Top

BMC Psychiatry

Published in:

01-12-2021 | Obsessive-Compulsive Disorder | Research

Recognizing obsessive-compulsive disorder: how suitable is the German Zohar-Fineberg obsessive-compulsive screen?

Authors: Franziska Kühne, Tatjana Paunov, Florian Weck

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

Despite the prevalence of obsessive-compulsive disorder (OCD), its precise identification remains challenging. With the Zohar-Fineberg Obsessive-Compulsive Screen (ZF-OCS; 5 or 6 items), a brief instrument is widely available mainly in English. As there is a lack of empirical studies on the ZF-OCS, the aim of the present study was to translate the items into German and investigate the instrument in a nonclinical sample.

Methods

In two consecutive online surveys, n = 304 and n = 51 students participated. Besides the ZF-OCS, they answered established measures on OCD, depression, health anxiety, general anxiety and health-related well-being.

Results

Whereas internal consistency was low (α = .53–.72; ω = .55–.69), retest reliability (r_t1,t2 = .89) at two weeks was high. As expected, we found high correlations with other OCD instruments (r > .61; convergent validity), and significantly weaker correlations with measures of depression (r = .39), health anxiety (r = .29), and health-related well-being (r = −.28, divergent validity). Nonetheless, the correlations with general anxiety were somewhere in between (r = .52).

Conclusions

Due to heterogeneous OCD subtypes, the ZF-OCS asks diverse questions which probably resulted in the present internal consistency. Nevertheless, the results on retest reliability and validity were promising. As for other OCD instruments, divergent validity regarding general anxiety seems problematic to establish. Even so, the ZF-OCS seems valuable for screening purposes, as it is short and easy to administer, and may facilitate initiating subsequent clinical assessment. Further studies should determine the instrument’s diagnostic accuracy.

Available only for authorised users

American Psychiatric Association [APA]. Diagnostic and statistical manual of mental disorders. 5th ed. Washington: American Psychiatric Publishing; 2013.

Abramowitz JS, Deacon BJ, Olatunji BO, Wheaton MG, Berman NC, Losardo D, et al. Assessment of obsessive-compulsive symptom dimensions: development and evaluation of the dimensional obsessive-compulsive scale. Psychol Assess. 2010;22(1):180–98. https://doi.org/10.1037/a0018260.CrossRefPubMed

Kessler RC, Petukhova M, Sampson NA, Zaslavsky AM, Wittchen HU. Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res. 2012;21(3):169–84. https://doi.org/10.1002/mpr.1359.CrossRefPubMedPubMedCentral

Jacobi F, Höfler M, Siegert J, Mack S, Gerschler A, Scholl L, et al. Twelve-month prevalence, comorbidity and correlates of mental disorders in Germany: the mental health module of the German health interview and examination survey for adults (DEGS1-MH). Int J Methods Psychiatr Res. 2014;23(3):304–19. https://doi.org/10.1002/mpr.1439.CrossRefPubMedPubMedCentral

Koran LM. OCD and quality of life. In: Fineberg NA, Marazziti D, Stein D, editors. Obsessive-compulsive disorder: a practical guide. London: Martin Dunitz; 2001. p. 51–60.

Huppert JD, Simpson HB, Nissenson KJ, Liebowitz MR, Foa EB. Quality of life and functional impairment in obsessive-compulsive disorder: a comparison of patients with and without comorbidity, patients in remission, and healthy controls. Depress Anxiety. 2009;26(1):39–45. https://doi.org/10.1002/da.20506.CrossRefPubMedPubMedCentral

Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde [German Association for Psychiatry, Psychotherapy and Psychosomatics; DGPPN]. S3-Leitlinie Zwangsstörungen [S3-Guideline for OCD]. 2014. https://www.awmf.org/uploads/tx_szleitlinien/ 038_017l_S3_Zwangsst%C3%B6rungen_2013-abgelaufen.pdf. Accessed 15 Apr 2020.

Wahl K, Kordon A, Kuelz KA, Voderholzer U, Hohagen F, Zurowski B. Obsessive-compulsive disorder (OCD) is still an unrecognised disorder: a study on the recognition of OCD in psychiatric outpatients. Eur Psychiatry. 2010;25(7):374–7. https://doi.org/10.1016/j.eurpsy.2009.12.003.CrossRefPubMed

Olariu E, Forero CG, Castro-Rodriguez JI, Rodrigo-Calvo MT, Álvarez P, Martín-López LM, et al. Detection of anxiety disorders in primary care: a meta-analysis of assisted and unassisted diagnoses. Depress Anxiety. 2015;32(7):471–84. https://doi.org/10.1002/da.22360.CrossRefPubMed

10.

Zohar J. Obsessive compulsive disorder: current science and clinical practice. Hoboken, New Jersey: Wiley; 2012. https://doi.org/10.1002/9781119941125.CrossRef

11.

