A quick and reliable screening measure for OCD in youth: reliability and validity of the obsessive compulsive scale of the Child Behavior Checklist

Abstract

Background The high prevalence and morbidity of obsessive compulsive disorder (OCD) in youth, the secretive nature of the disorder leading to under-recognition, and the lack of specialized child psychiatry services in many areas suggest that a simple, quick, and reliable screening tool to identify cases could be very useful to clinicians who work with children. Method We used 8 items from the Child Behavior Checklist (CBCL), an empirically derived instrument free of clinician bias, to investigate the usefulness of a previously reported CBCL-based obsessive compulsive scale (OCS) by Nelson et al [Nelson EC, Hanna GL, Hudziak JJ, Botteron KN, Heath AC, Todd RD. Obsessive-compulsive scale of the Child Behavior Checklist: Specificity, sensitivity, and predictive power. Pediatrics 2001;108(1):E14] in a separate cohort of youth with OCD. We computed the psychometric properties of the OCS in our sample of youth with OCD and in psychiatric and normal controls, and compared these to the published values. Results Using the recommended cutoff between the 60th and 70th percentiles of the OCS to best predict the presence of OCD, we found very high sensitivity (92%-78%), specificity (86%-94%), negative predictive value (96%-90%), and positive predictive value (77%-86%). Conclusions The OC scale of the CBCL shows good reliability and validity and acceptable psychometric properties to help discriminate youth with OCD.