Search

Objective: We investigated the diagnostic efficiency and clinical utility of the Dimensional Obsessive–Compulsive Scale (DOCS) and subscales for distinguishing obsessive–compulsive disorder (OCD) from anxiety disorders (ADs). Method: A total of 369 participants (167 male, Mage = 29.61 years) diagnosed with DSM-IV OCD or AD, recruited from specialty clinics across the United States, completed clinical interviews and self-report questionnaires, including the DOCS. Receiver operating characteristic analyses and diagnostic likelihood ratios (DiLRs) determined discriminative validity and provided clinical utility. Logistic regressions tested for incremental validity in the DOCS-total scale and subscales in predicting OCD status. Results: The DOCS-total scale and Contamination subscale performed best in differentiating between OCD and AD diagnosis (DOCS-total: Area under curve [AUC] = .75, p < .001; Contamination: AUC = .70, p < .001) as compared with the other subscales. At high scores (DOCS-total: 28+, Contamination: 6+), Contamination was more effective than the DOCS-total in differentiating OCD from ADs, with high scores in Contamination quadrupling OCD odds and DOCS-total by about threefold (Contamination DiLR+ = 4.04, DOCS-total DiLR+ = 2.82). At low scores (DOCS-total: 0-9, Contamination: 0-2), the converse was true, with low scores in Contamination cutting OCD odds by half and DOCS-total by one fifths (Contamination DiLR− = 0.52, DOCS-total DiLR− = 0.23). Conclusion: At high scores, the Contamination subscale is the most helpful subscale to differentiate OCD and ADs. For low scores, the DOCS-total scale performs the best among the scales.

Background: This study was carried out to enumerate the level of difference in functional impairment and quality of life (QOL) in obsessive-compulsive disorder (OCD) patients and normal control group to find out the relationship among ICD functional impairment and QOL. Methodology: Thirty patients diagnosed with OCD as per International Classification of Diseases Diagnostic Criteria for Research-10 were taken for study. The control group consists of 30 normal participants from the community. Functional impairment and QOL questionnaires were administered on both groups to measure functional impairment and QOL in OCD. Results: The mean age of onset of OCD was (23.8 ± 7.25), mean duration of illness was (6.3 ± 4.47), and mean duration of treatment was (2.56 ± 2.47). It was also observed that total score as well as all the domains of the World Health Organization QOL-BREF, OCD patients scored significantly less (P < 0.001) compared to normal controls. Dysfunctional Analysis Questionnaire (DAQ)-Social area and DAQ-Personal area had statistically significant positive correlation (P < 0.05) with an obsessive subscale of Yale–Brown Obsessive Compulsive Scale (Y-BOCS) whereas DAQ-social area (P < 0.05), DAQ-Personal Area (P < 0.05) had statistically significant positive correlation with a total score of Y-BOCS. Conclusion: The presence of functional impairment leads to poor QOL in the persons with OCD.

Obsessive-compulsive disorder (OCD) is characterized by obsessions and compulsions. Treatment usually consists of serotonergic medications along with exposure therapies. Danger ideation reduction therapy (DIRT) is an alternative therapy predominantly for washing compulsions and focuses on reduction of danger ideations. DIRT was tried on Ms. S. with a history of OCD for 15 years and improvement was noticed on Yale–Brown Obsessive Compulsive Scale, Padua Inventory, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale after 15 sessions of DIRT though she was not fully symptom-free. Thus, DIRT was found to improve OCD symptoms and improved her insight into illness.

Background: Reward-processing deficits have been demonstrated in obsessive–compulsive disorder (OCD) and this has been linked to ventral striatal abnormalities. However, volumetric abnormalities of the nucleus accumbens (NAcc), a key structure in the reward pathway, have not been examined in OCD. We report on the volumetric abnormalities of NAcc and its correlation with illness severity in drug-naïve, adult patients with OCD. Method: In this cross-sectional study of case–control design, the magnetic resonance imaging (MRI) 1.5-T (1-mm) volume of NAcc was measured using 3D Slicer software in drug-naïve OCD patients ( n = 44) and age, sex and handedness-matched healthy controls (HCs) ( n = 36) using a valid and reliable method. OCD symptoms were assessed using the Yale–Brown Obsessive Compulsive Scale (Y-BOCS) Symptom checklist and severity and the Clinical Global Impression-Severity (CGI-S) scale. Results: There was no significant difference in NAcc volumes on either side between OCD patients and HCs ( F = 3.45, p = 0.07). However, there was significant negative correlation between the right NAcc volume and Y-BOCS compulsion score ( r = −0.48, p = 0.001). Conclusions: Study observations suggest involvement of the NAcc in the pathogenesis of OCD, indicating potential reward-processing deficits. Correlation between the right NAcc volume deficit and severity of compulsions offers further support for this region as a candidate for deep brain stimulation treatment in OCD.

