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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorFARHAT, Luis C.
dc.contributor.authorOLFSON, Emily
dc.contributor.authorLEVINE, Jessica L. S.
dc.contributor.authorLI, Fenghua
dc.contributor.authorFRANKLIN, Martin E.
dc.contributor.authorLEE, Han-Joo
dc.contributor.authorLEWIN, Adam B.
dc.contributor.authorMCGUIRE, Joseph F.
dc.contributor.authorRAHMAN, Omar
dc.contributor.authorSTORCH, Eric A.
dc.contributor.authorTOLIN, David F.
dc.contributor.authorZICKGRAF, Hana F.
dc.contributor.authorBLOCH, Michael H.
dc.identifier.citationJOURNAL OF CHILD AND ADOLESCENT PSYCHOPHARMACOLOGY, v.30, n.5, p.306-315, 2020
dc.description.abstractObjectives: In clinical trials of pediatric trichotillomania (TTM), three instruments are typically employed to rate TTM severity: (1) the Massachusetts General Hospital Hair Pulling Scale (MGH-HPS), (2) the National Institute of Mental Health Trichotillomania Severity Scale (NIMH-TSS), and (3) the Trichotillomania Scale for Children (TSC). These instruments lack standardized definitions of treatment response, which lead researchers to determine their own definitions of response post hoc and potentially inflate results. We performed a meta-analysis to provide empirically determined accuracy measures for percentage reduction cut points in these three instruments. Methods: MEDLINE was searched for TTM clinical trials. A total of 67 studies were initially identified, but only 5 were clinical trials focused on TTM in pediatric populations and therefore were included in this meta-analysis (n = 180). A Clinical Global Impressions Improvement score <= 2 was used to define clinical response. Receiver operating characteristic principles were employed to determine accuracy measures for percentage reduction cut points on each one of the instruments. Meta-DiSc software was employed to provide pooled accuracy measures for each cut point for each instrument. The Youden Index and the distance to corner methods were used to determine the optimal cut point. Results: The optimal cut points to determine treatment response were a 45% reduction on the MGH-HPS (Youden Index 0.40, distance to corner 0.20), a 35% reduction on the NIMH-TSS (Youden Index 0.42, distance to corner 0.17), a 25% reduction on the TSC child version (TSC-C; Youden Index 0.40, distance to corner 0.18), and a 45% (distance to corner 0.30) or 50% reduction (Youden Index 0.33) on the TSC parent version (TSC-P). The TSC-C had less discriminative ability at determining response in younger children in comparison to older children; no age-related differences were observed on the TSC-P. Conclusions: This study provides empirically determined cut points of treatment response on three instruments that rate TTM severity. These data-driven cut points will benefit future research on pediatric TTM.eng
dc.description.sponsorshipNIMH NIH HHSUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Mental Health (NIMH) [R25 MH077823]
dc.publisherMARY ANN LIEBERT, INCeng
dc.relation.ispartofJournal of Child and Adolescent Psychopharmacology
dc.subjectchildren and adolescentseng
dc.subjectclinical trialseng
dc.subjectMassachusetts General Hospital Hair Pulling Scale (MGH-HPS)eng
dc.subjectNational Institute of Mental Health Trichotillomania Severity Scale (NIMH-TSS)eng
dc.subjectTrichotillomania Scale for Children (TSC)eng
dc.subject.otherfunctional impairmenteng
dc.subject.otherdescriptive psychopathologyeng
dc.subject.othertreating trichotillomaniaeng
dc.titleMeasuring Treatment Response in Pediatric Trichotillomania: A Meta-Analysis of Clinical Trialseng
dc.rights.holderCopyright MARY ANN LIEBERT, INCeng
dc.subject.wosPharmacology & Pharmacyeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng, Emily:Yale Univ, Dept Psychiat, New Haven, CT 06520 USA; Yale Child Study Ctr, POB 207900, New Haven, CT 06520 USA, Jessica L. S.:Yale Child Study Ctr, POB 207900, New Haven, CT 06520 USA, Fenghua:Yale Child Study Ctr, POB 207900, New Haven, CT 06520 USA, Martin E.:Univ Penn, Dept Psychiat, Perelman Sch Med, Child & Adolescent OCD Tic Trich & Anxiety Grp CO, Philadelphia, PA 19104 USA, Han-Joo:Univ Chicago, Dept Psychiat & Behav Neurosci, Chicago, IL 60637 USA, Adam B.:Univ S Florida, Dept Pediat, Tampa, FL 33620 USA, Joseph F.:Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21205 USA, Omar:Univ S Florida, Dept Pediat, Tampa, FL 33620 USA, Eric A.:Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA, David F.:Inst Living, Hartford, CT USA; Yale Univ, Sch Med, New Haven, CT USA, Hana F.:Univ Penn, Dept Psychiat, Perelman Sch Med, Child & Adolescent OCD Tic Trich & Anxiety Grp CO, Philadelphia, PA 19104 USA; Univ Chicago, Dept Psychiat & Behav Neurosci, Chicago, IL 60637 USA, Michael H.:Yale Univ, Dept Psychiat, New Haven, CT 06520 USA; Yale Child Study Ctr, POB 207900, New Haven, CT 06520 USA
hcfmusp.publisher.cityNEW ROCHELLEeng
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