title: Family accommodation of obsessional symptoms and naturalistic outcome of obsessive-compulsive disorder.
abstract: Accommodation of symptoms by families and expressed emotion (EE) may have a negative impact on the outcome of obsessive-compulsive disorder (OCD). The study examines the effect of family accommodation (FA) and EE on the 1-year naturalistic outcome of OCD. Patients with OCD who met the criteria for the Diagnostic and Statistical Manual of Mental Disorders-IV, text revision (DSM-IV TR; N=94) were followed up for 1 year and assessed every 3 months. Assessments included measurement of symptom severity, FA, EE and family burden. By the 12th month, the cumulative probability of remission was 58%. Non-remitters compared with remitters had a significantly higher FA, EE and family burden at the baseline and did not report significant reductions on any of the family variables over the year. In a Cox proportional hazard regression analysis, a higher FA at the baseline significantly predicted time to remission. FA of symptoms has a significant negative impact on the naturalistic outcome of OCD. This emphasises the need to design specific interventions to reduce FA for a better outcome.
authors.affiliation: Department of Psychiatry, K. S. Hegde Medical Academy, Nitte University, Mangalore, India; Department of Psychiatric Social Work, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India. Electronic address: anishvcherian@gmail.com.
authors.forename: Anish V
authors.initials: AV
authors.lastname: Cherian
authors.affiliation: Department of Psychiatric Social Work, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India.
authors.forename: Dhanasekhara
authors.initials: D
authors.lastname: Pandian
authors.affiliation: Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India.
authors.forename: Suresh
authors.initials: S
authors.lastname: Bada Math
authors.affiliation: Department of Biostatistics, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India.
authors.forename: Thennarasu
authors.initials: T
authors.lastname: Kandavel
authors.affiliation: Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India.
authors.forename: Y C
authors.initials: YC
authors.lastname: Janardhan Reddy
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017028:Caregivers / Q000523:psychology; D017281:Cost of Illness; D019260:Expressed Emotion; D005190:Family / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009770:Obsessive Behavior / Q000523:psychology*; D009771:Obsessive-Compulsive Disorder / Q000523:psychology*; D055815:Young Adult
keywords: Expressed emotion; Family accommodation; Obsessive–compulsive disorder; Outcome