Yale Brown Obsessive-Compulsive Scale (Y-BOCS)
If your patient is suspected of having OCD, use the Yale Brown Obsessive-Compulsive Scale (Y-BOCS) to gauge their symptoms.
Fact Checked by Ericka Pingol.
What is Obsessive-Compulsive Disorder?
Before we discuss what the Yale Brown Obsessive-Compulsive Scale is, let’s briefly talk about Obsessive-Compulsive Disorder.
Obsessive-Compulsive Disorder is a type of mental health disorder in which a person has to deal with recurring intrusive thoughts, fears, urges, and even images. All these things are referred to as obsessions. They are referred to as such, but that doesn’t necessarily mean the person with the disorder actually wants them. The person does not just have these obsessions. These obsessions actually make them do certain things and take on specific behaviors that they repeat from time to time. These are the compulsions.
Both obsessions and compulsions tend to disrupt a person’s daily life. The severity of the disruption will depend on the person, but those with Obsessive-Compulsive Disorder tend to feel distressed and anxious, and if they cannot enact their compulsions, it heightens their distress and anxiety even more.
Some examples of obsessions can include the need for things to be symmetrical, having certain things arranged in a certain order, and being germophobic. Some examples of compulsions include washing your hands every hour, ensuring that everything you’re wearing and everything around you is symmetrical, and arranging things neatly, even if objects were not out of place to begin with.
In order to diagnose a patient with Obsessive-Compulsive Disorder, healthcare professionals will ask them about OCD symptoms and medical history, assess their symptoms, and cross-check findings with the criteria found in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders.
One tool you can use during the diagnostic process is the Yale Brown Obsessive-Compulsive Scale.
Printable Yale Brown Obsessive-Compulsive Scale (Y-BOCS)
Download this Yale Brown Obsessive-Compulsive Scale (Y-BOCS) to better evaluate your clients.
How to use the Yale Brown Obsessive-Compulsive Scale (Y-BOCS)
The Yale Brown Obsessive-Compulsive Scale (Y-BOCS) is a short scale that gauges symptoms of Obsessive-Compulsive Disorder in patients. It comes in the form of a ten-item questionnaire. The questionnaire is divided into two parts, with five questions each. There are five questions related to obsessions and five related to compulsions. Here are the questions for each part:
Obsessions:
- How much time do you spend on obsessive thoughts?
- How much do your obsessive thoughts interfere with your personal, social, or work life?
- How much do your obsessive thoughts distress you?
- How hard do you try to resist your obsessions?
- How much control do you have over your obsessive thoughts?
Compulsions:
- How much time do you spend performing compulsive behaviors?
- How much do your compulsive behaviors interfere with your personal, social, or work life?
- How anxious would you feel if you were prevented from performing your compulsive behaviors?
- How hard do you try to resist your compulsive behaviors?
- How much control do you have over your compulsive behaviors?
Each question has a specific answer set, but what they all have in common is that they are arranged by the severity of answer choices, from 0 to 4.
You simply need to hand this to your patient so they can fill it out themselves, or you can conduct it like an interview and ask them questions and have them answer based on the choices for each question.
After receiving a fully accomplished scale, calculate the scores and check the following ranges to see the severity of their potential Obsessive-Compulsive Disorder:
- 8-15 = Mild Obsessive-Compulsive Disorder
- 16-23 = Moderate Obsessive-Compulsive Disorder
- 24-31 = Severe Obsessive-Compulsive Disorder
- 32-40 = Extreme Obsessive-Compulsive Disorder
Do note that they must have answers that aren’t scored 0 for both obsessions and compulsions in order to use the score range designations above.
Another thing that you should note is that the Yale Brown Obsessive-Compulsive Scale should not be used as the sole assessment to make an official diagnosis. It merely gauges symptoms. It’s best to use other assessments, consult the patient’s medical history, and cross-check everything in the Diagnostic and Statistical Manual of Mental Disorders before making a diagnosis.
