Defining Treatment Response and Remission in Obsessive-Compulsive Disorder: A Signal Detection Analysis of the Children's Yale-Brown Obsessive Compulsive Scale
Objective To examine the optimal Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) percent reduction cutoffs for predicting treatment response and clinical remission among children and adolescents with obsessive-compulsive disorder (OCD). Method Youth with OCD (N = 109; range 7 to 19 y...
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| Veröffentlicht in: | Journal of the American Academy of Child and Adolescent Psychiatry 2010-07, Vol.49 (7), p.708-717 |
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| creator | Storch, Eric A., Ph.D Lewin, Adam B., Ph.D De Nadai, Alessandro S., M.A Murphy, Tanya K., M.D |
| description | Objective To examine the optimal Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) percent reduction cutoffs for predicting treatment response and clinical remission among children and adolescents with obsessive-compulsive disorder (OCD). Method Youth with OCD (N = 109; range 7 to 19 years) received 14 sessions of weekly or intensive family-based CBT as part of previously published studies or through the standard clinical flow at our facility. Assessments were conducted before and after treatment and included the CY-BOCS, response and remission status on the Clinical Global Impressions Scale, and the Child Obsessive-Compulsive Impact Scale. Results Maximally efficient CY-BOCS cutoffs were observed at a 25% reduction for treatment response, a 45% to 50% reduction for symptom remission, and a CY-BOCS score of 14 when considering raw scores. OCD-related impairment improved as a function of treatment response and symptom remission. Conclusions These data indicate that a CY-BOCS reduction of 25% appears to be optimal for determining treatment response, a reduction of 45% to 50% appears to be optimal for detecting symptom remission, and a CY-BOCS raw score of 14 best reflects remission after treatment. Clinical trials should employ a consistent definition of treatment response for cross-study comparability. Clinicians can use these values for treatment planning decisions. |
| doi_str_mv | 10.1016/j.jaac.2010.04.005 |
| format | Article |
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Method Youth with OCD (N = 109; range 7 to 19 years) received 14 sessions of weekly or intensive family-based CBT as part of previously published studies or through the standard clinical flow at our facility. Assessments were conducted before and after treatment and included the CY-BOCS, response and remission status on the Clinical Global Impressions Scale, and the Child Obsessive-Compulsive Impact Scale. Results Maximally efficient CY-BOCS cutoffs were observed at a 25% reduction for treatment response, a 45% to 50% reduction for symptom remission, and a CY-BOCS score of 14 when considering raw scores. OCD-related impairment improved as a function of treatment response and symptom remission. Conclusions These data indicate that a CY-BOCS reduction of 25% appears to be optimal for determining treatment response, a reduction of 45% to 50% appears to be optimal for detecting symptom remission, and a CY-BOCS raw score of 14 best reflects remission after treatment. Clinical trials should employ a consistent definition of treatment response for cross-study comparability. Clinicians can use these values for treatment planning decisions.</description><identifier>ISSN: 0890-8567</identifier><identifier>EISSN: 1527-5418</identifier><identifier>DOI: 10.1016/j.jaac.2010.04.005</identifier><identifier>PMID: 20610140</identifier><identifier>CODEN: JAAPEE</identifier><language>eng</language><publisher>Maryland Heights, MO: Elsevier Inc</publisher><subject>Adolescent ; Adolescents ; Adult and adolescent clinical studies ; Alcohol Abuse ; Anxiety Disorders ; Anxiety disorders. Neuroses ; Behavior therapy. Cognitive therapy ; Biological and medical sciences ; Child ; Child & adolescent psychiatry ; Child clinical studies ; Children ; Children's Yale-Brown Obsessive-Compulsive Scale ; Cognitive Therapy ; cognitive-behavioral therapy ; Combined Modality Therapy ; Education ; Evaluation Methods ; Family Therapy ; Female ; Humans ; Implosive Therapy ; Male ; Measures (Individuals) ; Medical