Evidence-Based Assessment of Obsessive–Compulsive Disorder

Abstract

Obsessive–compulsive disorder (OCD) is a neuropsychiatric illness that often develops in childhood, affects 1%–2% of the population, and causes significant impairment across the lifespan. The first step in identifying and treating OCD is a thorough evidence-based assessment. This paper reviews the administration pragmatics, psychometric properties, and limitations of commonly used assessment measures for adults and youths with OCD. This includes diagnostic interviews, clinician-administered symptom severity scales, self-report measures, and parent/child measures. Additionally, adjunctive measures that assess important related factors (ie, impairment, family accommodation, and insight) are also discussed. This paper concludes with recommendations for an evidence-based assessment based on individualized assessment goals that include generating an OCD diagnosis, determining symptom severity, and monitoring treatment progress.

Validity and clinical utility of the obsessive compulsive inventory - child version: further evaluation in clinical samples

“…The international standard for the assessment of symptom severity and outcome in treatment trials of pediatric obsessive-compulsive disorder (OCD) is the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS [1,2]). The CY-BOCS is a clinician-administered interview that includes a symptom checklist followed by severity ratings for obsessions and compulsions, yielding an overall severity score.…”

“…For instance, self-report scales with sustained precision and validity have the potential to save time and resources for clinicians, which in turn can make assessments of OCD more scalable and facilitate costeffective ways of evaluating interventions. According to a review by Rapp et al [2], there are several self-reported measures for pediatric OCD: the CY-BOCS-Child Report [4]; the Obsessive Compulsive Inventory -Child Version (OCI-CV [5]); the Children's Florida Obsessive Compulsive Inventory (C-FOCI [6]); and the Children's Obsessional Compulsive Inventory (ChOCI [7]). Although all of these are promising measures to assess OCD symptoms, the OCI-CV [5] is the only self-report measure that captures the multidimensionality of OCD in youth.…”

The efficacy of biofeedback approaches for obsessive-compulsive and related disorders: A systematic review and meta-analysis

“…The main outcome measure was the change in psychometric scales score associated with symptomatic manifestation. Results are presented for the Y-BOCS (n = 7) or Padua Inventory-Washington State University Revision (PI-WSUR; n = 1 (Rapp et al, 2016)) since both scales evaluate the severity of obsessive-compulsive symptoms ( Table 2). Psychometric scales assessing other parameters (e.g.…”

“…OCD is the fourth most common psychiatric disorder and the tenth cause of disability worldwide. OCD is characterized by recurrent thoughts (obsessions) associated with high anxiety, followed by repetitive behaviors or mental tasks to relieve the anxiety (compulsions) (Rapp et al, 2016;Sachs and Erfurth, 2018). Anxiety symptoms comprise autonomic nervous system dysregulation namely increased heart rate, decreased heart rate variability, elevated skin electrodermal activity, and augmented breathing rate (Schoenberg and David, 2014;Simon et al, 2013).…”

Pathophysiology of refractory obsessive-compulsive disorder

“…Worldwide, lifetime prevalence estimates for OCD are approximately 2%. [1] Two popular and well-characterized treatments for OCD are cognitive behavior therapy and selective serotonin reuptake inhibitors, with 40% to 60% of patients achieving significant symptomatic improvement. [2] However, approximately 10% of patients exhibit no improvement despite long-term treatment with various therapies and are considered to have severe, treatment refractory OCD.…”