Yale Brown Obsessive-Compulsive Scale Example
Now you know the basic gist of Obsessive-Compulsive Disorder and what the Yale Brown Obsessive-Compulsive Scale is, it’s time for you to see what it looks like. The template that we have for the Y-BOCS is arranged the way the questions are arranged in the previous section. Beside each item is a row containing five possible answers. These answers have corresponding score numbers, which are indicated on the sheet. Each item also has radio buttons so you or the patient can tick whichever the patient’s answers are.
If you like what you see and believe this scale will help you better gauge patients suspected of having Obsessive-Compulsive Disorder, then by all means, download our free Yale Brown Obsessive-Compulsive Scale PDF template!
Download this Yale Brown Obsessive-Compulsive Scale (Y-BOCS) Example:
When is it best to use the Yale Brown Obsessive-Compulsive Scale (Y-BOCS)?
The best time to use the Yale Brown Obsessive-Compulsive Scale (Y-BOCS) is when a patient of yours presents themselves to discuss the possibility of having Obsessive-Compulsive Disorder.
Before using the scale, you must first educate your patient about the disorder, what the symptoms are, and what it entails. Then, you must tell them that before you diagnose them with the disorder, you need to ask them about these symptoms, gauge them using assessments, consult their medical history, and cross-check everything with the criteria in the Diagnostic and Statistical Manual of Mental Disorders.
If your patient agrees to have you check their symptoms, you can issue the Yale Brown Obsessive-Compulsive Scale (Y-BOCS). Again, you can have them answer the scale on their own time, or you can conduct it like an interview. It’s up to you how you want to go about it. The latter takes more time, but if you choose to do that, you’ll have the opportunity to have them expand on their answers, which should give you more information that you can use to cross-check with the criteria for OCD.
Again, remember that this scale should not be the one to make you decide to diagnose the patient. Make sure to conduct a comprehensive assessment of your patient.
What are the benefits of the Yale Brown Obsessive-Compulsive Scale?
It examines both aspects of a patient’s Obsessive-Compulsive Disorder.
One of the great things about the Yale Brown Obsessive-Compulsive Scale is that it has an equal number of questions for obsessions and compulsions. The scale is a structured measure that examines how frequently the patient is bombarded with their obsessions and how often they indulge their compulsions in order to attempt to deal with their obsessions. It also examines the intensity of their obsessions and compulsions. Their answers should serve well when cross-checking information with their medical history and the criteria in the Diagnostic and Statistical Manual of Mental Disorders.
It can help professionals determine what to do once an official diagnosis is made.
Another feature of the Yale Brown Obsessive-Compulsive Scale is that it has score ranges, and these score ranges have designations. These designations give professionals an idea of how severe their patient’s Obsessive-Compulsive Disorder is. The scores are not definite because you still have to conduct further assessments of your patient before you diagnose them, but once they get an official diagnosis, the score range they fell on for the scale can be used as a basis for what kind of treatment you’ll implement for your patient.
It can be used to monitor a patient’s progress over time.
Now, let’s stipulate you have officially diagnosed your patient with Obsessive-Compulsive Disorder and have implemented a treatment plan that includes medication and therapy (let’s go with Cognitive Behavioral Therapy). It’s only natural for you to wonder how they’re doing, so it’s best to schedule a routine check-up so you can see how they’re doing. You may reissue this scale as part of the check-up, and if the scores are lower than last time, then you can assume that the treatment is working and your patient is getting better. If the score is the same or somehow higher, then you might want to make changes and see if those changes do the trick.
Commonly asked questions
If your patient can answer immediately, it can take anywhere between 1 to 5 minutes at the very least.
Just add up the scores per item based on their answers.
Note down the score range and designation they fall on, then conduct more assessments, check the patient’s medical history, and cross-check all the information you have about your patient with the criteria for OCD in the Diagnostic and Statistical Manual of Mental Disorders. If they fit the bill, then you can make an official diagnosis, but remember that the Y-BOCS on its own is not enough and should not be the sole factor in diagnosing a patient with OCD.
