YBOCS, the Yale-Brown Obsessive Compulsive Scale, has become the preferred measurement tool for OCD. It is important to remember that the YBOCS 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 YBOCS: A Two-Part Interview
The YBOCS 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 YBOCS Scale
Once three target symptoms have been identified by the patient, the patient is asked to grade them in severity relative to:
- Time Occupied by Obsessive Thoughts
- Interference Due to Obsessive Thoughts
- Distress Associated With Obsessive Thoughts
- Resistance Against Obsessions
- Degree of Control Over Obsessive Thoughts
- Time Spent Performing Compulsive Behaviors
- Interference Due to Compulsive Behaviors
- Distress Associated with Compulsive Behaviors
- Resistance Against Compulsions
- 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 YBOCS 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 YBOCS 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).
