Gudmundur Skarphedinsson

• Ph.D.
• Professor at University of Iceland

The Bergen 4-day treatment (B4DT) for obsessive-compulsive disorder (OCD) is a concentrated form of exposure and response prevention that has been evaluated and implemented nationwide in Norway. Its effectiveness has yet to be fully established in other countries. A total of 86 patients with OCD underwent the treatment at the Icelandic Anxiety Cent...

Purpose: The current paper aimed to evaluate the psychometric properties of the Icelandic translation of the Strengths and Difficulties Questionnaire, for both parent and teacher reports. SDQ is a widely used questionnaire for screening mental problems among youth. However, only a few studies have conducted a factor analysis on the youngest and ol...

Obsessive-compulsive disorder (OCD), characterized by recurring obsessions and compulsions, affects 1–3% of the childhood population, often leading to severe impairment and reduced quality of life. Cognitive behavioral therapy (CBT) is well-documented as first choice treatment for pediatric OCD. Traditionally delivered face-to-face CBT has limitati...

Objective: Children and adolescents with obsessive-compulsive disorder (OCD) are at risk of long-term adversity, but factors influencing long-term outcomes are unclear. A general factor of psychopathology, often referred to as the p factor, captures variance shared by all mental disorders and has predicted long-term outcomes in youth with anxiety a...

Given diverse symptom expression and high rates of comorbid conditions, the present study explored underlying commonalities among OCD-affected children and adolescents to better conceptualize disorder presentation and associated features. Data from 830 OCD-affected participants presenting to OCD specialty centers was aggregated. Dependent mixture m...

Background Obsessive-compulsive disorder (OCD) is a debilitating mental health condition usually presenting with a high degree of comorbid symptoms in the majority of cases. Although face-to-face cognitive-behavioral therapy (CBT) is considered the therapeutic golden standard for pediatric OCD, its accessibility, availability, and consistency in de...

The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) is a valuable tool for diagnosing mental disorders in children and adolescents. Previous studies have examined its interrater reliability, but there is limited information on individual disorders, on the updated DSM-5 version. Thi...

Purpose: Obsessive-compulsive disorder (OCD) in children can lead to long-lasting symptoms and access to evidence-based evaluation and treatment is crucial for its prevention. In Iceland, the law guarantees public access to the highest quality healthcare services. To date, no study has evaluated the services available for children with OCD within...

Family accommodation (FA) involves the actions taken by family members, particularly parents, to accommodate a child´s obsessive–compulsive disorder (OCD) symptoms, reducing distress or impairment. This behavior may maintain compulsive and avoidant behavior, preventing corrective learning or habituation. This study aims to investigate the prevalenc...

The present study aimed to assess the efficacy of a group-based, brief transdiagnostic cognitive-behavioral therapy (CBT) program for adolescents with internalizing problems, such as anxiety and depressive disorders, seeking help in a primary health care clinic in Iceland. The group-based CBT program consisted of eight weekly 110-min sessions cover...

The first aim of this study was to explore whether children with obsessive compulsive disorder (OCD) and subclinical autistic traits can be differentiated from children with OCD without these traits based on clinical OCD-related characteristics, distinct OCD symptom patterns, and type of comorbidity. The second aim was to investigate whether autist...

The present study aimed to: (a) identify latent class trajectories of OCD-related functional impairment, before, during and over three years after stepped-care treatment in children and adolescents with OCD; (b) describe these classes according to pretreatment characteristics; (c) identify predictors of trajectory class membership and (d) examine t...

A recent study identified three distinct treatment-response trajectories in pediatric OCD where higher levels of contamination symptoms predicted a limited response to cognitive-behavioral therapy (CBT). This study extends these findings by examining which specific symptoms characterize limited CBT response from baseline to 3-year follow-up, with a...

It is unknown if long-term remission for pediatric obsessive-compulsive disorder (OCD) patients is associated with post-treatment OCD symptom severity. The aim of the present study was to evaluate if post-treatment symptom severity cut-offs can discriminate remitters from non-remitters in pediatric OCD patients during three years of follow-up. All...