This study evaluated acceptance and commitment therapy (ACT) for scrupulosity-based obsessive compulsive disorder (OCD). Five adults were treated with eight sessions of ACT, without in-session exposure, in a multiple baseline across participants design. Daily monitoring of compulsions and avoided valued activities were tracked throughout the study. The Obsessive Compulsive Inventory–Revised, Yale–Brown Obsessive Compulsive Scale (Y-BOCS), Penn Inventory of Scrupulosity, Beck Depression Inventory–II, Quality of Life Scale, Santa Clara Strength of Religious Faith Questionnaire, and the Acceptance and Action Questionnaire–II were completed at pretreatment, posttreatment, and 3-month follow-up. The Treatment Evaluation Inventory was completed at posttreatment. Average daily compulsions reduced as follows: pretreatment = 25.0, posttreatment = 5.6, and follow-up = 4.3. Average daily avoided valued activities reduced as follows: pretreatment = 6.0, posttreatment = 0.7, and follow-up = 0.5. Other measures showed similar patterns. Religious faith only slightly declined: 4% at posttreatment and 7% at follow-up. Treatment acceptability was high.

Objectives: To determine the accuracy and utility of a single-item screening tool for depression (the Yale, taken from the Yale—Brown Obsessive Compulsive Scale) in patients who have recently had a stroke. Design: Comparison of a clinical classification of depression with a screening tool in a defined cohort. Setting: A large teaching hospital in Liverpool, UK. Subjects: One hundred and twenty-two consecutive people admitted with an acute stroke who did not have severe cognitive or communication problems, and who were still in hospital in the second week post stroke. Main measures: Classification of depression using the Montgomery-Asberg Depression Rating Scale was compared with the Yale, a single-item screening tool. Results: When comparing the classification of depression according to the Montgomery-Asberg Depression Rating Scale and the response to the Yale we found that at week 2 the Yale had a sensitivity of 86% (57/66), a specificity of 84% (46/55), a positive predictive value of 86% (57/66) and a negative predictive value of 84% (46/55), with an overall efficiency of 85% (103/121); prevalence of depression was 54% (according to the Montgomery-Asberg Depression Rating Scale). At month 3 the Yale had a sensitivity of 95% (52/55), a specificity of 89% (32/36), a positive predictive value of 93% (52/56) and a negative predictive value of 91% (32/35), with an overall efficiency of 92% (84/91); prevalence of depression was 60%. Conclusions: The Yale, which only requires a `yes' or `no' answer to a single question, may prove a useful screening tool in identifying possible depression in people with stroke both two weeks and three months post stroke.

A clinical trial was conducted to evaluate the efficacy of a 7-week group behavioral therapy program for adolescents with obsessive-compulsive disorder (OCD). Group sessions included therapist-assisted exposure and response prevention exercises, information regarding OCD, and the extensive use of behavioral homework assignments. An additional family session was conducted to educate families about OCD and to encourage participation in the group member's behavioral program. At the end of the group, all clients showed improvement on their Children's Yale-Brown Obsessive Compulsive Scale scores; 6-month follow-up revealed further improve ment. Our findings provide preliminary support for the efficacy of group behavioral therapy for adolescents with OCD.

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.

The Arabic Obsessive-Compulsive Scale and the Maudsley Obsessional Compulsive Inventory were administered to 87 Kuwaiti (Arabic version) and 73 American college students (English form). Pearson correlations for the total score on the Arabic scale and the four subscores of the Maudsley scale: Checking, Cleaning, Slowness, and Doubting were .72, .48, .50, and .61 for the Kuwaitis and .52, .40, .51, and .52 for the Americans. The loadings of the total score of the Arabic scale onto a factor of obsession and compulsion were .83 and .79 for Kuwaiti and American students, respectively, denoting a good factorial validity of the Arabic scale.

The Arabic Obsessive–Compulsive Scale and the Maudsley Obsessional–Compulsive Inventory were administered to 159 Kuwaiti (Arabic version) and 72 American college students (English version). Pearson correlations for total score on the two scales were .68 and .64 for Kuwaiti and Americans, respectively, denoting a good convergent validity of the new Arabic Obsessive–Compulsive Scale against scores on the Maudsley Obsessional–Compulsive Inventory in the two different national groups.

The Arabic Obsessive-Compulsive Scale was administered to 204 Kuwaiti and 132 American college students. The Spearman-Brown reliabilities were, respectively .77 and .82. while Cronbach alphas were .76 and .82, denoting acceptable values for the two samples.