Print out this form and rate the average occurrence of each item during the prior week. Scores should reflect the composite effect of all of your obsessive compulsive symptoms.
Item | Range of Severity | |||||
---|---|---|---|---|---|---|
1. Time Spent on obsessions | 0 hr/day | 0-1 hrs/day | 1-3 hrs/day | 3-8 hrs/day | +8 hrs/day | |
Score | 0 | 1 | 2 | 3 | 4 | |
2. Interference from obsessions | None | Mild | Definite but Manageable |
Substantial Impairment |
Incapacitating | |
Score | 0 | 1 | 2 | 3 | 4 | |
3. Distress from obsessions | None | Little | Moderate but Manageable |
Severe | Near Constant, Disabling |
|
Score | 0 | 1 | 2 | 3 | 4 | |
4. Resistance to obsessions | Always Resist |
Much Resistance |
Some Resistance |
Often Yields |
Completely Yields |
|
Score | 0 | 1 | 2 | 3 | 4 | |
5. Control over obsessions | Complete Control |
Much Control |
Some Control |
Little Control |
No Control |
|
Score | 0 | 1 | 2 | 3 | 4 | |
6. Time spent on compulsions | 0 hr/day | 0-1 hrs/day | 1-3 hrs/day | 3-8 hrs/day | +8 hrs/day | |
Score | 0 | 1 | 2 | 3 | 4 | |
7. Interference from compulsions | None | Mild | Definite but Manageable |
Substantial Impairment |
Incapacitating | |
Score | 0 | 1 | 2 | 3 | 4 | |
8. Distress from compulsions | None | Little | Moderate but Manageable |
Severe | Near Constant Disabling |
|
Score | 0 | 1 | 2 | 3 | 4 | |
9. Resistance to compulsions | Always Resist |
Much Resistance |
Some Resistance |
Often Yields |
Completely Yields |
|
Score | 0 | 1 | 2 | 3 | 4 | |
10. Control over compulsions | Complete Control |
Much Control |
Some Control |
Little Control |
No Control |
|
Score | 0 | 1 | 2 | 3 | 4 |
Total Score
|
Severity
|
0-7
|
Subclinical
|
8-15
|
Mild
|
16-23
|
Moderate
|
24-31
|
Severe
|
32-40
|
Extreme
|
If your score falls in the Subclinical to Mild range, you may benefit from relaxation and/or mindfullness coaching
If your score falls in the Moderate to Severe range, you may benefit from specific therapy from a counsellor experienced with OCD treatment
If your score falls in the Extreme range, you may benefit from the help of a phsychiatrist and a counsellor experienced with OCD treatment
This is only a preliminary screening test for obsessive/compulsive symptoms that does not replace in any way a formal psychiatric evaluation. It is designed to give a preliminary idea about the presence of obsessive/compulsive symptoms that indicate the need for an evaluation by a psychiatrist or medical practitioner.