Szentagotai-Tatar A, Nechita DM, Miu AC. Shame in anxiety and obsessive-compulsive disorders. Current Psychiatry Reports. 2020;22(4):16. https://doi.org/10.1007/s11920-020-1142-9.CrossRefPubMed

12.

Veldhuis J, Dieleman JP, Wohlfahrt T, Storosum JG, van den Brink W, Sturkenboom CJ, et al. Incidence and prevalence of “diagnosed OCD” in a primary care, treatment seeking, population. Int J Psychiatry Clin Pract. 2012;16(2):85–92. https://doi.org/10.3109/13651501.2011.617454.CrossRefPubMed

13.

Fineberg NA, Roberts A. Obsessive compulsive disorder: a twenty-first century perspective. In: Fineberg NA, Marazziti D, Stein D, editors. Obsessive-compulsive disorder: a practical guide. London: Martin Dunitz; 2001. p. 1–13. https://doi.org/10.3109/9780203212899.CrossRef

14.

National Institute for Health and Care Excellence [NICE]. Obsessive-compulsive disorder (NICE Guideline 31). 2016. https://www.nice.org.uk/guidance/cg31/evidence. Accessed 15 Apr 2020.

15.

Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiler E, et al. The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59:34.

16.

Fineberg NA, O’Doherty C, Rajagopal S, Reddy K, Banks A, Gale TM. How common is obsessive-compulsive disorder in a dermatology outpatient clinic? J Clin Psychiatry. 2003;64(2):152–5. https://doi.org/10.4088/jcp.v64n0207.CrossRefPubMed

17.

Kühne F, Paunov T, Abramowitz JS, Fink-Lamotte J, Hansen B, Kvale G, et al. Screening for obsessive-compulsive symptoms: validation of the dimensional obsessive-compulsive scale – English and German short forms. J Obsess Compuls Relat Disord. 2021;29:100625. https://doi.org/10.1016/j.jocrd.2021.100625.CrossRef

18.

Fink-Lamotte J, Jahn I, Stierle C, Kühne F, Lincoln T, Stengler K, et al. Die Validierung der dimensional obsessive-compulsive scale (DOCS) an einer deutschsprachigen Stichprobe [validation of the dimensional obsessive-compulsive scale (DOCS) in a German sample]. Verhaltenstherapie. 2020;31(2):119–31. https://doi.org/10.1159/000510093.CrossRef

19.

Thibodeau MA, Leonard RC, Abramowitz JS, Riemann BC. Secondary psychometric examination of the dimensional obsessive-compulsive scale: classical testing, item response theory, and differential item functioning. Assessment. 2015;22(6):681–9. https://doi.org/10.1177/1073191114559123.CrossRefPubMed

20.

Foa EB, Huppert JD, Leiberg S, Langner R, Kichic R, Hajcak G, et al. The obsessive-compulsive inventory: development and validation of a short version. Psychol Assess. 2002;14(4):485–96. https://doi.org/10.1037/1040-3590.14.4.485.CrossRefPubMed

21.

Gönner S, Leonhart R, Ecker W. The obsessive-compulsive inventory-revised (OCI-R): validation of the German version in a sample of patients with OCD, anxiety disorders, and depressive disorders. J Anxiety Disord. 2008;22(4):734–49. https://doi.org/10.1016/j.janxdis.2007.07.007.CrossRefPubMed

22.

Gönner S, Leonhart R, Ecker W. Das Zwangsinventar OCI-R - die deutsche version des obsessive-compulsive inventory-revised - ein kurzes Selbstbeurteilungsinstrument zur mehrdimensionalen Messung von Zwangssymptomen [the German version of the obsessive-compulsive inventory-revised: a brief self-report measure for the multidimensional assessment of obsessive-compulsive symptoms]. Psychotherapie, Psychosomatik, Medizinische Psychologie. 2007. https://doi.org/10.1055/s−2007−970894.

23.

Löwe B, Wahl I, Rose M, Spitzer C, Glaesmer H, Wingenfeld K, et al. A 4-item measure of depression and anxiety: validation and standardization of the patient health Questionnaire-4 (PHQ-4) in the general population. J Affect Disord. 2010;122(1-2):86–95. https://doi.org/10.1016/j.jad.2009.06.019.CrossRefPubMed

24.

Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7. https://doi.org/10.1001/archinte.166.10.1092.CrossRefPubMed

25.

Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, et al. Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Med Care. 2008;46(3):266–74. https://doi.org/10.1097/MLR.0b013e318160d093.CrossRefPubMed

26.

Hinz A, Klein AM, Brähler E, Glaesmer H, Luck T, Riedel-Heller SG, et al. Psychometric evaluation of the generalized anxiety disorder screener GAD-7, based on a large German general population sample. J Affect Disord. 2017;210:338–44. https://doi.org/10.1016/j.jad.2016.12.012.CrossRefPubMed

27.