research ; Medical sciences ; Neuroses ; Observation ; obsessive-compulsive disorder ; Obsessive-Compulsive Disorder - diagnosis ; Obsessive-Compulsive Disorder - psychology ; Obsessive-Compulsive Disorder - therapy ; Obsessive-compulsive disorders ; Outcomes of Treatment ; Pediatrics ; Personality Assessment - statistics & numerical data ; Prediction ; Prevention ; Prognosis ; Psychiatry ; Psychological aspects ; Psychology. Psychoanalysis. Psychiatry ; Psychometrics - statistics & numerical data ; Psychopathology. Psychiatry ; Quantitative psychology ; Rape ; Raw Scores ; Reproducibility of Results ; Signal Detection, Psychological ; Treatment Outcome ; treatment response ; Treatments</subject><ispartof>Journal of the American Academy of Child and Adolescent Psychiatry, 2010-07, Vol.49 (7), p.708-717</ispartof><rights>American Academy of Child and Adolescent Psychiatry</rights><rights>2010 American Academy of Child and Adolescent Psychiatry</rights><rights>2015 INIST-CNRS</rights><rights>2010 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Lippincott Williams & Wilkins Jul 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c450t-ea637307e9368f407d1d34d91c47f521a51b7a42868e14d6441f71766ae35fe03</citedby><cites>FETCH-LOGICAL-c450t-ea637307e9368f407d1d34d91c47f521a51b7a42868e14d6441f71766ae35fe03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0890856710003540$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,30976,65306</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ944617$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22989857$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20610140$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Storch, Eric A., Ph.D</creatorcontrib><creatorcontrib>Lewin, Adam B., Ph.D</creatorcontrib><creatorcontrib>De Nadai, Alessandro S., M.A</creatorcontrib><creatorcontrib>Murphy, Tanya K., M.D</creatorcontrib><title>Defining Treatment Response and Remission in Obsessive-Compulsive Disorder: A Signal Detection Analysis of the Children's Yale-Brown Obsessive Compulsive Scale</title><title>Journal of the American Academy of Child and Adolescent Psychiatry</title><addtitle>J Am Acad Child Adolesc Psychiatry</addtitle><description>Objective To examine the optimal Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) percent reduction cutoffs for predicting treatment response and clinical remission among children and adolescents with obsessive-compulsive disorder (OCD). Method Youth with OCD (N = 109; range 7 to 19 years) received 14 sessions of weekly or intensive family-based CBT as part of previously published studies or through the standard clinical flow at our facility. Assessments were conducted before and after treatment and included the CY-BOCS, response and remission status on the Clinical Global Impressions Scale, and the Child Obsessive-Compulsive Impact Scale. Results Maximally efficient CY-BOCS cutoffs were observed at a 25% reduction for treatment response, a 45% to 50% reduction for symptom remission, and a CY-BOCS score of 14 when considering raw scores. OCD-related impairment improved as a function of treatment response and symptom remission. Conclusions These data indicate that a CY-BOCS reduction of 25% appears to be optimal for determining treatment response, a reduction of 45% to 50% appears to be optimal for detecting symptom remission, and a CY-BOCS raw score of 14 best reflects remission after treatment. Clinical trials should employ a consistent definition of treatment response for cross-study comparability. Clinicians can use these values for treatment planning decisions.</description><subject>Adolescent</subject><subject>Adolescents</subject><subject>Adult and adolescent clinical studies</subject><subject>Alcohol Abuse</subject><subject>Anxiety Disorders</subject><subject>Anxiety disorders. Neuroses</subject><subject>Behavior therapy. Cognitive therapy</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child & adolescent psychiatry</subject><subject>Child clinical studies</subject><subject>Children</subject><subject>Children's Yale-Brown Obsessive-Compulsive Scale</subject><subject>Cognitive Therapy</subject><subject>cognitive-behavioral therapy</subject><subject>Combined Modality Therapy</subject><subject>Education</subject><subject>Evaluation