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Diagnostic Discrimination of Patients with Different OCD Main Symptom Domains from each Other and from Anxious and Depressive Controls

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Abstract

The extent to which the subscales of multidimensional OCD measures accurately distinguish patients with specific OCD main symptom domains from controls at different cutscores has not yet been examined. Diagnostic accuracy of OCD measures usually is determined by comparing the total scores of heterogeneous OCD samples and controls and therefore may underestimate the measures’ discrimination potential. In the current study, subtype-specific diagnostic accuracy and criterion-related validity of the Obsessive-Compulsive Inventory-Revised (OCI-R) subscales were examined in 327 patients with OCD, anxiety, and/or depressive disorders. All subscales demonstrated good to excellent criterion-related validity and diagnostic accuracy for distinguishing patients with specific OCD main symptom domains from controls. As expected, the single OCI-R subscales lead to more accurate diagnostic decisions than the total scale. Thus, the subscale-specific cutscores significantly improve the OCI-R’s utility for subtype-specific treatment planning and outcome measurement. Furthermore, an alternative classification algorithm distinguishing patients with OCD from controls based on subscale cutscores leads to a better sensitivity, but also to a lower specificity than discrimination based on the total scale cutscore.

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Notes

  1. Fifty-four patients with OCD who participated in the Gönner et al. (2008) study had to be excluded, because they either did not answer the Y-BOCS-SRS Symptom Checklist (n = 21; at the beginning of the study, the first participants did not receive the Checklist) or did not rate which symptoms of the Checklist are the most severe and impairing obsessions and compulsions (n = 33). Drop-out analyses showed no significant differences between completers and drop-outs in symptom severity and socio-demographic variables like age, sex, and education.

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Authors and Affiliations

  1. Psychosomatic Clinic of Bad Dürkheim, Bad Dürkheim, Germany

    Sascha Gönner

  2. Institute of Behaviour Therapy, Bad Dürkheim, Germany

    Willi Ecker

  3. Department of Social Psychology and Methodology, University of Freiburg, Freiburg, Germany

    Rainer Leonhart

  4. Poliklinische Institutsambulanz für Psychotherapie, Johannes Gutenberg-Universität Mainz, Staudinger Weg 9, 55099, Mainz, Germany

    Sascha Gönner

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  1. Sascha Gönner
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  2. Willi Ecker
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  3. Rainer Leonhart
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Correspondence to Sascha Gönner.

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Gönner, S., Ecker, W. & Leonhart, R. Diagnostic Discrimination of Patients with Different OCD Main Symptom Domains from each Other and from Anxious and Depressive Controls. J Psychopathol Behav Assess 31, 159–167 (2009). https://doi.org/10.1007/s10862-008-9114-0

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