Eric A Storch1, Alessandro S De Nadai2, Maria Conceição do Rosário3, Roseli G Shavitt4, Albina R Torres5, Ygor A Ferrão6, Euripedes C Miguel4, Adam B Lewin7, Leonardo F Fontenelle8. 1. Department of Pediatrics, University of South Florida, St. Petersburg, FL, United States; Department of Health Policy & Management, University of South Florida, Tampa, FL, United States; Rogers Behavioral Health-Tampa Bay, Tampa, FL, United States; All Children's Hospital-Johns Hopkins Medicine, St. Petersburg, FL, United States. Electronic address: estorch@health.usf.edu. 2. Department of Pediatrics, University of South Florida, St. Petersburg, FL, United States. 3. Federal University of São Paulo, São Paulo, Brazil. 4. Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. 5. Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Univ Estadual Paulista, São Paulo, Brazil. 6. Department of Psychiatry, Health Sciences Federal University of Porto Alegre, Porto Alegre, Brazil. 7. Department of Pediatrics, University of South Florida, St. Petersburg, FL, United States; All Children's Hospital-Johns Hopkins Medicine, St. Petersburg, FL, United States. 8. Anxiety and Obsessive-Compulsive Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro & D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
Abstract
OBJECTIVE: The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is the most commonly used instrument to assess the clinical severity of obsessive-compulsive symptoms. Treatment determinations are often based on Y-BOCS score thresholds. However, these benchmarks are not empirically based, which may result in non-evidence based treatment decisions. Accordingly, the present study sought to derive empirically-based benchmarks for defining obsessive-compulsive symptom severity. METHOD: Nine hundred fifty-four adult patients with obsessive-compulsive disorder (OCD), recruited through the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders, were evaluated by experienced clinicians using a structured clinical interview, the Y-BOCS, and the Clinical Global Impressions-Severity scale (CGI-Severity). RESULTS: Similar to results in treatment-seeking children with OCD, our findings demonstrated convergence between the Y-BOCS and global OCD severity assessed by the CGI-Severity (Nagelkerke R(2)=.48). Y-BOCS scores of 0-13 corresponded with 'mild symptoms' (CGI-Severity=0-2), 14-25 with 'moderate symptoms' (CGI-Severity=3), 26-34 with 'moderate-severe symptoms' (CGI-Severity=4) and 35-40 with 'severe symptoms' (CGI-Severity=5-6). Neither age nor ethnicity was associated with Y-BOCS scores, but females demonstrated more severe obsessive-compulsive symptoms than males (d=.34). Time spent on obsessions/compulsions, interference, distress, resistance, and control were significantly related to global OCD severity although the symptom resistance item pairing demonstrated a less robust relationship relative to other components of the Y-BOCS. CONCLUSIONS: These data provide empirically-based benchmarks on the Y-BOCS for defining the clinical severity of treatment seeking adults with OCD, which can be used for normative comparisons in the clinic and for future research.
OBJECTIVE: The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is the most commonly used instrument to assess the clinical severity of obsessive-compulsive symptoms. Treatment determinations are often based on Y-BOCS score thresholds. However, these benchmarks are not empirically based, which may result in non-evidence based treatment decisions. Accordingly, the present study sought to derive empirically-based benchmarks for defining obsessive-compulsive symptom severity. METHOD: Nine hundred fifty-four adult patients with obsessive-compulsive disorder (OCD), recruited through the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders, were evaluated by experienced clinicians using a structured clinical interview, the Y-BOCS, and the Clinical Global Impressions-Severity scale (CGI-Severity). RESULTS: Similar to results in treatment-seeking children with OCD, our findings demonstrated convergence between the Y-BOCS and global OCD severity assessed by the CGI-Severity (Nagelkerke R(2)=.48). Y-BOCS scores of 0-13 corresponded with 'mild symptoms' (CGI-Severity=0-2), 14-25 with 'moderate symptoms' (CGI-Severity=3), 26-34 with 'moderate-severe symptoms' (CGI-Severity=4) and 35-40 with 'severe symptoms' (CGI-Severity=5-6). Neither age nor ethnicity was associated with Y-BOCS scores, but females demonstrated more severe obsessive-compulsive symptoms than males (d=.34). Time spent on obsessions/compulsions, interference, distress, resistance, and control were significantly related to global OCD severity although the symptom resistance item pairing demonstrated a less robust relationship relative to other components of the Y-BOCS. CONCLUSIONS: These data provide empirically-based benchmarks on the Y-BOCS for defining the clinical severity of treatment seeking adults with OCD, which can be used for normative comparisons in the clinic and for future research.
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