Are the symptom dimensions a predictor of short-term response to pharmacotherapy in pediatric obsessive-compulsive disorder? A retrospective cohort study

BACKGROUND: Obsessive-compulsive disorder (OCD) symptom dimensions respond differently to behavioral and pharmacological interventions, and some dimensions are reported to be more resistant to treatment. AIM: We aimed to investigate the responses of three symptom dimensions (harm/sexual, symmetry/hoarding, and contamination/cleaning) to serotonin reuptake inhibitor (SRI) therapy in pediatric OCD. METHODS: Children who were between 6 and 17 years old, diagnosed with OCD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, followed up at our clinic for at least 3 months, and received SRI treatment were included in our study. Response to treatment was assessed using the Clinical Global Impressions scale. Predictors of treatment response were analyzed using regression models. RESULTS: Of the 102 children with a mean age of 11.84 ± 2.87 years, 57.8% were male and the mean follow-up period was 12.39 ± 9.55 months. The overall response rate to pharmacotherapy was 66.7%. Patients with symmetry/hoarding symptoms [relative risk (RR) = 0.66, 95% confidence interval (CI) (0.12–0.79), P = 0.015] did not respond as well to SRIs. Besides, adolescent age (RR = 0.65, 95% CI (0.10–0.73), P = 0.01) was associated with a less favorable SRI response. CONCLUSION: This study shows that symptom dimensions are one of the factors predicting response to pharmacotherapy in pediatric OCD. It is hypothesized that considering the dimensions is important to plan more appropriate treatment and provide more accurate prognostic information when assessing children with OCD.