Calculators / Obsessive-compulsive disorder

Y-BOCS

Yale-Brown Obsessive Compulsive Scale, severity ratings. Clinician-rated OCD severity.

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The Y-BOCS calculator is in the Library.

Every rating scale calculator comes with the Library, along with the prescribing guides, medication handouts, DSM-5 criteria and sheets, and the Guide Builder.

Use it for

  • Rating the severity of OCD in a person who already has the diagnosis.
  • Setting a baseline and tracking response to exposure and response prevention or to medication.
  • Applying the consensus definitions of response and remission.

Do not use it for

  • Screening or diagnosing OCD. It is a severity rating for a known diagnosis.
  • Replacing the interview. The ratings come from the interview and the checklist, which this page does not contain.
  • Mixing with the Y-BOCS-II. That revision rates 0 to 5 on each item, so its scores are not interchangeable with these.

The Y-BOCS is owned by OCD Scales, LLC, and its interview, anchors and checklist cannot be posted on a website. This page therefore does not reproduce them. Interview the person and rate each item on your own authorized copy, covering the past week, then enter the ten 0 to 4 ratings here.

For resistance, a higher number means less resistance. For control, a higher number means less control. The one-word labels are reminders of the direction only. The full anchors are on the form.

Obsessions

Rate from the obsessions part of your authorized form.

1Time occupied by obsessionsHow much of the day the obsessive thoughts take up.
2Interference from obsessionsHow much they get in the way of social, work and other functioning.
3Distress from obsessionsHow upsetting the thoughts are.
4Resistance against obsessionsHow hard the person tries to resist. A higher number means less resistance.
5Control over obsessionsHow well the person can stop or redirect the thoughts. A higher number means less control.

Compulsions

Rate from the compulsions part of your authorized form. Mental rituals count.

6Time spent on compulsionsHow much of the day the compulsive behaviors and mental rituals take up.
7Interference from compulsionsHow much they get in the way of social, work and other functioning.
8Distress from compulsionsHow distressed the person would feel if prevented from carrying them out.
9Resistance against compulsionsHow hard the person tries to resist. A higher number means less resistance.
10Control over compulsionsHow well the person can stop the behavior or ritual. A higher number means less control.

Y-BOCS

Answer the questions to see the result.

This calculator adds up the score in your browser. Nothing you enter is stored or sent.

More about the Y-BOCS

About the Y-BOCSWhat it is and what it is for

The Y-BOCS is the standard clinician-rated measure of obsessive-compulsive disorder severity. Goodman and colleagues published it in 1989. After an interview that includes a symptom checklist, the clinician rates ten items from 0 to 4. Five items rate obsessions and five rate compulsions, each on time, interference, distress, resistance and control. The total runs from 0 to 40.

Severity is rated apart from the content of the symptoms, so the same scale fits contamination, checking, symmetry, intrusive thoughts and mental rituals. It is the primary outcome in most OCD treatment trials.

How to use itGiving it and scoring it

Interview the person with your authorized copy of the Y-BOCS and rate the ten items for the past week. Add items 1 to 5 for the obsessions subtotal and items 6 to 10 for the compulsions subtotal. The total is the sum of all ten, from 0 to 40. This page does the addition.

The symptom checklist is not scored. Use it to find the obsessions and compulsions you are rating.

Interpreting the scoreScore ranges and what they suggest
Y-BOCS totalWhat it suggestsUsual response
0 to 7SubclinicalFew or no OCD symptoms.If in treatment, this is well inside the remission range. Continue the plan and watch for relapse.
8 to 15MildSymptoms present, with limited impairment.Exposure and response prevention is first line. Medication is an option, by preference.
16 to 23ModerateClear symptoms with impairment.Exposure and response prevention, a serotonin reuptake inhibitor, or both.
24 to 31SevereMarked symptoms and impairment.Combined treatment. Assess depression, safety and family accommodation.
32 to 40ExtremeVery severe symptoms, often disabling.Combined treatment, close follow-up, and consider a higher level of care.

These are the bands most often quoted for the 0 to 40 total. They are conventions, not validated cutpoints, and studies that derived severity ranges from data have landed somewhat differently. Say which bands you use.

Pearls and pitfallsTips and common mistakes
  • Always record the baseline total. Response and remission both depend on it.
  • Count mental rituals, reassurance seeking and avoidance as compulsions. Missing them is the commonest reason a score looks low.
  • Ask about family accommodation at every visit. It predicts a poorer outcome and is a treatment target.
  • A drop in the total without functional gain is not a good result. Pair the Y-BOCS with the CGI-I.
  • For depression that travels with OCD, use the PHQ-9 or MADRS alongside it.
EvidenceAccuracy and reliability
  • Goodman and colleagues (1989) developed the scale and reported good interrater reliability and internal consistency, with scores that correlated with other measures of OCD. It has been the main outcome measure in OCD trials since.
  • An expert consensus (Mataix-Cols 2016) set the standard definitions of response, partial response and remission used in this calculator.
  • The Y-BOCS-II (Storch 2010) was built to fix weaknesses in the original, including the resistance items. It is a different instrument with a 0 to 50 range.
  • The American Psychiatric Association guideline (Koran 2007) names exposure and response prevention and serotonin reuptake inhibitors as first-line treatments and describes augmentation for partial response.
Source, license and referencesWhere it comes from

The Y-BOCS (Goodman and colleagues, 1989) is owned by OCD Scales, LLC. The rights holder says its interview, anchors and checklist may not be posted on a website or distributed without authorization, and offers paper copies for clinicians through ocdscales.com. This page does not contain them. It only adds up the ten 0 to 4 ratings you give from your own authorized copy, and the one-word labels here are not the published anchors.

  1. Goodman WK, Price LH, Rasmussen SA, et al. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006-1011.
  2. Goodman WK, Price LH, Rasmussen SA, et al. The Yale-Brown Obsessive Compulsive Scale. II. Validity. Arch Gen Psychiatry. 1989;46(11):1012-1016.
  3. Mataix-Cols D, Fernandez de la Cruz L, Nordsletten AE, Lenhard F, Isomura K, Simpson HB. Towards an international expert consensus for defining treatment response, remission, recovery and relapse in obsessive-compulsive disorder. World Psychiatry. 2016;15(1):80-81.
  4. Storch EA, Rasmussen SA, Price LH, Larson MJ, Murphy TK, Goodman WK. Development and psychometric evaluation of the Yale-Brown Obsessive-Compulsive Scale, Second Edition. Psychol Assess. 2010;22(2):223-232.
  5. Koran LM, Hanna GL, Hollander E, Nestadt G, Simpson HB. Practice guideline for the treatment of patients with obsessive-compulsive disorder. Am J Psychiatry. 2007;164(7 Suppl):5-53.

Clinical decision support, not a diagnosis. Each calculator scores a published scale the way its authors intended. A score informs a clinical interview and examination and never replaces them. If you are a patient using this page, please review the result with your clinician. In an emergency, call 911 or call or text 988 in the United States.