A recent study identified three distinct OCD treatment-response trajectories during and after treatment in a large pediatric sample, where higher levels of contamination symptoms predicted a limited response to cognitive-behavioral therapy (CBT). This study is an extension of this, examining what characterizes limited responders to CBT regarding co...

The present study aimed to investigate the long-term quality of life (QoL) in a large sample of pediatric obsessive–compulsive disorder (OCD) patients. The study included 220 pediatric OCD patients from the Nordic Long-term OCD Treatment Study (NordLOTS) who were evaluated at seven time points before, during, and after stepped-care treatment over a...

The aim was to explore the potential clinical role of health anxiety (HA) symptoms in children and adolescents diagnosed with obsessive–compulsive disorder (OCD). The study investigated differences in demographic and various clinical variables between young people with OCD, with and without HA symptoms, and the effect of HA symptoms on overall OCD...

Purpose: To assess the efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) and selective noradrenaline reuptake inhibitors (SNRIs) in comparison with various control contingencies (e.g. pill placebo and cognitive behavioral treatment) for pediatric anxiety disorders. Additionally, we wanted to investigate whether serious adverse...

Aim: Cognitive behavioral treatment (CBT) and selective serotonin reuptake inhibitors (SSRIs) are considered first-line treatments for childhood anxiety disorders (ADs). The objective of this current analysis was to conduct a network meta-analysis to evaluate the comparative effectiveness of CBT, pharmacotherapy, and the combination of the two in...

Obsessive–compulsive disorder (OCD) is characterized by recurring obsessions and compulsions often with severe impairment affecting 1–3% of children and adolescents. Cognitive behavioural therapy (CBT) is the therapeutic golden standard for paediatric OCD. However, face-to-face CBT is limited by accessibility, availability, and quality of delivery....

Background: Studies on child and adolescent obsessive-compulsive disorder (OCD) indicate that symptom severity is similar across age, but significant age differences of symptom profile and comorbid disorders have been observed. These earlier studies have yielded mixed results, are methodologically heterogenous and tend to have fairly small sample...

Background Obsessive-compulsive disorder (OCD) in children can lead to a huge burden on the concerned patients and their family members. While successful state-of-the art cognitive behavioral interventions exist, there is still a lack of available experts for treatment at home, where most symptoms manifest. Internet-based cognitive behavioral thera...

Sexual obsessions occur in pediatric and adult OCD including thoughts about sexual acts with family members, sexually inappropriate behavior, or homosexual orientation. They may remain undiagnosed because of embarrassment to report thoughts that are perceived as unacceptable. Prevalence studies of sexual obsessions in pediatric populations are rare...

The aims of the study were to estimate the prevalence of body dysmorphic symptoms in a sample of children and adolescents with obsessive-compulsive disorder, possible clinical correlates and whether BDD symptoms predict poorer treatment outcomes after cognitive behavioral therapy. The study included 269 children and adolescents with OCD, aged 7–17...

Objective Previous research suggests that agreement, between youths and their parents, regarding assessment of youth psychiatric problems is limited. Due to this discrepancy, a multi-informant, multimethod approach is recommended when gathering psychopathological information. This study examines parent–youth agreement regarding youth psychiatric pr...

Comorbidities are seen with obsessive-compulsive disorder (OCD) across the lifespan. Neurodevelopmental comorbidities are common in young children, followed by mood, anxiety, and obsessive-compulsive related disorders (OCRDs) in children, adolescents and adults, and neurological and degenerative disorders in the elderly. Understanding comorbidity p...

To identify neurochemical factors measured pre-treatment that may predict cognitive behavioural treatment (CBT) outcome, aiming at understanding possible causes of poor CBT response. 1H magnetic resonance spectroscopy was used before treatment with CBT in treatment naïve 11–18 year-old patients with moderate–severe OCD. Diagnoses and assessment of...

Cognitive behavioral therapy (CBT) is the first choice of treatment of obsessive–compulsive disorder (OCD) in children and adolescents. However, there is often a lack of access to appropriate treatment close to the home of the patients. An internet-based CBT via videoconferencing could facilitate access to state-of-the-art treatment even in remote...

