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Predictors and moderators of treatment outcome in the Pediatric Obsessive Compulsive Treatment Study (POTS I) Garcia AM; Sapyta JJ; Moore PS; Freeman JB; Franklin ME; March JS; Foa EBJ Am Acad Child Adolesc Psychiatry 2010[Oct]; 49 (10): 1024-33; quiz 1086OBJECTIVE: To identify predictors and moderators of outcome in the first Pediatric OCD Treatment Study (POTS I) among youth (N = 112) randomly assigned to sertraline, cognitive behavioral therapy (CBT), both sertraline and CBT (COMB), or a pill placebo. METHOD: Potential baseline predictors and moderators were identified by literature review. The outcome measure was an adjusted week 12 predicted score for the Children's Yale Brown Obsessive Compulsive Scale (CY-BOCS). Main and interactive effects of treatment condition and each candidate predictor or moderator variable were examined using a general linear model on the adjusted predicted week 12 CY-BOCS scores. RESULTS: Youth with lower obsessive-compulsive disorder (OCD) severity, less OCD-related functional impairment, greater insight, fewer comorbid externalizing symptoms, and lower levels of family accommodation showed greater improvement across treatment conditions than their counterparts after acute POTS treatment. Those with a family history of OCD had more than a sixfold decrease in effect size in CBT monotherapy relative to their counterparts in CBT without a family history of OCD. CONCLUSIONS: Greater attention is needed to build optimized intervention strategies for more complex youth with OCD. Youth with a family history of OCD are not likely to benefit from CBT unless offered in combination with an SSRI. CLINICAL TRIALS REGISTRATION INFORMATION: Treatment of Obsessive Compulsive Disorder (OCD) in Children, http://www.clinicaltrials.gov, NCT00000384.|*Cognitive Behavioral Therapy[MESH]|Adolescent[MESH]|Awareness[MESH]|Child[MESH]|Codependency, Psychological[MESH]|Combined Modality Therapy[MESH]|Comorbidity[MESH]|Disability Evaluation[MESH]|Female[MESH]|Humans[MESH]|Internal-External Control[MESH]|Linear Models[MESH]|Male[MESH]|Obsessive-Compulsive Disorder/diagnosis/genetics/psychology/*therapy[MESH]|Parent-Child Relations[MESH]|Prognosis[MESH]|Selective Serotonin Reuptake Inhibitors/*therapeutic use[MESH]|Sertraline/*therapeutic use[MESH] |