Methods</subject><subject>Family Therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Implosive Therapy</subject><subject>Male</subject><subject>Measures (Individuals)</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Neuroses</subject><subject>Observation</subject><subject>obsessive-compulsive disorder</subject><subject>Obsessive-Compulsive Disorder - diagnosis</subject><subject>Obsessive-Compulsive Disorder - psychology</subject><subject>Obsessive-Compulsive Disorder - therapy</subject><subject>Obsessive-compulsive disorders</subject><subject>Outcomes of Treatment</subject><subject>Pediatrics</subject><subject>Personality Assessment - statistics & numerical data</subject><subject>Prediction</subject><subject>Prevention</subject><subject>Prognosis</subject><subject>Psychiatry</subject><subject>Psychological aspects</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychometrics - statistics & numerical data</subject><subject>Psychopathology. Psychiatry</subject><subject>Quantitative psychology</subject><subject>Rape</subject><subject>Raw Scores</subject><subject>Reproducibility of Results</subject><subject>Signal Detection, Psychological</subject><subject>Treatment Outcome</subject><subject>treatment response</subject><subject>Treatments</subject><issn>0890-8567</issn><issn>1527-5418</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFks9uEzEQxlcIRNPCCyCELCTU04ax117vIoSUJuWfKlUi5cDJcryzrcPGDvamKE_Dq-JVQqh6gJM9nt98Gs83WfaMwpgCLV8vx0utzZhBegA-BhAPshEVTOaC0-phNoKqhrwSpTzKjmNcAgCVVfU4O2JQJgUOo-zXDFvrrLsmVwF1v0LXky8Y195FJNo1KVjZGK13xDpyuYiYglvMp3613nTDlcxs9KHB8IZMyNxeO92RGfZo-qFoksJttJH4lvQ3SKY3tmsCutNIvukO87Pgf97RJXd05yYBT7JHre4iPt2fJ9nX9-dX04_5xeWHT9PJRW64gD5HXRayAIl1UVYtB9nQpuBNTQ2XrWBUC7qQmrOqrJDypuSctpLKstRYiBahOMlOd7rr4H9sMPYqfdtg12mHfhOVFLySjEH9f5LXwHjNBvLlPXLpNyENJCrBChBCSJYgtoNM8DEGbNU62JUOW0VBDTarpRpsVoPNCrhKNqeiF3vlzWKFzaHkj68JeLUHdExjbIN2xsa_HKuruhIycc93HAZrDunzzzXnJR3Sb_fpNPpbi0FFY9EZbGxIBqvG23-3-e5euenSsqWGvuMW42EaVEWmQM2HfR3WlaZNLUT6xm-1EOOP</recordid><startdate>20100701</startdate><enddate>20100701</enddate><creator>Storch, Eric A., Ph.D</creator><creator>Lewin, Adam B., Ph.D</creator><creator>De Nadai, Alessandro S., M.A</creator><creator>Murphy, Tanya K., M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier BV</general><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20100701</creationdate><title>Defining Treatment Response and Remission in Obsessive-Compulsive Disorder: A Signal Detection Analysis of the Children's Yale-Brown Obsessive Compulsive Scale</title><author>Storch, Eric A., Ph.D ; Lewin, Adam B., Ph.D ; De Nadai, Alessandro S., M.A ; Murphy, Tanya K., M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c450t-ea637307e9368f407d1d34d91c47f521a51b7a42868e14d6441f71766ae35fe03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Adolescents</topic><topic>Adult and adolescent clinical studies</topic><topic>Alcohol Abuse</topic><topic>Anxiety Disorders</topic><topic>Anxiety disorders. Neuroses</topic><topic>Behavior therapy. Cognitive therapy</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child & adolescent psychiatry</topic><topic>Child clinical studies</topic><topic>Children</topic><topic>Children's Yale-Brown Obsessive-Compulsive Scale</topic><topic>Cognitive Therapy</topic><topic>cognitive-behavioral therapy</topic><topic>Combined Modality Therapy</topic><topic>Education</topic><topic>Evaluation Methods</topic><topic>Family Therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Implosive Therapy</topic><topic>Male</topic><topic>Measures (Individuals)</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Neuroses</topic><topic>Observation</topic><topic>obsessive-compulsive disorder</topic><topic>Obsessive-Compulsive Disorder - diagnosis</topic><topic>Obsessive-Compulsive Disorder - psychology</topic><topic>Obsessive-Compulsive Disorder - therapy</topic><topic>Obsessive-compulsive disorders</topic><topic>Outcomes of Treatment</topic><topic>Pediatrics</topic><topic>Personality Assessment - statistics & numerical data</topic><topic>Prediction</topic><topic>Prevention</topic><topic>Prognosis</topic><topic>Psychiatry</topic><topic>Psychological aspects</topic><topic>Psychology. 