The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores from 0 to 40. Which score range indicates SEVERE OCD requiring aggressive treatment consideration including clomipramine augmentation or deep brain stimulation referral?
- A 0-7 (subclinical)
- B 8-15 (mild)
- C Greater than or equal to 24 (severe to extreme) ✓
- D 16-23 (moderate)
Correct answer: C. Greater than or equal to 24 (severe to extreme)
Explanation
Y-BOCS scoring: 0-7 subclinical, 8-15 mild, 16-23 moderate, 24-31 severe, 32-40 extreme. Scores ≥24 indicate severe OCD warranting aggressive pharmacotherapy (high-dose SSRI, clomipramine augmentation, or combination) and consideration of neuromodulation (DBS, rTMS) in treatment-resistant cases. Y-BOCS assesses time occupied by obsessions/compulsions, interference, distress, resistance, and control, separately for obsessions and compulsions.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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