Objective A lack of universal definitions for response and remission in pediatric obsessive-compulsive disorder (OCD) has hampered the comparability of results across trials. To address this problem, we conducted an individual participant data diagnostic test accuracy meta-analysis to evaluate the discriminative ability of the Children’s Yale-Brown...

The Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) are widely used measures of psychiatric symptoms and lately also adapted to the DSM. The incremental validity of adding the scales to each other has not been studied. We validated the DSM subscales for affective, anxiety, attention deficit/hyperactivity (ADHD), oppositional defiant (OD...

Aims To assess feasibility and acceptability of exercise in clinically referred adolescents with major depression. Methods Outpatients12 to 17 years with mild to moderate persistent depression participated in a supervised, pulse monitored, 14-week aerobic exercise but without control group. Primary outcome was adherence and secondary was clinician...

Studies on child and adolescent obsessive-compulsive disorder (OCD) indicate that symptom severity is similar across age, but significant age differences of symptom profile and comorbid disorders have been observed. The current study examines these differences in one of the largest samples to date, and the first sample outside of an English-speakin...

Objective Standard assessment of pediatric obsessive-compulsive disorder (OCD) patients includes ratings of insight, avoidance, indecisiveness, sense of responsibility, pervasive slowness, pathological doubting, and obsession-free intervals. The present study aims to identify pre-treatment associations of these clinical features to symptom severity...

Hoarding disorder (HD) is characterised by difficulties in discharging or parting with possessions irrespective of their actual value, urges to save and acquire new items and excessive clutter in living areas. There is an urgent need to advance the understanding of HD in child and adolescent populations. The aim of this paper is to cover the assess...

Background To evaluate screening efficiency and suggest cut-offs for parent and child Mood and Feelings Questionnaire (MFQ) and the short version (SMFQ) in unselected help seeking child- and adolescent psychiatric outpatients for subgroups of 6–12 versus 13–17 year olds and boys versus girls. Method Eligible for inclusion were newly admitted outpa...

Background: The Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) is a semi-structured interview based on the Diagnostic and Statistical Manual of Mental Disorders (DSM), and assesses past and present symptoms in children aged 6-18 years old. It has been translated into more than 20 languages and is widely...

Aim: Pediatric Anxiety Disorders (AD) are common. Cognitive behavioral therapy (CBT) is one of two first-line treatments of youth AD and it has previously been shown to be superior to wait-list but not placebo therapy. This study consists of a systematic review and meta-analysis of the literature to assess the efficacy of CBT modalities in comparis...

Background: First-line treatments for pediatric obsessive-compulsive disorder (OCD) include exposure-based cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs). No studies have thus far identified distinct classes and associated predictors of long-term symptom severity during and after treatment. Yet, these could...

Objective: Identifying factors associated with early treatment response is important, because it can help allocate limited resources in psychiatric care more appropriately. This study examined baseline characteristics of participants with early response to exposure-based cognitive behavior therapy (CBT) for pediatric obsessive-compulsive disorder...

Hoarding, common in pediatric obsessive–compulsive disorder (OCD), has specific clinical correlates and is associated with poor prognosis. However, there are few studies of hoarding in pediatric OCD. This study estimates the occurrence of hoarding symptoms in a sample of children and adolescents with OCD, investigating possible differences in demog...

The presence of comorbid conditions associated with paediatric obsessive–compulsive disorder (OCD) is reported to range from 50 to 80% and to have an impact on treatment outcome. Accurate identification of comorbid psychiatric disorders is necessary in order to provide personalised care. Reliable and valid diagnostic interviews are essential in the...

Objective: This study evaluates the long-term outcomes of a stepped care treatment for pediatric obsessive-compulsive disorder (OCD) and investigates whether response to first step cognitive- behavioral therapy (CBT) is an important indicator of three-year outcomes. Method: This study is a part of the Nordic Long-term OCD Treatment study (NordLO...