Weck F, Bleichhardt G, Hiller W. Screening for hypochondriasis with the illness attitude scales. J Pers Assess. 2010;92(3):260–8. https://doi.org/10.1080/00223891003670216.CrossRefPubMed

28.

Höfling V, Weck F. Assessing bodily preoccupations is sufficient: clinically effective screening for hypochondriasis. J Psychosom Res. 2013;75(6):526–31. https://doi.org/10.1016/j.jpsychores.2013.10.011.CrossRefPubMed

29.

Brähler E, Mühlan H, Albani C, Schmidt S. Teststatistische Prüfung und Normierung der deutschen Versionen des EUROHIS-QOL Lebensqualität-index und des WHO-5 Wohlbefindens-index [testing and standardization of the German version of the EUROHIS-QOL and WHO-5 quality of life indices]. Diagnostica. 2007;53(2):83–96. https://doi.org/10.1026/0012-1924.53.2.83.CrossRef

30.

Bland JM, Altman DG. Cronbach’s alpha. BMJ (Clinical Research Ed.). 1997; doi: https://doi.org/10.1136/bmj.314.7080.572.

31.

Hayes AF, Coutts JJ. Use omega rather than Cronbach’s alpha for estimating reliability. But …. Commun Methods Measures. 2020;14:1–24.CrossRef

32.

Feißt M, Hennigs A, Heil J, Moosbrugger H, Kelava A, Stolpner I, et al. Refining scores based on patient reported outcomes–statistical and medical perspectives. BMC Med Res Methodol. 2019;19(1):167. https://doi.org/10.1186/s12874-019-0806-9.CrossRefPubMedPubMedCentral

33.

Moosbrugger H, Kelava A. Testtheorie und Fragebogenkonstruktion [test theory and questionnaire construction]. 2nd ed. Berlin: Springer; 2012. https://doi.org/10.1007/978-3-642-20072-4.CrossRef

34.

Bortz J, Döring N. Forschungsmethoden und evaluation für human- und Sozialwissenschaftler [research methods and evaluation for human and social scientists]. Berlin: Springer; 2006. https://doi.org/10.1007/978-3-540-33306-7.CrossRef

35.

Weaver B, Wuensch KL. SPSS and SAS programs for comparing Pearson correlations and OLS regression coefficients. Behav Res Methods. 2013;45(3):880–95. https://doi.org/10.3758/s13428-012-0289-7.CrossRefPubMed

36.

American Psychiatric Association [APA]. Practice guideline for the treatment of patients with obsessive-compulsive disorder. 2007. http//www.psych.org/psych_pract/treatg/pg/prac_guide. cfm. Accessed 29 Oct 2020.

37.

Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int J Med Educ. 2011;2:53–5. https://doi.org/10.5116/ijme.4dfb.8dfd.CrossRefPubMedPubMedCentral

38.

Eilertsen T, Hansen B, Kvale G, Abramowitz JS, Holm SE, Solem S. The dimensional obsessive-compulsive scale: development and validation of a short form (DOCS-SF). Front Psychol. 2017;5(8):1503. https://doi.org/10.3389/fpsyg.2017.01503.CrossRef

39.

Abramowitz JS. Presidential address: are the obsessive-compulsive related disorders related to obsessive-compulsive disorder? A critical look at DSM-5’s new category. Behav Ther. 2018;49(1):1–11. https://doi.org/10.1016/j.beth.2017.06.002.CrossRefPubMed

40.

Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen [Institute for Quality and Efficiency in Health Care; IQWIG]. Glossar zu den allgemeinen Methoden [Glossary of general methods]. 2008. https://www.iqwig.de/download/Glossar_Version_1_0_zu_den_Allgemeinen_ Methoden_Version_3_0.pdf. Accessed 26 Oct 2020.

Title: Recognizing obsessive-compulsive disorder: how suitable is the German Zohar-Fineberg obsessive-compulsive screen?
Authors: Franziska Kühne
Tatjana Paunov
Florian Weck
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Obsessive-Compulsive Disorder
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03458-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Recognizing obsessive-compulsive disorder: how suitable is the German Zohar-Fineberg obsessive-compulsive screen?

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Simple action for depression detection: using kinect-recorded human kinematic skeletal data

Sex differences between serum total bilirubin levels and cognition in patients with schizophrenia

Suicidal ideation associated with depression and social support: a survey-based analysis of older adults in South Korea

Elevated levels of neutrophil gelatinase-associated lipocalin among OCD patients: an exploratory study

Prevalence of depression and associated factors among patients with type 2 diabetes mellitus in eastern Sudan

Understanding factors relevant to poor sleep and coping methods in people with schizophrenia