Yale Brown Obsessive Compulsive Scale (Y-BOCS)

Evaluates the severity of OCD symptoms experienced by the patient in the past week.

There is more information about the scale and its interpretation in the text below the calculator.


The Yale Brown obsessive compulsive scale helps monitor the evolution of OCD symptoms based on what the patient declares they have experienced in the past week.

The scale was built by Goodman et al. in 1989 and also functions as an OCD severity assessment tool.

The ten questions in the scale are focused on the perceived alteration of life quality caused by this mental health condition.


The Y-BOCS scale provides two partial scores, one for obsessions (items 1-5) and one for compulsions (items 6-10).

The sum of these two determines the total score which is interpreted as follows:

Y-BOCS score Level Of Obsessive Compulsive Disorder
0 - 7 Sub clinical
8 - 15 Mild
16 - 23 Moderate
24 - 31 Severe
32 - 40 Extreme

1

How much of your time is occupied by obsessive thoughts?

2

How much do your obsessive thoughts interfere with functioning in your social, work, or other roles?

3

How much distress do your obsessive thoughts cause you?

4

How much of an effort do you make to resist the obsessive thoughts?

5

How much control do you have over your obsessive thoughts?

6

How much time do you spend performing compulsive behaviors?

7

How much do your compulsive behaviors interfere with functioning in your social, work, or other roles?

8

How anxious would you become if you were prevented from performing your compulsive behaviors?

9

How much of an effort do you make to resist the compulsions?

10

How much control do you have over the compulsions?

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About the Y-BOCS

This is a clinician-rated scale that evaluates the severity of obsessive compulsive disorder and its effect on day to day functioning.

Before administering the scale, the assessor is advised to explain to the patient what is understood by obsessions and by compulsions and to provide some relevant examples.

Obsessions are unwelcome and distressing ideas, thoughts, images or impulses that repeatedly enter the mind and seem to occur against the patient’s will. The patient may find them repugnant and recognize them as senseless.

Compulsions are behaviors or acts that the patient feels driven to perform although they do recognize them as senseless or excessive. Resistance to compulsions may prove difficult and a feeling of anxiety may occur and will not diminish until the behaviour is completed.

The ten questions in the scale refer to the following:

1. Time occupied by obsessive thoughts.

2. Interference due to obsessive thoughts.

3. Distress associated with obsessive behavior.

4. Resistance against obsessions.

5. Degree of control over obsessive thoughts.

6. Amount of time spent performing compulsive behaviors.

7. Interference due to compulsive behaviors.

8. Distress associated with compulsive behavior.

9. Resistance against compulsions.

10. Degree of control over compulsive behavior.

The Y-BOCS was created by Goodman et al. in 1989. It is aimed at providing a specific measure of the severity of symptoms of obsessive-compulsive disorder that is not influenced by the type of obsessions or compulsions present.

The study involved a cohort of 40 patients that were assessed by four raters at different stages of the treatment. The interrater reliability for each of the 10 individual items and the internal consistency were found to be excellent.

The Yale-Brown scale was deemed a reliable instrument for measuring the severity of illness in patients with obsessive-compulsive disorder.

 

Result interpretation

Each of the 10 items in the scale is awarded a number of points, depending on how severe the impact of the OCD is on the specific activity. The interpretation of the result is left at the judgment of the medical professional.

There are also two partial scores calculated:

■ Obsessions subtotal (sum of points from items 1 to 5);

■ Compulsions subtotal (sum of points from items 6 to 10).

The total result is interpreted as follows:

Y-BOCS score Level Of Obsessive Compulsive Disorder
0 - 7 Sub clinical
8 - 15 Mild
16 - 23 Moderate
24 - 31 Severe
32 - 40 Extreme

The higher the score in either or both components, the greater the perceived negative impact of the mental health condition on patient’s quality of life and interpersonal relations.

 

Diagnosis of OCD

Assessments for the diagnosis of obsessive compulsive disorder are used in the primary setting to check whether the symptoms the patient experiences are consistent with the disease. These are then followed by a full psychological evaluation.

In some cases, diagnosis is delayed because patients may not report their symptoms or report them partially because of shame or lack of awareness to their extent.

There are three levels of mental health severity that are used in the classification of the OCD diagnosis:

■ Mild functional impairment: means that symptoms manifest less than an hour per day in general;

■ Moderate functional impairment: obsessive, compulsive behaviors manifest for almost three hours a day;

■ Severe functional impairment: OCD characteristic thinking and behaviour patterns occur daily and disrupt activities for more than three hours a day.

 

Obsessive compulsive disorder symptoms

The following is a list of several types of obsessions and compulsions and can be used during the assessment to check the patient’s symptoms:

Aggressive obsessions - Fear might harm self;
- Fear might harm others;
- Violent or horrific images;
- Fear of blurting out obscenities or insult;
- Fear of doing something else embarrassing;
- Fear will act on unwanted impulses (e.g., to stab friend);
- Fear will steal things;
- Fear will harm others because not careful enough (e.g. hit/run motor vehicle accident);
- Fear will be responsible for something else terrible happening (e.g., fire, burglary).
Contamination obsessions - Concerns or disgust with bodily waste or secretions;
- Excessive concern with household items (e.g. cleaners solvents);
- Excessive concern with animals (e.g. insects);
- Excessive concern with environmental contaminants (e.g. asbestos, radiation toxic waste);
- Bothered by sticky substances or residues;
- Concerned will get ill because of contaminant.
Sexual obsessions - Forbidden or perverse sexual thoughts, images or impulses that may involve children, incest or homosexuality.
Hoarding obsessions - That are distinguishable from hobbies.
Religious obsessions - Concerns with sacrilege and blasphemy.
Miscellaneous obsessions - Need for symmetry, exactness;
- Need to know or remember;
- Fear of saying certain things or not saying the right thing;
- Fear of losing things;
- Bothered by certain sounds/noises;
- Lucky/unlucky numbers;
- Colors with special significance.
Compulsions - Repeating compulsions, in the shape or re-reading, re-writing, repeating routine activities;
- Counting compulsions;
- Ordering, arranging compulsions.
 

Original source

Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989; 46(11):1006-11.

Other references

1. Rosario-Campos MC, Miguel EC, Quatrano S, Chacon P, Ferrao Y, Findley D, Katsovich L, Scahill L, King RA, Woody SR, Tolin D, Hollander E, Kano Y, Leckman JF. The Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS): an instrument for assessing obsessive-compulsive symptom dimensions. Mol Psychiatry. 2006; 11(5):495-504.

2. Garnaat SL, Norton PJ. Factor structure and measurement invariance of the Yale-Brown Obsessive Compulsive Scale across four racial/ethnic groups. J Anxiety Disord. 2010; 24(7):723-8.

3. Federici A, Summerfeldt LJ, Harrington JL, McCabe RE, Purdon CL, Rowa K, Antony MM. Consistency between self-report and clinician-administered versions of the Yale-Brown Obsessive-Compulsive Scale. J Anxiety Disord. 2010; 24(7):729-33.


App Version: 1.0.1

Coded By: MDApp

Specialty: Psychiatry

System: Nervous

Objective: Evaluation

Type: Scale

No. Of Items: 10

Year Of Study: 1989

Abbreviation: Y-BOCS

Article By: Denise Nedea

Published On: June 16, 2017 · 10:29 AM

Last Checked: June 16, 2017

Next Review: June 16, 2018