The Obsessive-Compulsive Symptom (OCS) scale of the Child Behavior Checklist: A comparison between Swedish children with Obsessive-Compulsive Disorder from a specialized unit, regular outpatients and a school sample

Centre for Child and Adolescent Mental Health, Eastern and Southern Norway Gullhaug Torg 4B, 0484 Oslo, Norway.
Journal of Anxiety Disorders (Impact Factor: 2.96). 02/2008; 22(7):1172-9. DOI: 10.1016/j.janxdis.2007.12.004
Source: PubMed


To evaluate the discriminative power of various items as reported by parents in the OCS-scale extracted from the Child Behavior Checklist (CBCL) problem scale and to compare findings with outcomes of previous validation studies. Children referred to a specialized child psychiatric Obsessive-Compulsive Disorder (OCD) clinic (OCD group) (n=185) receiving a formal OCD diagnosis according to DSM IV criteria based on interviews with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) were compared to a sample recruited from regular child and adolescent psychiatric outpatient clinics (CPO group) (n=177). Both samples were compared to a normative school sample (SS group) and all three groups were matched for age and gender. Thirty seven CBCL items, mostly representing core internalizing symptoms and parts of the thought problem scale as well as physical and sleep problems, were first identified. Ten of these items (including all discriminative items in previous validation studies) could distinguish children with OCD from CPO patients. In a subsequent analysis, the results of a logistic regression showed that four CBCL items, "Obsessions," "Fearful and Anxious," "Compulsions," and "Worries" remained significant predictors. These four OCS items and previously used CBCL OCS-scales were further examined by means of ROC-analysis showing that the "Obsessions" and "Compulsions" CBCL items were the strongest predictors. These two CBCL items performed well as screens for OCS symptoms in children and adolescents and the addition of similar CBCL items did not further increase sensitivity or specificity. It is suggested that parental responses on these two items could preferably be used as screen for OCD in children and adolescents in regular child psychiatric clinics.

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Available from: Tord Ivarsson
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    • "Otra difi cultad diagnóstica reside en el hecho que frecuentemente los niños se muestran reservados acerca de los síntomas obsesivo-compulsivos, siendo frecuente que intenten minimizarlos o negarlos. Además, el 75% de los pacientes con TOC presentan otros síntomas comórbidos que pueden enmascarar el trastorno principal (Geller et al., 2000; Hanna, 1995; Ivarsson, Melin y Wallin, 2008). Otra de las causas que contribuyen en la difícil tarea de diagnosticar el TOC infantil es la limitación en la disponibilidad de instrumentos de detección propios (Batlle et al., 2005). "

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    • "Although specific items on the CBCL reflect evidence of delusions or hallucinations ( " I hear sounds of voices that other people think aren't there " or " I see things that other people think aren't there " ), these items were very rarely endorsed (6.1%) in this largely at-risk sample, and there were no notable differences across maternal risk groups for these specific items. The two most frequently endorsed items in this sample on the CBCL Thought Problems Scale (42.9% of the sample endorsed " can't get his/her mind off certain thoughts, obsessions " and 14.3% of the sample endorsed " repeats acts over and over " ) may or may not represent problems associated with psychosis (Ivarsson & Larsson, 2008). Furthermore, there is tentative evidence that these two items appear elevated in the at-risk maternal groups (56.3% of O-BD, 45.2% of O-UNI, and 31.7% of O-WELL). "
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    • "It has been shown to be both reliable and valid (Geller et al., 2006; Hudziak et al., 2006; Storch et al., 2006). Although there have been various adaptations of the CBCL-OCS tested, with fewer items including versions with six items (Storch et al., 2006), three items (Geller et al., 2006), and even just two items (Ivarsson and Larsson, 2008), we used the original eight-item scale (Nelson et al., 2001) for the purposes of our research. The CBCL-OCS was the main scale of interest. "
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