Paediatric obsessive-compulsive disorder and depressive symptoms: clinical correlates and CBT treatment outcomes.

Depression frequently co-occurs with paediatric obsessive-compulsive disorder (OCD), yet the clinical correlates and impact of depression on CBT outcomes remain unclear. The prevalence and clinical correlates of depression were examined in a paediatric specialist OCD-clinic sample (N = 295; Mean = 15 [7 - 18] years, 42 % female), using both dimensional (Beck Depression Inventory-youth; n = 261) and diagnostic (Development and Wellbeing Assessment; n = 127) measures of depression. The impact of depressive symptoms and suspected disorders on post-treatment OCD severity was examined in a sub-sample who received CBT, with or without SSRI medication (N = 100). Fifty-one per-cent of patients reported moderately or extremely elevated depressive symptoms and 26 % (95 % CI: 18 - 34) met criteria for a suspected depressive disorder. Depressive symptoms and depressive disorders were associated with worse OCD symptom severity and global functioning prior to CBT. Individuals with depression were more likely to be female, have had a psychiatric inpatient admission and less likely to be attending school (ps < 0.01). OCD and depressive symptom severity significantly decreased after CBT. Depressive symptoms and depressive disorders predicted worse post-treatment OCD severity (βs = 0.19 and 0.26, ps < 0.05) but became non-significant when controlling for pre-treatment OCD severity (βs = 0.05 and 0.13, ns). Depression is common in paediatric OCD and is associated with more severe OCD and poorer functioning. However, depression severity decreases over the course of CBT for OCD and is not independently associated with worse outcomes, supporting the recommendation for treatment as usual in the presence of depressive symptoms

Forensic interviewing of mentally disordered suspects: The impact of interview style on investigation outcomes.

The investigative interviewing of a vulnerable suspect is a complex and difficult task. Current best practice advocates for the use of open questions in order to elicit a free recall. However, those with mental health conditions have limited cognitive abilities that relate to free recall and episodic memory, and there is emerging evidence that suggests open questions may not always be most suitable for the vulnerable interviewee. As such, the present study examined the impact of two different interview models (best practice v modified interview) on the amount and accuracy of investigation relevant information obtained within an experimental vulnerable ‘suspect’ sample. Participants engaged in two tasks; a minor transgression and a matched non-transgression. Each participant was then subject to either a best practice (containing largely open questions) or a modified interview (containing largely closed questions). Vulnerable participants provided a significantly higher and more accurate amount of investigation relevant information during the modified interview rather than the best practice interview. In addition, participants that have mental health conditions sought more clarifications during the best practice interviews. The type of interview did not impact upon the level of vulnerability displayed. Our findings challenge current best practice in that vulnerable participants performed worse in interviews containing more open questions than closed questions. These findings add to the emerging evidence base that vulnerable individuals may require an alternative method of questioning, including the use of closed questions as ‘scaffolding’ during an investigative interview