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Psychiatry</topic><topic>Quantitative psychology</topic><topic>Rape</topic><topic>Raw Scores</topic><topic>Reproducibility of Results</topic><topic>Signal Detection, Psychological</topic><topic>Treatment Outcome</topic><topic>treatment response</topic><topic>Treatments</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Storch, Eric A., Ph.D</creatorcontrib><creatorcontrib>Lewin, Adam B., Ph.D</creatorcontrib><creatorcontrib>De Nadai, Alessandro S., M.A</creatorcontrib><creatorcontrib>Murphy, Tanya K., M.D</creatorcontrib><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Academy of Child and Adolescent Psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Storch, Eric A., Ph.D</au><au>Lewin, Adam B., Ph.D</au><au>De Nadai, Alessandro S., M.A</au><au>Murphy, Tanya K., M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ944617</ericid><atitle>Defining Treatment Response and Remission in Obsessive-Compulsive Disorder: A Signal Detection Analysis of the Children's Yale-Brown Obsessive Compulsive Scale</atitle><jtitle>Journal of the American Academy of Child and Adolescent Psychiatry</jtitle><addtitle>J Am Acad Child Adolesc Psychiatry</addtitle><date>2010-07-01</date><risdate>2010</risdate><volume>49</volume><issue>7</issue><spage>708</spage><epage>717</epage><pages>708-717</pages><issn>0890-8567</issn><eissn>1527-5418</eissn><coden>JAAPEE</coden><abstract>Objective To examine the optimal Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) percent reduction cutoffs for predicting treatment response and clinical remission among children and adolescents with obsessive-compulsive disorder (OCD). Method Youth with OCD (N = 109; range 7 to 19 years) received 14 sessions of weekly or intensive family-based CBT as part of previously published studies or through the standard clinical flow at our facility. Assessments were conducted before and after treatment and included the CY-BOCS, response and remission status on the Clinical Global Impressions Scale, and the Child Obsessive-Compulsive Impact Scale. Results Maximally efficient CY-BOCS cutoffs were observed at a 25% reduction for treatment response, a 45% to 50% reduction for symptom remission, and a CY-BOCS score of 14 when considering raw scores. OCD-related impairment improved as a function of treatment response and symptom remission. Conclusions These data indicate that a CY-BOCS reduction of 25% appears to be optimal for determining treatment response, a reduction of 45% to 50% appears to be optimal for detecting symptom remission, and a CY-BOCS raw score of 14 best reflects remission after treatment. Clinical trials should employ a consistent definition of treatment response for cross-study comparability. Clinicians can use these values for treatment planning decisions.</abstract><cop>Maryland Heights, MO</cop><pub>Elsevier Inc</pub><pmid>20610140</pmid><doi>10.1016/j.jaac.2010.04.005</doi><tpages>10</tpages></addata></record> |
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| subjects | Adolescent Adolescents Adult and adolescent clinical studies Alcohol Abuse Anxiety Disorders Anxiety disorders. Neuroses Behavior therapy. Cognitive therapy Biological and medical sciences Child Child & adolescent psychiatry Child clinical studies Children Children's Yale-Brown Obsessive-Compulsive Scale Cognitive Therapy cognitive-behavioral therapy Combined Modality Therapy Education Evaluation Methods Family Therapy Female Humans Implosive Therapy Male Measures (Individuals) Medical research Medical sciences Neuroses Observation obsessive-compulsive disorder Obsessive-Compulsive Disorder - diagnosis Obsessive-Compulsive Disorder - psychology Obsessive-Compulsive Disorder - therapy Obsessive-compulsive disorders Outcomes of Treatment Pediatrics Personality Assessment - statistics & numerical data Prediction Prevention Prognosis Psychiatry Psychological aspects Psychology. Psychoanalysis. Psychiatry Psychometrics - statistics & numerical data Psychopathology. Psychiatry Quantitative psychology Rape Raw Scores Reproducibility of Results Signal Detection, Psychological Treatment Outcome treatment response Treatments |
| title | Defining Treatment Response and Remission in Obsessive-Compulsive Disorder: A Signal Detection Analysis of the Children's Yale-Brown Obsessive Compulsive Scale |
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