The Nordic Long-Term OCD Treatment Study (NordLOTS):Treatment Outcomes and One-year Follow-up of Initial Cognitive Behavioral Therapy Responders
Bibliographic record
Abstract
Abstract: Objective The purpose of the Nordic Long- Term OCD Treatment Study (NordLOTS) was to examine the acute effectiveness of manualized exposure-based Cognitive Behavioral Therapy (CBT) as an initial treatment for pediatric Obsessive-Compulsive Disorder (OCD). Also, to investigate the effectiveness of sertraline (SRT) versus continued CBT in children and adolescents who did not respond to the initial course of CBT. Finally, to describe the 1-year treatment outcome of the initial CBT responders. Method The study included 269 participants, age 7-17, diagnosed with OCD according to DSM-IV. In step I, all received CBT for 14 weekly sessions. In step II, 54 nonresponders to CBT were randomized to SRT or continued CBT for 16 weeks. Treatment response was in all cases defined as a Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) score of =15 at post treatment. The 177 responders to CBT from step I were assessed with the CY-BOCS at 6- and 12-month follow-up. Results In step I, 241 participants (89.6%) completed all 14 weeks of treatment with a treatment response of 72.6% (95% CI: 66.7%-77.9%) and a mean symptom reduction on the CY-BOCS of 52.9% (SD = 30.9). In step II, 21 of 28 participants (75 %) completed continued CBT, and 15 of 22 participants (69.2 %) completed SRT treatment. The response rate was 50.0 % in the CBT group and 45.4 % in the SRT group. Comparison of the CY-BOCS total score did not reveal a significant difference between the treatment types (p = 0.351). At 1-year follow-up of step I CBT responders (n=177), a total of 155 (87.6%) were available for assessment, with 142 (91.6%) still rated as responders. On average, the CY-BOCS total scores dropped by 1.72 points during the first year after terminating step I CBT (p = 0.001). Conclusion This study found that CBT can be applied effectively in community mental health clinics and that that CBT non-responders are equally likely to benefit from either continued CBT or treatment with SSRI. CBT for pediatric OCD is shown to have durable effects for those who respond to an initial course of CBT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".