Brief Assessment Tools for Obsessive Compulsive Disorders in Children: A Systematic Review.

Abstract

Children and adolescents with suspected obsessive-compulsive disorder (OCD). To estimate the comparative performance of brief diagnostic assessment tools. PubMed, the Cochrane Register of Clinical Trials, the Cochrane Database of Systematic Reviews, Embase, CINAHL, PsycINFO, and ERIC, and for unpublished studies with reported results in ClinicalTrials.gov through May 15, 2024. Studies of children (up to age 21) with a clinical suspicion of OCD that evaluated the accuracy (predictive validity) of brief assessment tools for OCD, compared to a reference standard. We extracted participant characteristics, scale and reference standard information, results, and risk of bias assessment. We performed random-effects diagnostic meta-analysis where feasible. We assessed strength of evidence for each scale. There is moderate strength of evidence that the 8-question version of the Child Behavior Checklist-Obsessive Compulsive subscale is sufficiently sensitive and specific (summary area under the curve of 0.84, 95% CI 0.74 to 0.91) to prompt specialist referral for additional diagnostic assessment. Other tools may perform as well or better, but the current evidence is insufficient to justify broad conclusions about their performance. Few studies per scale, case-control studies, and homogenous White populations may preclude generalizability of tool performance. Based on the current evidence the CBCL-OCS probably is sufficiently accurate to indicate which youth should be further evaluated for OCD, but further research is needed to establish that the 8-question subscale can function as a stand-alone measure. The available evidence is insufficient for other brief assessment tools.