Psychometric properties of the OCI-4: a brief screening tool for perinatal obsessive-compulsive disorder

PurposeObsessive-compulsive disorder (OCD) has an elevated prevalence among pregnant and postpartum women, with negative impacts on both mother and child. There is a need for brief, efficient screening tools for OCD in perinatal care because OCD is underrecognized. We evaluated the psychometric properties of the 4-item Obsessive Compulsive Inventory (OCI-4), and investigated it as a screening measure, in a perinatal sample.MethodsPregnant women were assessed at 20- and 34-weeks' gestation, 6 weeks postpartum, and 6 months postpartum. Reliability was assessed via test-retest analyses, and validity was examined through correlations with established measures. Criterion-related validity and diagnostic sensitivity were also examined.ResultsThe OCI-4 demonstrated good test-retest reliability, convergent and discriminant validity, and criterion-related validity. The measure also showed moderate to high diagnostic sensitivity. A score of 3 provided the best balance of sensitivity and specificity for screening.ConclusionThe OCI-4 is an effective screener that should be used for identifying OCD symptoms in perinatal settings. Despite the need for further study, its ease of use and quick administration make it a valuable tool for early detection and referral for assessment intervention. The OCI-4 reliably detects OCD symptoms in pregnant and postpartum women.The OCI-4 distinguishes OCD from generalized anxiety, especially well in the postpartum period.A score of 3 on the OCI-4 is effective for identifying potential OCD during pregnancy and postpartum.OCI-4 is best used to flag potential OCD for a psychiatric referral, not for a definitive diagnosis.