This study reports follow-up 2 and 3 years after the initial assessment of a sample of youth with a primary diagnosis of OCD. Participants were 109 children and adolescents, aged 5–17 years, recruited from a specialized, outpatient OCD clinic in Sweden. Patients were treated with cognitive behavioral therapy (CBT), augmented when indicated by selec...

Our aims were to examine: (1) classes of comorbid disorders in a sample of children and adolescents with Obsessive-Compulsive Disorder (OCD), (2) how these classes relate to obsessive-compulsive symptom dimensions, and (3) the extent to which obsessive-compulsive symptom dimensions predict Cognitive-Behavioral Therapy (CBT) outcome. Participants (N...

We evaluated the clinical utility of the Swedish SCARED-R in child- and adolescent psychiatric outpatients (n = 239) and validated it against Longitudinal Expert All Data (LEAD) DSM IV diagnoses based on the Children’s Schedule for Affective Disorders and Schizophrenia (KSADS) and subsequent clinical work-up and treatment outcome. The SCARED-R tota...

In this chapter, we illustrate how to provide psychoeducation about cognitive-behavior therapy (CBT) for pediatric obsessive-compulsive disorder (OCD). We present practical suggestions on how to present this information to children, adolescents and other family members in a developmentally appropriate way. The chapter covers how to communicate both...

Drug treatment in pediatric OCD has been used for close to 40 years, and the evidence for the efficacy of Serotonin reuptake Inhibiting (SRI) drugs that has been accumulated is substantial. Starting out with placebo controlled studies it was established that patients on SRI (e.g., clomipramine, sertraline, fluoxetine or fluvoxamine) did decrease OC...

Objective This study describes one-year treatment outcomes from a large sample of cognitive-behavioral therapy (CBT) responders, investigates age as a possible moderator of these treatment outcomes, and evaluates clinical relapse at the one-year follow-up. Method This study is the planned follow-up to the Nordic Long-term OCD [obsessive-compulsive...

Some studies have shown that children and adolescents with obsessive-compulsive disorder (OCD) and co-morbid tics differ from those without co-morbid tics in terms of several demographic and clinical characteristics. However, not all studies have confirmed these differences. This study examined children and adolescents with OCD and with possible or...

This chapter first considers what is known about the phenomenology of obsessive compulsive disorder (OCD), its course, and what model or understanding of OCD pathogenesis is most appropriate. Then, it discusses what implications this understanding has for the way care for patients should be organized. The chapter argues that pediatric OCD should be...

The underlying structure of obsessive-compulsive disorder (OCD) remains to be confirmed in child and adolescent populations. In this paper we report the first factor analytic study of individual OCD items from Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). OCD symptoms were assessed using the CY-BOCS symptom checklist in a sample of 85...

Objective To identify both responders and remitters, at the half-way point (week 7) to exposure-based CBTfor pediatric OCD. Furthermore, evaluate the stability of the improvements, by examining both week 7 and week 14 (post-treatment)response and remission. Method 269 children and adolescents, mean age 12.8, 51.3% female with a DSM-IV diagnosis of...

Objective To identify both responders and remitters, at the half-way point (week 7) to exposure-based CBTfor pediatric OCD. Furthermore, evaluate the stability of the improvements, by examining both week 7 and week 14 (post-treatment)response and remission. Method 269 children and adolescents, mean age 12.8, 51.3% female with a DSM-IV diagnosis...

The objective of the study was to examine the optimal Children’s Yale-Brown Obsessive–Compulsive Scale (CY-BOCS) percent reduction and raw cutoffs for predicting cognitive-behavioral treatment (CBT) response among children and adolescents with obsessive–compulsive disorder (OCD). The sample consisted of children and adolescents with OCD (N = 241) p...

Motivation is a key ingredient in the successful treatment of pediatric obsessive-compulsive disorder (OCD). As a first-line treatment, cognitive-behavior therapy (CBT) requires extensive client engagement, including participating in exposures and doing homework tasks. A lack of motivation to comply with these tasks may seriously affect treatment o...

