Identification of Main Symptoms in OCD Patients by Use of Symptom Scales. Criterion Validity and Diagnostic Accuracy of the OCI-R

Identification of Main Symptoms in OCD Patients by Use of Symptom Scales. Criterion Validity and Diagnostic Accuracy of the OCI-R Background: In clinical practice, OCD patients are often mis-diagnosed and therefore do not receive optimal psychotherapeutic care. The diagnostic utility of multidimensional OCD measures is still unclear. It has not yet been examined to which extent the subscales of multidimensional OCD measures accurately distinguish patients with corresponding OCD main symptom domains from non-clinical controls. Diagnostic accuracy (sensitivity and specificity) of OCD measures is usually determined by comparing the total scores of heterogeneous OCD samples and controls. This, however, results in an underestimation of the measures' discrimination potential. Methods: Subtype-specific diagnostic accuracy and criterion-related validity of the Obsessive-Compulsive Inventory-Revised (OCI-R) subscales were examined in 113 patients with OCD and 320 non-clinical healthy controls. All subscales demonstrated very good criterion validity and excellent diagnostic accuracy to distinguish patients with specific OCD main symptom domains from controls. Conclusions: The cut-off-scores of the OCI-R and its subscales lead to accurate diagnostic decisions. The subscales are well suited for the discrimination of OCD subgroups from non-clinical controls and an identification of the treatment-relevant main symptoms of each patient. Thus, the OCI-R is not only an adequate screening instrument but can also be recommended to facilitate the selection of subgroup-specific interventions during treatment planning.