Dissecting the Yale-Brown Obsessive-Compulsive Scale severity scale to understand the routes for symptomatic improvement in obsessive-compulsive disorder

Abstract

We aimed to investigate which items of the Yale-Brown Obsessive-Compulsive Severity Scale best discriminate the reduction in total scores in obsessive-compulsive disorder patients after 4 and 12 weeks of pharmacological treatment. Data from 112 obsessive-compulsive disorder patients who received fluoxetine (⩽80 mg/day) for 12 weeks were included. Improvement indices were built for each Yale-Brown Obsessive-Compulsive Severity Scale item at two timeframes: from baseline to week 4 and from baseline to week 12. Indices for each item were correlated with the total scores for obsessions and compulsions and then ranked by correlation coefficient. A correlation coefficient ⩾0.7 was used to identify items that contributed significantly to reducing obsessive-compulsive disorder severity. At week 4, the distress items reached the threshold of 0.7 for improvement on the obsession and compulsion subscales although, contrary to our expectations, there was greater improvement in the control items than in the distress items. At week 12, there was greater improvement in the time, interference, and control items than in the distress items. The use of fluoxetine led first to reductions in distress and increases in control over symptoms before affecting the time spent on, and interference from, obsessions and compulsions. Resistance did not correlate with overall improvement. Understanding the pathway of improvement with pharmacological treatment in obsessive-compulsive disorder may provide clues about how to optimize the effects of medication.

Is it time to change the gold standard of obsessive-compulsive disorder severity assessment? Factor structure of the Yale-Brown Obsessive-Compulsive Scale

“…Evidence from previous studies has shown that resistance items may, in fact, measure a different construct when compared to other items (Anholt et al, 2010; Kim et al, 1994; Moritz et al, 2002). Adding further evidence to this argument, a recent study examined which Y-BOCS items best discriminated the reduction in total scores after 4 and 12 weeks of fluoxetine (Costa et al, 2017). Resistance items showed the lowest correlation coefficients among all items.…”

Increased Production of the Potent Oxidant Peroxynitrite in the Serum of Obsessive-Compulsive Disorder Patients

“…The case group consisted of 21 OCD patients (9 males and 15 females). The patients completed the Yale-Brown Obsession Compulsion Scale (Y-BOCS) to determine the severity of OCD (15). The control group consisted of 21 healthy volunteers who were completely normal and did not have any history of psychiatric disorders according to the exclusion criteria and physical and biochemical examinations.…”