Anxiety and OCD — Screening for Anxiety — Clinical Pathway: Outpatient Behavioral Health and Primary Care

Anxiety Disorder and OCD Clinical Pathway — Outpatient Behavioral Health and Primary Care

Screening for Anxiety and OCD

Screening and assessing a patient for anxiety and OCD can be effectively done through:

  • Standard clinical interview or
  • Use of a validated Screening Tool listed below

Note:
For younger patients or patients with substantial developmental delays or communication challenges,
information from parents/caregivers can augment the screening and assessment

Clinical Interview
  • Information gathered during the interview focused on the patient’s symptoms can effectively screen patient’s of all ages at risk who would benefit from further evaluation of possible anxiety / OCD Disorder.
  •  
  • Evaluate for the following:
    • Parent / patient with concern for Anxiety or OCD symptoms
    • Somatic complaints with out medical origin or treatment failure of physical symptoms
      e.g. chronic abdominal pain or headaches
    • Developmentally inappropriate behaviors
Screening tools
  • Identify patients that benefit from further evaluation
Assessment Rating Scales
  • Physical complaints not associated with medical diagnosis
  • Medical work up as indicated normal

Validated Brief Screening and/or Assessment Tools for Anxiety and OCD

Tool Age Range Details Scoring Criteria
SCARED
Screen for Child Anxiety Related Disorders
  • ≥ 8
  • Anxiety Screening & Assessment Tool
  • Parent and child self report versions available
  • Can be used as screening and/or assessment tool for all anxiety disorders
  • (Does not screen for OCD)
GAD-7
General Anxiety
Disorder - 7
  • ≥ 13
  • Generalized Anxiety Screening & Assessment Tool
  • Child self-report and parent version available
  • 7 question screen for :
    • GAD, Panic Disorder, and
    • Social Anxiety Disorder
  • Can be used as assessment/progress monitoring tool also
  • GAD-7 total score ranges from 0 to 21.
  • Consider further evaluation if score ≥ 10
Mild 5
Moderate 10
Severe 15
  • Meaningful change is 5 or more points
PSC-17
Pediatric Symptom Checklist  
  • 4 - 17
  • Broadband Mental Health Screening tool
  • Designed for use in primary care setting.
  •  
  • Child self-report and parent version available
  • Internalizing (including anxiety) score positive if ≥ 5
  • Externalizing score positive if ≥ 7
  • Attention score positive if ≥ 7
  • Total score positive if ≥ 15
CYBOCS – self report
Children’s Yale Brown Obsessive Compulsive Scale
  • 8 - 17
  • OCD Assessment Tool
  • Parent and child self report versions available
  •  
  • Assesses OCD symptoms over the past 1 week
  • Note:
    This version does not rate severity
  •  
CYBOCS – clinician administered
Children’s Yale-Brown Obsessive Compulsive Scale
  • 8 - 17
  •  
  • (18+ can use YBOCS)
  • OCD Assessment Tool
  • Clinician administered child report; can be done with child and parent together.
  •  
  • Assesses specific OCD-related obsessions and compulsions
  •  
  • Rates Severity
  • CYBOCS - Severity
  • Interpretation (Total score)
0 - 7 Subclinical
8 - 15 Mild
16 - 23 Moderate
24 - 31 Severe
32 - 40 Extreme
BOCS
Brief Obsessive Compulsive Scale
  • ≥ 15 self-report
  •  
  • < 15 interview completed by clinician
  • OCD Assessment Tool
  • Measures symptoms of OCD and identifying present (within the past week) and past symptoms.
  •  
  • Assesses current severity level.
  • Scoring instructions located at the bottom of the measure.