Obsessive Compulsive Screening Checklist
People with OCD usually have difficulty with some of the following activities. Answer each question by checking the appropriate number next to it.
General Information
(optional)
Name of Doctor/Therapist:
Name of Patient:
List Obsessions:
List Compulsions:
OCD Screening Checklist
Instructions:
0 - No problem with activity; takes me same time as average person. I do not need to repeat or avoid it.
1 - Activity takes me twice as long as most people, or I have to repeat it twice, or I tend to avoid it.
2 - Activity takes me three times as long as most people, or I have to repeat it three or more times, or I usually avoid it.
- Activity -
- Score -
1.
Taking a Bath or Shower
0
1
2
2.
Washing Hands and Face
0
1
2
3.
Care of Hair (eg, washing, combing, brushing)
0
1
2
4.
Brushing Teeth
0
1
2
5.
Dressing and Undressing
0
1
2
6.
Using Toilet to Urinate
0
1
2
7.
Using Toilet to Defecate
0
1
2
8.
Touching People or Being Touched
0
1
2
9.
Handling Waste or Waste Bins
0
1
2
10.
Washing Clothing
0
1
2
11.
Washing Dishes
0
1
2
12.
Handling or Cooking Food
0
1
2
13.
Cleaning your Home
0
1
2
14.
Keeping things Tidy
0
1
2
15.
Bed Making
0
1
2
16.
Cleaning Shoes
0
1
2
17.
Touching Door Handles
0
1
2
18.
Touching own Genitals, Petting, or Sexual Intercourse
0
1
2
19.
Throwing Things Away
0
1
2
20.
Visiting a Hospital
0
1
2
21.
Turning Lights and Taps On or Off
0
1
2
22.
Locking or Closing Doors or Windows
0
1
2
23.
Using Electrical Appliances (eg, heaters)
0
1
2
24.
Doing Arithmetic, Accounts or Bills
0
1
2
25.
Getting to Work or School
0
1
2
26.
Doing Own Work
0
1
2
27.
Writing
0
1
2
28.
Filling Out Forms
0
1
2
29.
Mailing Letters
0
1
2
30.
Reading
0
1
2
Interpretation
Total score 11-20: increases the possibility of OCD and further evaluation is recommended
Total score +20: highly suggestive of OCD
This page has been visited:
times since 02/04/00. Updated: 02/06/00
Source: Solvay Pharmaceuticals OCD Screener form.