Predictors of family accommodation in obsessive-compulsive disorder.
BACKGROUND
Obsessive-compulsive disorder (OCD) is a serious, disabling illness. Family members are frequently involved by attempting to stop rituals or by performing rituals for their relative. Factors associated with family accommodation of OCD have been largely overlooked in the literature. This study aims to identify the frequency and clinical predictors of OCD family accommodation behaviors.


METHODS
Participants include those with a first admission to the McLean/Massachusetts General Hospital OCD Institute (N = 110). The Family Accommodation Scale was completed independently by family members. Univariate relationships between factors and family accommodation were assessed via graphs, parametric and non-parametric testing. Multiple regression analyses modeled relationships between family accommodation and predictor variables.


RESULTS
Family accommodation was reported in 96.9% of cases, and predominantly occurred at least daily (59.1% of cases). Most common behaviors included providing reassurance and waiting for ritual completion. Two of 13 potential predictors were significantly correlated with family accommodation both in univariate regression analysis and in the final regression model (F = 10.15; p < 0.0001; R-square = 0.17; adjusted R-Square = 0.15). These include OCD severity (p = 0.0007) and the cleaning/contamination symptom dimension (p = 0.03).


CONCLUSIONS
Family accommodation is ubiquitous in OCD. Psychoeducation regarding potential deleterious effects of accommodation must not be overlooked in management of this illness.
OCD Institute, McLean Hospital, Psychiatric and Neurodevelopmental Genetics Unit, Belmont, Massachusetts 02114, USA. stewart@pngu.mgh.harvard.edu
S Evelyn
SE
Stewart
Caitlin
C
Beresin
Stephen
S
Haddad
Denise
D
Egan Stack
Jeanne
J
Fama
Michael
M
Jenike
D000328:Adult; D001290:Attitude; D001519:Behavior; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology* / Q000523:psychology*; D011379:Prognosis; D012720:Severity of Illness Index