaluation: acute (n = 127, N = 147), slow (n = 46, N = 63), and limited responders (n = 47, N = 59). Patients' QoL was assessed using parent and child ratings of the revised Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R). QoL was analyzed by trajectory class using a random mixed effects model. The association between pre-treatment factors and long-term QoL was investigated across classes in a multivariate model. Three years after treatment, the acute responder class had reached QoL levels from a general population, whereas the limited responder class had not. The slow responder class reached norm levels for the child-rated QoL only. Higher levels of co-occurring externalizing symptoms before treatment were associated with lower parent-rated QoL during follow-up, while adolescence and higher levels of co-occurring internalizing symptoms were associated with lower child-rated QoL during follow-up. For some patients, residual OCD symptoms in the years after treatment, even at levels below assumed clinical significance, are associated with compromised QoL. Co-occurring symptoms could be part of the explanation. Assessing QoL after OCD treatment, beyond the clinician-rated symptom severity, could detect patients in need of further treatment and/or assessment. Trial registry: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; ; ISRCTN66385119.

Original languageEnglish
JournalEuropean Child & Adolescent Psychiatry
Pages (from-to)1377–1389
Number of pages13
Publication statusPublished - 2022

    Research areas

  • Quality of life, Obsessive-compulsive disorder, Children and adolescents, Long-term, Treatment outcome, Stepped-care treatment

ID: 261378741