Defining Treatment Outcomes in Pediatric Obsessive-Compulsive Disorder Using a Self-Report Scale

Abstract

This study examined benchmarks of treatment response and clinical remission on the Obsessive Compulsive Inventory-Child Version (OCI-CV) for youth with obsessive-compulsive disorder (OCD). Participants were 91 youth who enrolled in a randomized controlled trial that examined the benefit of augmenting cognitive behavior therapy (CBT) with either d-cycloserine or placebo. Youth completed the OCI-CV at baseline, Week 4 (prior to initiating exposure therapy), and posttreatment. Receiver operator curve (ROC) analyses examined optimal benchmarks for treatment response and clinical remission as identified by independent evaluators at the post-treatment assessment using the Clinical Global Impression (CGI) scales of Improvement (CGI-Improvement), Severity (CGI-Severity), and Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Optimal benchmarks for treatment response were a 20-25% reduction in the OCI-CV total score. Meanwhile, optimal benchmarks for remission were a 55-65% reduction in the OCI-CV total score and a post-treatment total score ≤6-8. OCI-CV benchmarks exhibited moderate agreement with the CY-BOCS for treatment response and clinical remission. Meanwhile, fair agreement was observed for response and remission with CGI scales. A lower pre-treatment OCI-CV total score was associated with less agreement between classification approaches. Findings provide benchmarks for classifying treatment response and clinical remission in an efficient manner. Given the moderate agreement between the CY-BOCS and OCI-CV benchmarks, the OCI-CV may serve as a useful alternative when clinician-rated scales cannot be administered due to limited resources (e.g., time, training). Thus, evidence-based measurement can be incorporated to monitor therapeutic response and remission in clinical practice.

Validity and clinical utility of the obsessive compulsive inventory - child version: further evaluation in clinical samples

“…Further, change scores on the OCI-CV and the CY-BOCS were significantly correlated in the moderate range. These findings suggest that OCI-CV captures change in overall OCD severity reasonably well, and may be used alongside the CY-BOCS to provide complementary information about improvement in specific symptom dimensions, which is in line with the findings and recommendations by McGuire et al [19] for assessing treatment response based on the OCI-CV.…”

“…The authors observed a similar six-factor structure as in the original study, but suggested that these factors might be grouped under a second-order factor. Recently, the OCI-CV has also been proposed as an alternative measure to evaluate treatment response and clinical remission [19].…”

Overview of Ten Child Mental Health Clinical Outcome Measures: Testing of Psychometric Properties with Diverse Client Populations in the U.S.

“…There were no studies testing CGI on U.S. child populations, even though it is in use as a child mental health measure—it appeared in 8 studies in our exploratory scan—and has been used as a benchmark to test other measures developed for children (e.g. the Obsessive–Compulsive Inventory—Child Version, see McGuire et al, 2019 ). This gap in testing may be partly because CGI was originally developed for schizophrenia (Guy, 1976 ) and only later adopted as a general measure of functioning.…”

Preliminary Real-World Evidence Supporting the Efficacy of a Remote Neurofeedback System in Improving Mental Health: Retrospective Single-Group Pretest-Posttest Study

“…Questionnaire results were analyzed in terms of improvement in total score from pre- to postintervention, including mean change in points, effect size (ie, Cohen d ), and percent of users with clinically significant improvement, defined as 20% improvement [ 65 , 66 ]. Results are presented separately for participants scoring in healthy and abnormal ranges at baseline, as per conventional clinical cutoff values.…”