Pietermaritzburg Patient Form – YBOCS form for OCD

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This form is strictly confidential and is encrypted with a SSL certificate on a secure server. We never share your information with any third parties. Alternatively you can download a copy of the form and submit it to [email protected].

A copy of your results will be emailed to KetaMIND Clinics South Africa. Should your score indicate you are severely obsessive-compulsive, we may contact you to discuss available treatment options, including but not limited to KCSA Infusion Therapy.

This form is to be filled in prior to coming in for treatment.

    Obsessions

    Obsessions are frequent, unwelcome, and intrusive thoughts.

    1. How much time do you spend on obsessive thoughts?

    01234

    2. How much do your obsessive thoughts interfere with your personal, social, or work life?

    01234

    3. How much do your obsessive thoughts distress you?

    01234

    4. How hard do you try to resist your obsessions?

    01234

    5. How much control do you have over your obsessive thoughts?

    01234

    Compulsions

    Compulsions are repetitive behaviors or mental acts aimed at reducing anxiety or preventing a dreaded event.

    6. How much time do you spend performing compulsive behaviors?

    01234

    7. How much do your compulsive behaviors interfere with your personal, social, or work life?

    01234

    8. How anxious would you feel if prevented from performing compulsive behaviors?

    01234

    9. How hard do you try to resist your compulsive behaviors?

    01234

    10. How much control do you have over your compulsive behaviors?

    01234

    Total OCD Score:

    Interpretation:

    If you have both obsessions and compulsions, and your total score is:

    8–15 = Mild OCD

    16–23 = Moderate OCD

    24–31 = Severe OCD

    32–40 = Extreme OCD

    No single test is completely accurate. Always consult your physician.



      Tell us about your experience!

      We strive for high levels of patient care, we would really value your feedback on the bad experience you had

        Tell us about your experience!

        We strive for high levels of patient care, we would really value your feedback on the bad experience you had

          Tell us about your experience!

          We strive for high levels of patient care, we would really value your feedback on the bad experience you had

            Tell us about your experience!

            We strive for high levels of patient care, we would really value your feedback on the bad experience you had

              Tell us about your experience!

              We strive for high levels of patient care, we would really value your feedback on the bad experience you had

                Tell us about your experience!

                We strive for high levels of patient care, we would really value your feedback on the bad experience you had