Obsessive-Compulsive Inventory-Revised

The Obsessive-Compulsive Inventory-Revised (OCI-R) is a widely used, psychometrically robust self-report measure designed to evaluate the severity and type…

Questions: 18
Duration: 5 min
Original title: OCI-R — Obsessive-Compulsive Inventory
Adaptation: Obsessive-Compulsive Inventory-Revised
Authors: Foa, E.B., Huppert, J.D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., & Salkovskis, P.M.
Created: 2002

The Obsessive-Compulsive Inventory-Revised (OCI-R) is a widely used, psychometrically robust self-report measure designed to evaluate the severity and type of obsessive-compulsive symptoms in adults. Developed by Foa et al. (2002) as a streamlined version of the original 42-item OCI, it retains excellent clinical utility while reducing patient burden.

The OCI-R captures symptom distress across six core dimensions: washing, obsessing, checking, ordering, neutralizing, and hoarding. Recognizing that hoarding often functions independently from other obsessive-compulsive traits, modern scoring guidelines isolate the hoarding items. This structural separation allows clinicians to track classic OCD severity while simultaneously monitoring hoarding pathology.

As a repeatable measure, the OCI-R is highly sensitive to treatment effects, making it a valuable tool for tracking progress throughout a course of therapy. By establishing a clear baseline of symptom severity and distress, clinicians can better tailor their interventions, whether mapping the OCD loop or initiating graded exposure. It serves both as an initial metric to anchor shared psychoeducation and an ongoing tool to evaluate treatment outcomes.

Example result

Fictitious result, computed from a sample set of answers.

OCI-OCD score — OCD symptoms (15 items, hoarding excluded)

30/ 60

An 18-item self-report questionnaire assessing the severity of obsessive-compulsive symptoms over the past month in adults. Since the DSM-5 reclassification of hoarding disorder as a distinct condition from OCD, it is scored into two separate totals: the score displayed here is the OCI-OCD (0–60), the sum of the 15 items covering five dimensions of OCD — washing, obsessing, ordering, checking, and neutralizing (3 items each). The 3 hoarding items are NOT included in this score: they form the OCI-HD score (0–12), presented below in the “hoarding” subscale with its own clinical cutoff (≥ 6).

0–11

Below clinical threshold

12–21

Mildly distressing

22–36

Moderately distressing

37–51

Very distressing

52–60

Extremely distressing

Descriptor based on published percentile divisions of the OCD normative sample (OCI-OCD score 0–60).

For information

Cut-off≥ 12Clinical level of distress from OCD behaviours

Best balance between false positives and false negatives to indicate clinical significance for the OCD component. [15-item OCI-OCD score, 0–60 — the total no longer includes hoarding.]

Wootton et al. (2015)

Scoring

Total sum + subscale sum, total score ranging from 0 to 60, each item is scored on a 5-point scale (from 0 to 4).

Washing

5/ 12

Assesses concerns about contamination and the compulsive washing and cleaning behaviors used to neutralize these fears.

items 5, 11, 17

généralemixed · general population · Spain · n = 84 · Belloch et al. (2013)

012

M = 0.84 ± 1.22

généralemixed · general population · Italy · n = 340 · Sica et al. (2009)

012

M = 0.9 ± 1.5

cliniquemixed · pathology: ocd · Spain · n = 90 · Belloch et al. (2013)

012

M = 4.63 ± 4.24

cliniquemixed · pathology: anxiety disorder · Spain · n = 31 · Belloch et al. (2013)

012

M = 0.58 ± 0.84

cliniquemixed · pathology: ocd · Italy · n = 52 · Sica et al. (2009)

012

M = 4.4 ± 4.6

cliniquemixed · pathology: anxiety disorder · Italy · n = 36 · Sica et al. (2009)

012

M = 0.5 ± 1.1

Checking

6/ 12

Assesses repetitive checking behaviors driven by doubts and the need to prevent feared consequences.

items 2, 8, 14

généralemixed · general population · Spain · n = 84 · Belloch et al. (2013)

012

M = 2.96 ± 2.47

généralemixed · general population · Italy · n = 340 · Sica et al. (2009)

012

M = 1.3 ± 2

cliniquemixed · pathology: ocd · Spain · n = 90 · Belloch et al. (2013)

012

M = 6.2 ± 4.18

cliniquemixed · pathology: anxiety disorder · Spain · n = 31 · Belloch et al. (2013)

012

M = 3.45 ± 3.39

cliniquemixed · pathology: ocd · Italy · n = 52 · Sica et al. (2009)

012

M = 3.6 ± 3.5

cliniquemixed · pathology: anxiety disorder · Italy · n = 36 · Sica et al. (2009)

