Yale-Brown Obsessive Compulsive Scale (Y-BOCS)

The Yale-Brown Obsessive Compulsive Scale [Y-BOCS] has become the preferred measurement tool for OCD. It is important to remember that the Y-BOCS is not a diagnostic tool. Rather, it is a scale used to gague the severity and nature of OCD symptoms.

The scale can be measured periodically over the course of OCD treatment to gague improvement.

The Y-BOCS: A Two-Part Interview

The Y-BOCS is intended to be conducted as a one-on-one interview between the patient and a medical health professional or clinician. The interviewer begins with a checklist of symptoms. Then the patient chooses three most prominent or disturbing symptoms and the scale is used to rate the severity the these three most-distressing symptoms.

The YBOCS Checklist

The Checklist asks the patient to simply state whether or not s/he has or has had in the past certain types of obsessions or compulsions. Both obsessions and compulsions are grouped into broad categories of symptoms:

Obsession Categories

• Aggressive Obsessions
• Contamination Obsessions
• Sexual Obsessions
• Hoarding/Saving
• Religious
• Need for Symmetry or Exactness
• Somatic Obsessions (hypochondria or body appearance)
• Miscellaneous

Compulsion Categories

• Cleaning/Washing
• Checking
• Repeating Rituals
• Counting
• Ordering/Arranging
• Hoarding/Collecting
• Mental Rituals other than checking/counting
• Miscellaneous

The Y-BOCS Scale

Once three target symptoms have been identified by the patient, the patient is asked to grade them in severity relative to:

1. Time Occupied by Obsessive Thoughts
2. Interference Due to Obsessive Thoughts
3. Distress Associated With Obsessive Thoughts
4. Resistance Against Obsessions
5. Degree of Control Over Obsessive Thoughts
6. Time Spent Performing Compulsive Behaviors
7. Interference Due to Compulsive Behaviors
8. Distress Associated with Compulsive Behaviors
9. Resistance Against Compulsions
10. Degree of Control Over Compulsive Behavior

After the checklist and scale have been completed, a score is tallied and the severity of OCD is graded as either Subclinical, Mild, Moderate, Severe, or Extreme.

The Y-BOCS Scale was developed by:

• Dr. Wayne K. Goodman, MD, Professor and Chair of the Mount Sinai School of Medicine
• Lawrence H. Price, MD, Professor, Psychiatry and Human Behavior, Brown University
• Steven A. Rasmussen, MD, MMS, Associate Professor, Psychiatry and Human Behavior, Brown University

References

• WK Goodman et al, "The Yale-Brown Obsessive Compulsive Scale," Arch Gen Psychiatry. 1989; 46:1006-1011.
• Goodman WK, Price LH, Rasmussen SA, ct al.: The Yale-Brown Obsessive Compulsive Scale (Y- BOCS): Part II. Validity. Arch Gen Psvchiatry (46:1012-1016, 1989).
• Stanford School of Medicine
• CNS Forum
• Additional information regarding the development, use, and psychometric properties of the Y-BOCS can be found in Goodman WK, Price LH, Rasmussen SA, et al.: The Yale-Brown Obsessive Compulsive Scale (YBOCS): Part I. Development, use, and reliability. Arch Gen Psychiatry (46:1006~1011, 1989).