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Objectives The use of normative data has become well-accepted and a common strategy to interpret individual's health outcome scores, which can help in making decisions. The objectives of this study were to obtain population normative data for the domains and component summaries of the 36-item SF-36® Health Survey (SF-36), and to evaluate its reliability and construct validity. Methods This study was conducted using population-based data from the Welsh Health Survey (WHS; 2011–2015). This study used version 2 of the SF-36 (SF-36v2® Health Survey). The descriptive statistics and normative data for the eight domains and two summaries, physical component summary (PCS) and mental component summary (MCS), were calculated. Reliability assessment used internal consistency methods and construct validity assessment used known group comparisons and item–scale correlations. Study design and sample We performed a secondary analyses of data from the Welsh Health Survey (WHS). Results This study included 74,578 participants aged 16 years or older (53.6% were women). Participants aged 16–24 years scored higher on SF-36 scale than older groups on all domains. The SF-36 profiles by age group demonstrated lower scores for older age groups, with the most pronounced differences shown on the physical-related scales. Across the age groups, men had higher PCS and MCS scores than women. All SF-36 domains and PCS and MCS achieved a good to excellent internal consistency reliability exceeding 0.7. The scales demonstrated construct validity by showing associations with a range of factors known to be related to health. Conclusions This study provides SF-36 normative data for Wales based on a representative data and confirms the construct validity and reliability of the SF-36., Objectives: The use of normative data has become well-accepted and a common strategy to interpret individual's health outcome scores, which can help in making decisions. The objectives of this study were to obtain population normative data for the domains and component summaries of the 36-item SF-36® Health Survey (SF-36), and to evaluate its reliability and construct validity. Methods: This study was conducted using population-based data from the Welsh Health Survey (WHS; 2011–2015). This study used version 2 of the SF-36 (SF-36v2® Health Survey). The descriptive statistics and normative data for the eight domains and two summaries, physical component summary (PCS) and mental component summary (MCS), were calculated. Reliability assessment used internal consistency methods and construct validity assessment used known group comparisons and item–scale correlations. Study design and sample: We performed a secondary analyses of data from the Welsh Health Survey (WHS). Results: This study included 74,578 participants aged 16 years or older (53.6% were women). Participants aged 16–24 years scored higher on SF-36 scale than older groups on all domains. The SF-36 profiles by age group demonstrated lower scores for older age groups, with the most pronounced differences shown on the physical-related scales. Across the age groups, men had higher PCS and MCS scores than women. All SF-36 domains and PCS and MCS achieved a good to excellent internal consistency reliability exceeding 0.7. The scales demonstrated construct validity by showing associations with a range of factors known to be related to health. Conclusions: This study provides SF-36 normative data for Wales based on a representative data and confirms the construct validity and reliability of the SF-36.

Background: Symptoms of depression and anxiety are common in children with obsessive-compulsive disorder (OCD) and associated with more severe OCD, greater impairment, and worse treatment outcome. Beyond twin studies showing that genetic factors contribute to the high co-occurrence, few studies have examined how OCD, depression, and anxiety are linked in youth, and current studies often fail to account for OCD and anxiety heterogeneity. Methods: Network analysis was used to investigate how OCD were linked to depression and anxiety in multinational youth diagnosed with OCD (total n = 419) and in school-recruited, community-based samples of youth (total n = 2 991). Results: Initial results aligned with earlier work showing that severity of obsession-related symptoms are important in linking OCD to depression in youth with OCD. However, when symptom content of OCD (e.g., washing, ordering) was fully taken into account and when measures of anxiety were included, specific OCD symptom dimensions (primarily obsessing and doubting/checking) were linked to specific anxiety dimensions (primarily panic and generalized anxiety) which in turn were linked to depression. These results were replicated in three separate community-based samples from Chile, Italy, and Spain using different measures of anxiety and depression. Limitations: Cross-sectional data were analyzed which precludes causal inference. Self-report measures were used. Conclusions: Youth with OCD with symptoms related to doubting/checking and obsessing should be carefully assessed for symptoms of panic and generalized anxiety. Non-responders to standard OCD treatment may benefit from interventions targeting panic and generalized anxiety, but more research is needed to test this hypothesis.

Objective: Obsessive-compulsive disorder (OCD) is a heterogeneous condition with well-established symptom dimensions across the lifespan. The objective of the present study was to use network analysis to investigate the internal structure of these dimensions in unselected schoolchildren and in children with OCD. Method: We estimated the network structure of OCD symptom dimensions in 6,991 schoolchildren and 704 children diagnosed with OCD from 18 sites across 6 countries. All participants completed the Obsessive-Compulsive Inventory−Child Version. Results: In both the school-based and clinic-based samples, the OCD dimensions formed an interconnected network with doubting/checking emerging as a highly central node, that is, having strong connections to other symptom dimensions in the network. The centrality of the doubting/checking dimension was consistent across countries, sexes, age groups, clinical status, and tic disorder comorbidity. Network differences were observed for age and sex in the school-based but not the clinic-based samples. Conclusion: The centrality of doubting/checking in the network structure of childhood OCD adds to classic and recent conceptualizations of the disorder in which the important role of doubt in disorder severity and maintenance is highlighted. The present results suggest that doubting/checking is a potentially important target for further research into the etiology and treatment of childhood OCD.