Long-term outcome of pediatric obsessive-compulsive disorder: a meta-analysis and qualitative review of the literature

Acta Psychiatr Scand. 2004 Jul;110(1):4-13. doi: 10.1111/j.1600-0447.2004.00302.x.

Abstract

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.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Adolescent
  • Age of Onset
  • Child
  • Comorbidity
  • Female
  • Humans
  • Male
  • Obsessive-Compulsive Disorder / psychology*
  • Obsessive-Compulsive Disorder / therapy*
  • Prognosis
  • Recurrence
  • Regression Analysis
  • Treatment Outcome