Quality of life in pediatric patients with obsessive-compulsive disorder during and 3 years after stepped-care treatment.
Sanne JensenKatja Anna HybelDavíð R M A HøjgaardJudith Becker NissenBernhard WeidleTord IvarssonGudmundur SkarphedinssonKarin MelinNor Christian TorpAnders Helles CarlsenErik Lykke MortensenFabian LenhardScott N ComptonPer Hove ThomsenPublished in: European child & adolescent psychiatry (2021)
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; www.controlled-trials.com ; ISRCTN66385119.
Keyphrases
- obsessive compulsive disorder
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- healthcare
- prognostic factors
- study protocol
- mental health
- palliative care
- machine learning
- combination therapy
- deep learning
- chronic pain
- patient reported outcomes
- pain management
- intensive care unit
- big data
- patient reported
- artificial intelligence
- high resolution