012

M = 1.6 ± 2.5

Hoarding

3/ 12

Measures difficulty discarding possessions, excessive acquisition of items, and problems with clutter that interfere with living spaces.

items 1, 7, 13

0–5

Hoarding: below threshold

6–12

Clinical level of hoarding

OCI-HD score below the clinical cutoff of 6.

généralemixed · general population · Spain · n = 84 · Belloch et al. (2013)

012

M = 3.01 ± 2.38

généralemixed · general population · Italy · n = 340 · Sica et al. (2009)

012

M = 1.7 ± 2.1

cliniquemixed · pathology: ocd · Spain · n = 90 · Belloch et al. (2013)

012

M = 3.41 ± 3.15

cliniquemixed · pathology: anxiety disorder · Spain · n = 31 · Belloch et al. (2013)

012

M = 2.55 ± 2.8

cliniquemixed · pathology: ocd · Italy · n = 52 · Sica et al. (2009)

012

M = 1.9 ± 2.5

cliniquemixed · pathology: anxiety disorder · Italy · n = 36 · Sica et al. (2009)

012

M = 0.9 ± 1.7

Ordering

9/ 12

Captures the need for symmetry, exactness, and arranging objects in precise ways until they feel “just right.”

items 3, 9, 15

généralemixed · general population · Spain · n = 84 · Belloch et al. (2013)

012

M = 3.71 ± 2.67

généralemixed · general population · Italy · n = 340 · Sica et al. (2009)

012

M = 1.9 ± 2.3

cliniquemixed · pathology: ocd · Spain · n = 90 · Belloch et al. (2013)

012

M = 4.61 ± 3.7

cliniquemixed · pathology: anxiety disorder · Spain · n = 31 · Belloch et al. (2013)

012

M = 4.03 ± 3.71

cliniquemixed · pathology: ocd · Italy · n = 52 · Sica et al. (2009)

012

M = 4.3 ± 3.8

cliniquemixed · pathology: anxiety disorder · Italy · n = 36 · Sica et al. (2009)

012

M = 1.4 ± 2.1

Obsessing

3/ 12

Measures distressing intrusive thoughts, images, or impulses that are difficult to remove from one’s mind.

items 6, 12, 18

généralemixed · general population · Spain · n = 84 · Belloch et al. (2013)

012

M = 1.98 ± 2.04

généralemixed · general population · Italy · n = 340 · Sica et al. (2009)

012

M = 1.6 ± 2.4

cliniquemixed · pathology: ocd · Spain · n = 90 · Belloch et al. (2013)

012

M = 7.9 ± 3.44

cliniquemixed · pathology: anxiety disorder · Spain · n = 31 · Belloch et al. (2013)

012

M = 4.19 ± 3.11

cliniquemixed · pathology: ocd · Italy · n = 52 · Sica et al. (2009)

012

M = 8 ± 3.6

cliniquemixed · pathology: anxiety disorder · Italy · n = 36 · Sica et al. (2009)

012

M = 3.4 ± 3.3

Neutralizing

7/ 12

Measures mental rituals and covert behaviors (such as repeating special words, praying, or counting) used to cancel or neutralize distressing thoughts or prevent feared outcomes.

items 4, 10, 16

généralemixed · general population · Spain · n = 84 · Belloch et al. (2013)

012

M = 0.59 ± 1.19

généralemixed · general population · Italy · n = 340 · Sica et al. (2009)

012

M = 0.3 ± 0.93

cliniquemixed · pathology: ocd · Spain · n = 90 · Belloch et al. (2013)

012

M = 3.13 ± 3.9

cliniquemixed · pathology: anxiety disorder · Spain · n = 31 · Belloch et al. (2013)

012

M = 1.61 ± 2.44

cliniquemixed · pathology: ocd · Italy · n = 52 · Sica et al. (2009)

012

M = 2.7 ± 3.9

cliniquemixed · pathology: anxiety disorder · Italy · n = 36 · Sica et al. (2009)

012

M = 0.2 ± 0.7

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What the test measures

The OCI-R measures the level of distress caused by various obsessive-compulsive symptoms over the past month. It isolates six distinct clinical dimensions to help clinicians understand the anxiety experience and map the patient's primary areas of difficulty.

Washing: Distress related to contamination fears and excessive cleaning behaviors.
Obsessing: The frequency and emotional burden of intrusive, unwanted thoughts.
Checking: Compulsions involving the repeated verification of safety details, such as locks or appliances.
Ordering: The rigid need for symmetry, specific arrangements, or distress when objects are displaced.
Neutralizing: Mental compulsions such as counting or relying on "good" and "bad" numbers to mitigate anxiety.
Hoarding: Difficulty discarding objects and the accumulation of unnecessary possessions.

