psychiatry

Y-BOCS — Yale-Brown Obsessive Compulsive Scale

10-item clinician-rated severity scale for OCD (Goodman 1989). 5 obsession items + 5 compulsion items, each 0–4. Total 0–40.

Obsessions — time occupied*

Obsessions — interference*

Obsessions — distress*

Obsessions — resistance*

Obsessions — control*

Compulsions — time spent*

Compulsions — interference*

Compulsions — distress if prevented*

Compulsions — resistance*

Compulsions — control*

Score interpretation

Subclinical OCD 0–7

→ Psychoeducation. Reassess if symptoms develop.

Mild OCD 8–15

→ CBT with exposure and response prevention (ERP) — first-line per NICE CG31.

Moderate OCD 16–23

→ Combine ERP + SSRI (sertraline, fluoxetine, paroxetine, citalopram) at moderate dose; review at 12 weeks.

Severe OCD 24–31

→ High-dose SSRI (above licensed range under specialist) + intensive ERP; consider clomipramine if SSRI fails. Specialist OCD service referral.

Extreme OCD 32–40

→ Highly specialist national OCD service. Augmentation with antipsychotic (aripiprazole, risperidone), inpatient ERP, neuromodulation (rTMS, DBS) for refractory disease.

Interpretation bands for the Y-BOCS. Apply clinical judgement and local guidance.

References

Curated clinical cross-links plus same-class fallbacks.

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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