Psychiatric Interview Components
One important component of the psychiatric interview is gathering the history of present illness (HPI) (Carlat, 2017). One piece of the HPI is gathering information on the current and premorbid level of functioning (Carlat, 2017). I find this component important because it establishes which symptoms of the illness may be interfering with the patient’s daily activities. For example, a patient may state that their anxiety has gotten to the point where they are no longer able to participate in family gatherings, which is something they once enjoyed. In addition, this establishes a baseline for the patient (Carlat, 2017). This information may establish treatment goals for the patient. Yale-Brown Obsessive-Compulsive Scale
A second component of the psychiatric interview is obtaining a family psychiatric history (Carlat, 2017). I find this component of the interview important because oftentimes psychiatric illnesses, or risk of substance use disorders, have a familial tie. For example, for a patient presenting to the clinic with depressive symptoms that have a significant family history of bipolar, it may be pertinent to inquire about symptoms of mania that the patient may not recognize as symptoms of a psychiatric disorder.
A third component of the psychiatric interview is obtaining a psychiatric history (Carlat, 2017). I find this piece of the psychiatric interview important because it gathers information about past treatments and the age of onset of symptoms (Carlat, 2017) Yale-Brown Obsessive-Compulsive Scale. It is important for a clinician to know which treatments were already tried and whether or not they were successful.
The rating scale that I was assigned to explore and discuss is the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Originally developed for adults, this is a ten-item scale that establishes the severity of Obsessive-Compulsive Disorder (OCD) after a formal diagnosis is made (Stanford Medicine, 2020). The scale was developed in 1989, it showed psychometric properties in measuring the effects of medication and psychotherapy for the treatment of OCD (Castro-Rodrigues et al., 2018). However, the original scale showed a weakness in measuring severe cases and inconsistently measuring resistance to obsessions (Castro-Rodrigues et al., 2018).
The scale was revised in 2000, now known as the Y-BOCS-II (Castro-Rodrigues et al., 2018). Items in the scale were rephrased and the order of assessments were changed; this is now used as the gold standard to measure the severity of OCD symptom (Castro-Rodrigues et al., 2018) Yale-Brown Obsessive-Compulsive Scale.
Rating Scale Used in Practice
As stated above, the Y-BOCS is not used to make a case for the diagnosis of OCD, but rather establish the severity of symptoms. A clinician may implement this assessment and then share it with their patient in an attempt to assist the patient in recognizing the severity of their symptoms, and which symptoms may be part of their illness (Standford Medicine, 2020). In addition, a response to treatment may be measured through a decrease in scoring on the sale (Stanford Medicine, 2020).The revised scale, Y-BOCS II, has been found to have excellent psychometric properties in the measurement of the severity of OCD symptoms (Castro-Rodrigues et al., 2018) Yale-Brown Obsessive-Compulsive Scale.
Since its creation in 1989 for use in adult patients, the scale has been modified to assess children and adolescents (Lopez-Pina et al., 2015). In addition to assessing the severity of symptoms in OCD, the scale is useful in measuring the severity of symptoms where compulsions are a symptom of the disorder; for example, such as eating disorders, gambling, etc. (Lopez-Pina et al., 2015).
Carlot, D. (2017).The psychiatric interview(4thed.). Wolters Kluwer.
Castro-Rodrigues, P., Camacho, M., Almeida, S., Marinho, M., Soares, S., Barahona-
Correa, J., & Oliveira-Maia, A. (2018). Criterion validity of the Yale-Brown Obsessive-Compulsive Scale second edition for the diagnosis of obsessive-compulsive disorder in adults.Frontiers in Psychiatry, 9,431. https://www.frontiers.org/articles/10.3389/fpsyt.2018.00431/full Yale-Brown Obsessive-Compulsive Scale
Lopez-Pina, J., Sanchez-Meca, J., Lopez-Lopez, J., Marin-Martinez, F., Nunez-Nunez,
R., Rosa-Alcazar, A., … & Ferrer-Requena, J. (2015). The Yale-Brown Obsessive-Compulsive Scale: a reliability generalization meta-analysis.Assessment, 22(5), 619.628. https://www.researchgate.net/profile/Ja-Lopez-Pina/publication/266380252_The_Yale-Brown_Obessive_Compulsive_Scale/links/550090d70cf2de950a6ea031/The-Yale-Brown-Obsessive-Compulsive-Scale.pdf
Stanford Medicine. (2020). Obsessive-compulsive and related disorders.
https://med.stanford.edu/ocd/about/diagnosis.html Yale-Brown Obsessive-Compulsive Scale