This instrument is designed for adults, both in clinical and non-clinical settings, to pinpoint specific symptom clusters and quantify subjective distress.

When and why to use it

Clinicians utilize the OCI-R to efficiently assess and monitor obsessive-compulsive symptoms throughout the therapeutic process. It offers targeted insights that facilitate diagnostic clarity and treatment planning.

Intake baseline: To map the topography of the patient's symptoms during the initial assessment and recognize OCD presentations across multiple domains.
Monitoring change: To track specific improvements in targeted behavioral routines over the course of therapy.
Screening and cut-off: To identify clinically significant symptom burden using validated thresholds for both classic OCD and hoarding.
Differential support: To distinguish obsessive-compulsive distress from general worry or health anxiety, clarifying the clinical formulation.

Using a validated score provides an objective anchor that complements clinical impression, ensuring that nuanced shifts in symptom distress are accurately documented over time.

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The questions

The following statements refer to experiences that many people have in their everyday lives. Read each statement carefully and indicate HOW MUCH that experience has distressed or bothered you DURING THE PAST MONTH. The numbers correspond to the following answers: 0 = Not at all; 1 = A little; 2 = Moderately; 3 = A lot; 4 = Extremely.
1. I have hoarded so many things that they get in my way.
This item probes the physical impact of accumulating possessions on the patient's living space.
- Not at all
- A little
- Moderately
- A lot
- Extremely
2. I check things more often than is necessary.
This item assesses the general frequency of checking behaviors beyond practical necessity.
- Not at all
- A little
- Moderately
- A lot
- Extremely
3. I get upset if objects are not arranged properly.
This item evaluates the emotional distress triggered by a lack of symmetry or order.
- Not at all
- A little
- Moderately
- A lot
- Extremely
4. I feel compelled to count while I'm doing things.
This item screens for mental or behavioral compulsions related to counting during daily activities.
- Not at all
- A little
- Moderately
- A lot
- Extremely
5. I have difficulty touching an object when I know it has been touched by strangers or by certain people.
This item probes contamination fears specifically linked to contact with other people.
- Not at all
- A little
- Moderately
- A lot
- Extremely
6. I have difficulty controlling my own thoughts.
This item explores the subjective difficulty in managing intrusive or unwanted cognitive processes.
- Not at all
- A little
- Moderately
- A lot
- Extremely
7. I collect things I don't need.
This item assesses the tendency to acquire items that lack functional value or necessity.
- Not at all
- A little
- Moderately
- A lot
- Extremely
8. I check doors, windows, drawers, etc. over and over.
This item targets specific checking rituals related to domestic security features.
- Not at all
- A little
- Moderately
- A lot
- Extremely
9. I get upset if others change the way I have arranged things.
This item evaluates distress when external interference disrupts the patient's rigid spatial arrangements.
- Not at all
- A little
- Moderately
- A lot
- Extremely
10. I feel the need to repeat certain numbers.
This item screens for neutralizing compulsions involving the repetition of specific numbers.
- Not at all
- A little
- Moderately
- A lot
- Extremely
11. I sometimes have to wash or clean myself simply because I feel contaminated.
This item probes the urge to engage in washing rituals driven by a subjective sense of contamination.
- Not at all
- A little
- Moderately
- A lot
- Extremely
12. Unpleasant thoughts come into my mind against my will and I can't get rid of them.
This item assesses the presence of ego-dystonic, intrusive thoughts that cause emotional distress.
- Not at all
- A little
- Moderately
- A lot
- Extremely
13. I have difficulty throwing things away because I'm afraid I might need them later.
This item evaluates the difficulty discarding possessions due to anticipatory anxiety about future needs.
- Not at all
- A little
- Moderately
- A lot
- Extremely
14. I check the gas, water taps, and light switches over and over after turning them off.
This item targets checking compulsions specifically related to household hazards and appliances.
- Not at all
- A little
- Moderately
- A lot
- Extremely
15. I need things to be arranged in a particular order.
This item probes the rigid need for specific spatial organization or visual symmetry.
- Not at all
- A little
- Moderately
- A lot
- Extremely
16. I feel that there are good and bad numbers.
This item screens for superstitious thinking or magical associations assigned to particular numbers.
- Not at all
- A little
- Moderately
- A lot
- Extremely
17. I wash my hands more often and for longer than is necessary.
This item assesses the excessive frequency and duration of hand-washing behaviors.
- Not at all
- A little
- Moderately
- A lot
- Extremely
18. I frequently have unpleasant thoughts and have difficulty getting rid of them.
This item explores the chronicity of disturbing cognitive intrusions and the difficulty dismissing them.
- Not at all
- A little
- Moderately
- A lot
- Extremely