Routine screening for obsessive-compulsive disorder in child and youth mental health services using the Obsessive-compulsive Inventory-Child Version-5 (OCI-CV-5)

Background Obsessive Compulsive Disorder (OCD) is a debilitating disorder affecting 2–3% of children and adolescents. Despite availability of effective treatments, diagnosis is often delayed. We investigated the implementation of routine OCD screening in public mental health services for children and young people. Methods Six public health service teams and their clients were invited to participate. Three services consecutively implemented the Obsessive-compulsive Inventory-Child Version-5 (OCI-CV-5) screener. Clients with positive OCI-CV-5 scores were offered referral to a specialised OCD team for assessing diagnostic caseness using the Anxiety Disorders Interview Schedule-5 (ADIS-5) including clinical severity scores. Receiver Operating Characteristic (ROC) analysis on the confirmed OCD diagnosis group to re-examine the sensitivity and specificity of the OCDI-CV-5. Results Despite variable implementation across services, the OCI-CV-5 showed moderate, positive correlation with ADIS-5 clinician severity ratings r  = 0.46, p  = 0.007. Significant differences among the diagnostic groups were found on OCI-CV-5 score, H(2) = 7.08, p  = 0.029, with the diagnosis group ranking highest (20.91), the subclinical group (16.00) and no diagnosis group (9.50). An ROC analysis demonstrated raising the OCI-CV-5 cut-off from 3 to 7 would improve sensitivity (0.56) and specificity (0.12). Conclusions Paediatric OCD detection in public health services remains an important challenge. Future research should evaluate screening measures, including the OCI-CV-5, across settings.