Y-BOCS (Yale-Brown Obsessive Compulsive Scale)
Y-BOCS scoring guide: 10-item clinician-administered OCD severity scale. Two subscales — Obsessions (0–20) and Compulsions (0–20). Total score 0–40. Severity cutoffs: 0–7 subclinical, 8–15 mild, 16–23 moderate, 24–31 severe, 32–40 extreme. Goodman et al. (1989).
Y-BOCS Score Interpreter
Score 8–15. Mild OCD; clinically significant symptoms that may warrant treatment.
10 items across two subscales (Obsessions and Compulsions), each rated 0–4; total score 0–40; higher scores indicate greater OCD severity.
| Total score | Interpretation |
|---|---|
| 32+ | ExtremeScore 32–40. Extreme symptom severity; near-constant obsessions/compulsions with severe functional impairment. |
| 24–31 | SevereScore 24–31. Severe OCD with major interference in daily functioning. |
| 16–23 | ModerateScore 16–23. Moderate OCD; typical range for clinical trial enrollment. |
| 8–15 | MildScore 8–15. Mild OCD; clinically significant symptoms that may warrant treatment. |
| 0–7 | SubclinicalScore 0–7. Subclinical range; consistent with remission or no clinically significant OCD. |
Goodman et al. (1989) developed the scale. Severity ranges reflect common clinical convention. Educational reference only — not a diagnostic tool.
What is the Y-BOCS?
The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was developed by Wayne Goodman, Lawrence Price, Steven Rasmussen, and colleagues and published in 1989. It was specifically designed to measure the severity of obsessive-compulsive disorder (OCD) independently of the specific type or content of obsessions and compulsions, allowing consistent tracking across highly heterogeneous presentations, from contamination fears to symmetry obsessions to harm obsessions and checking rituals.
The Y-BOCS consists of 10 items divided into two subscales: five items rating obsessions and five items rating compulsions. Each item is rated 0 (none) to 4 (extreme) across five dimensions: time occupied, interference with functioning, distress, resistance, and perceived control. The Obsessions Subscale ranges from 0 to 20 and the Compulsions Subscale ranges from 0 to 20, giving a total possible score of 0 to 40. The scale is administered via structured clinical interview, which is typically preceded by a Y-BOCS Symptom Checklist to identify the patient's specific obsessions and compulsions.
The Y-BOCS is the universally accepted primary outcome measure in OCD clinical trials and is the standard against which newer OCD scales are validated. A 35% or greater reduction in total Y-BOCS score is the most commonly used definition of treatment response in clinical trials of cognitive-behavioural treatment and pharmacotherapy. It remains essential for both research and clinical measurement-based care in OCD.
Obsessions Subscale (O)
5 items: O1 time occupied by obsessions; O2 interference; O3 distress; O4 resistance; O5 control. Each rated 0–4. Subscale total 0–20.
Compulsions Subscale (C)
5 items: C1 time occupied by compulsions; C2 interference; C3 distress; C4 resistance; C5 control. Each rated 0–4. Subscale total 0–20.
Symptom Checklist (Optional)
The Y-BOCS Symptom Checklist (58 items) identifies the specific obsessions and compulsions present before scoring begins. Not scored but guides rating focus.
Y-BOCS Score Interpretation
Goodman et al. (1989). The total score is the sum of the Obsessions Subscale (0–20) and Compulsions Subscale (0–20). A 35% or greater total score reduction is the standard definition of treatment response in clinical trials.
Subscale Score Reference
Enter the Obsessions and Compulsions subscale totals from a completed Y-BOCS interview to calculate the total score and severity band. Educational reference only. Cannot replace clinical evaluation or a full structured Y-BOCS interview.
The Five Y-BOCS Dimensions
Both the Obsessions and Compulsions subscales use the same five dimensions, each rated 0 (none) to 4 (extreme). This parallel structure allows direct comparison between obsessive and compulsive symptom burden.
Time Occupied
How much time per day is consumed by obsessions or compulsions? 0=none; 1=less than 1 hour/day; 2=1–3 hours; 3=3–8 hours; 4=more than 8 hours. Captures the overall symptom burden most directly.
Interference
How much do the symptoms interfere with social, occupational, or other functioning? 0=none; 1=slight; 2=definite impairment but manageable; 3=substantial impairment; 4=nearly incapacitating. Reflects functional impact.
Associated Distress
How much distress do the obsessions or compulsions cause? 0=none; 1=mild; 2=moderate; 3=severe; 4=near-constant, disabling distress. Distress ratings often diverge between obsessions and compulsions.
Resistance
How much does the patient try to resist? 0=always tries to resist; 4=completely gives in. Note that this dimension is reverse-scored in clinical interpretation, higher resistance effort means lower clinical concern, but higher ratings (less resistance) indicate greater severity.
Control
How much control does the patient have over the obsessions or compulsions? 0=complete control; 4=no control. Control captures the experienced sense of ability to resist or stop symptoms and tends to be highly sensitive to treatment change.
Track Y-BOCS Treatment Response Longitudinally in HiBoop
Automated subscale scoring, treatment response tracking, and clinical documentation for OCD patients, Y-BOCS alongside OCI-R and other measures in HiBoop.
Frequently Asked Questions
What does a high Y-BOCS score mean?
A Y-BOCS total score of 24–31 indicates severe OCD, and a score of 32–40 indicates extreme OCD. These ranges reflect a commonly used clinical convention and are not derived from a single primary publication. Higher scores indicate greater time occupied by symptoms, more interference with functioning, more distress, less resistance, and less control over obsessions and compulsions.
Is the Y-BOCS self-report or clinician-administered?
The Y-BOCS is a clinician-administered structured interview. A trained clinician rates each of the 10 items using standardized anchor descriptions during a face-to-face interview, typically preceded by a Symptom Checklist. It cannot be scored from a questionnaire alone, though separate self-report adaptations (such as the Y-BOCS-II Self-Report) have been developed and validated for research use.
Can the Y-BOCS diagnose OCD?
No. The Y-BOCS measures symptom severity in people already assessed for OCD — it is not a diagnostic instrument. A diagnosis of OCD requires a structured clinical interview or evaluation against DSM-5 or ICD-11 criteria. The Y-BOCS is used after diagnosis to quantify severity, guide treatment planning, and track response over time.
What Y-BOCS score reduction indicates treatment response?
A reduction of 35% or more in total Y-BOCS score from baseline is the standard definition of treatment response used in clinical trials of both cognitive-behavioural therapy (exposure and response prevention) and serotonin reuptake inhibitor pharmacotherapy. This threshold was established in the original Goodman et al. (1989) validation work and has remained the field standard.
References
- 1.Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006-1011.View source
- 2.Goodman WK, Price LH, Rasmussen SA, Mazure C, Delgado P, Heninger GR, Charney DS. The Yale-Brown Obsessive Compulsive Scale. II. Validity. Arch Gen Psychiatry. 1989;46(11):1012-1016.View source
- 3.López-Pina JA, Sánchez-Meca J, López-López JA, et al. The Yale-Brown Obsessive Compulsive Scale: A Reliability Generalization Meta-Analysis. Assessment. 2015;22(5):619-628.View source
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The Y-BOCS (Yale-Brown Obsessive Compulsive Scale) qualifies for reimbursement under these CPT codes (US).
Last reviewed: Jun 3, 2026
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