Children and adolescents with obsessive-compulsive disorder (OCD) are at risk for long-term adversity, but factors influencing long-term outcomes are unclear. A general factor of psychopathology, often referred to as the factor, captures variance shared by all mental disorders and has predicted long-term outcomes in youth with anxiety and depressive disorders. The factor has never been examined in relation to outcomes in pediatric OCD. Here, we examine whether the factor predicts 4 important outcomes over both short and long durations in youth with OCD. We used data from the Nordic Long-term OCD Treatment Study (NordLOTS), in which youth with OCD (N = 248, mean age = 12.83 years [SD = 2.72], 51.6% girls) received exposure-based cognitive–behavioral therapy. The factor was estimated using parent-reported Child Behavior Checklist data at baseline and was examined in relation to clinician-rated OCD severity, clinician-rated psychosocial functioning, self-reported depressive symptoms, and self- and parent-reported quality of life directly after treatment and 1, 2, and 3 years after treatment. The factor was associated with acute treatment outcomes for OCD severity and psychosocial functioning, but not for depressive symptoms and quality of life. For the long-term outcomes, the factor was significantly associated with all outcomes except OCD severity. The factor outperformed traditional psychiatric comorbidity as a predictor of long-term outcomes. Youth with OCD who experience symptoms across multiple psychiatric domains have poorer long-term outcomes. Compared to traditional classification of psychiatric diagnoses, assessing psychopathology using a dimensional factor approach may be advantageous for informing prognosis in pediatric OCD.

中文翻译：

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精神病理学的一般因素可预测患有强迫症的儿童和青少年的治疗和长期结果


患有强迫症（OCD）的儿童和青少年面临长期逆境的风险，但影响长期结果的因素尚不清楚。精神病理学的一般因素（通常称为因子）捕获了所有精神障碍共有的差异，并预测了患有焦虑症和抑郁症的青少年的长期结果。从未检查过该因素与儿童强迫症结局的关系。在这里，我们研究该因素是否可以预测强迫症青少年短期和长期的 4 个重要结果。我们使用了北欧长期强迫症治疗研究 (NordLOTS) 的数据，其中患有强迫症的青少年（N = 248，平均年龄 = 12.83 岁 [SD = 2.72]，51.6% 为女孩）接受了基于暴露的认知行为治疗。该因素是使用基线时家长报告的儿童行为检查表数据进行估计的，并根据临床医生评定的强迫症严重程度、临床医生评定的心理社会功能、自我报告的抑郁症状以及自我和家长报告的生活质量进行检查。治疗期间以及治疗后 1 年、2 年和 3 年。该因素与强迫症严重程度和心理社会功能的急性治疗结果相关，但与抑郁症状和生活质量无关。对于长期结果，该因素与除强迫症严重程度之外的所有结果均显着相关。作为长期结果的预测因素，该因素优于传统的精神合并症。患有多个精神领域症状的强迫症青少年的长期结果较差。与传统的精神病学诊断分类相比，使用维度因素方法评估精神病理学可能有利于了解儿科强迫症的预后。