Long-term outcome of pediatric obsessive–compulsive disorder: a meta-analysis and qualitative review of the literature
Article first published online: 28 MAY 2004
Acta Psychiatrica Scandinavica
Volume 110, Issue 1, pages 4–13, July 2004
How to Cite
Stewart, S. E., Geller, D. A., Jenike, M., Pauls, D., Shaw, D., Mullin, B. and Faraone, S. V. (2004), Long-term outcome of pediatric obsessive–compulsive disorder: a meta-analysis and qualitative review of the literature. Acta Psychiatrica Scandinavica, 110: 4–13. doi: 10.1111/j.1600-0447.2004.00302.x
- Issue published online: 28 MAY 2004
- Article first published online: 28 MAY 2004
- Accepted for publication January 16, 2004
- obsessive–compulsive disorder;
- pediatrics outcome assessment
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.