The literature on subclinical autism spectrum (ASD) symptoms in pediatric obsessive-compulsive disorder (OCD) is scarce, and it remains unclear whether ASD symptoms are related to OCD severity. The aims of the present study were to assess the prevalence of ASD symptoms and age and sex differences in children and adolescents with OCD, and to explore...

Þó að gagnreyndum meðferðarúrræðum fyrir börn og unglinga með geðraskanir hafi fjölgað mikið á síðustu 30-40 árum, þá vantar enn mikið upp á reynslugögn fyrir framhaldsmeðferð. Margar geðraskanir eru langvinnar þar sem þörf er á meðferð, í einu eða öðru formi, í langan tíma. Í þessari grein er fjallað um nauðsyn þrepaskiptrar einstaklingsbundinnar...

Beskrivelse: Schedule for Affective Disorders and Schizophrenia for School-Age Children- Present and Lifetime Version (K-SADS-PL) er et semi-strukturert diagnostisk intervju for å evaluere nåværende og tidligere episoder av psykopatologi hos barn og ungdom. DSM-IV versjonen ble revidert av Joan Kaufman og kollega. Den norske versjonen er oversatt a...

Unlabelled: Pediatric obsessive-compulsive disorder (OCD) is characterized by recurrent obsessions and compulsions. In this review we depict evidence-based treatments for pediatric OCD patients. We searched PubMed for relevant publications including randomized controlled trials, reviews, and expert guidelines. Substantial evidence for cognitive be...

Obsessive compulsive disorder (OCD) is a neuropsychiatric entity. The aim was to explore the association of familial OCD, tics, anxiety, and depression with the presentation of OCD in offspring. To our knowledge, this is the first study examining the association of other familial psychiatric disorders with OCD in offspring.A total of 198 families r...

Objective: To investigate the effectiveness of sertraline (SRT) versus continued CBT in children and adolescents that did not respond to an initial course of CBT and to evaluate whether the presence of tic disorder is negatively associated with SRT outcomes. Method: The study was a part of the Nordic Long-Term OCD Treatment Study (NordLOTS). Intent...

Objective: The purpose of this study was to investigate the effect of sertraline (SRT) in children and adolescents with obsessive-compulsive disorder (OCD) who did not respond to two consecutive courses of cognitive-behavior therapy (CBT). Methods: Observational study with 11 participants (males, n=6), 7-17 years of age with Diagnostic and Stati...

Abstract Objective: To identify predictors of treatment response in a large sample of pediatric participants with obsessive-compulsive disorder (OCD). The Nordic long-term OCD treatment study (NordLOTS), included 269 children and adolescents, 7 to 17 years of age with a DSM-IV diagnosis of OCD. Outcomes were evaluated after 14 weekly sessions of ex...

Beskrivelse: Screen for Child Anxiety Related Emotional Disorders (SCARED) ble utviklet av Boris Birmaher for å måle angstsymptomer hos barn og unge. Første versjon kom i 1997 (38 testledd) og ble revidert i 1999 (41 testledd). Nederlandske Peter Muris har lagt til underskalaer for spesifikk fobi, tvangslidelse og traumatisk stresslidelse (66 testl...

Pediatric obsessive-compulsive disorder (OCD) is a chronic, disabling, and common disorder. In this paper, we describe evidence-based treatments in treatment-naïve and treatment-refractory pediatric OCD patients. We conducted a PubMed search to identify randomized controlled trials, reviews, and expert guidelines. The evidence for cognitive behavio...

Our aims were to investigate the effectiveness of sertraline (SRT) versus continued CBT in children and adolescents that did not respond to an initial course of CBT and to evaluate whether the presence of tic disorder is negatively associated with SRT outcomes, but not with continued CBT.The study was a part of the Nordic Long-Term OCD Treatment St...

The purpose of this study was to investigate whether the presence of tic disorder is negatively associated with sertraline (SRT) outcomes, but not with continued cognitive-behavioral therapy (CBT), in a sample of youth who were unresponsive to an initial full course of CBT. In the Nordic Long-Term OCD Study, children and adolescents with OCD who we...