Dimensional analysis of burden in family caregivers of patients with obsessive-compulsive disorder: Dimensions of burden in OCD caregivers

Department of Neurology, Psychology and Psychiatry, Botucatu Medical School Botucatu Medical School, Institute of Biosciences, Univ Estadual Paulista, Botucatu, SP, Brazil.
Psychiatry and Clinical Neurosciences (Impact Factor: 1.63). 08/2012; 66(5):432-41. DOI: 10.1111/j.1440-1819.2012.02365.x
Source: PubMed


Obsessive-compulsive disorder (OCD) also generates emotional burden in the patient's family members, but no study has evaluated the specific dimensions of burden. The objectives were to evaluate the dimensions of the Zarit Burden Interview (ZBI) and possible correlates.
This was a cross-sectional study involving 47 patients and 47 caregivers, using a sociodemographic questionnaire; the ZBI; the Self Reporting Questionnaire; the Family Accommodation Scale; and the Yale-Brown Obsessive-Compulsive Scale. The ZBI factor analysis was conducted using Varimax Rotation.
Six factors were identified, explaining 74.2% of the total variance: factor 1, interference in the caregiver's personal life (36.6% of the variance); factor 2, perception of patient's dependence (10.8%); factor 3, feelings of irritation or intolerance (9.2%); factor 4, guilt (7.2%); factor 5, insecurity (5.6%); and factor 6, embarrassment (4.8%). The six ZBI factors were associated with greater OCD severity and with greater accommodation to the patient's symptoms, and factors 1, 2, 5 and 6 with caregiver's psychological morbidity. Caregiver's sex (female) was associated with factors 5 and 6, relationship with the patient (being a parent or son/daughter) with factor 5, higher educational level with factor 6, living with the patient with factor 3, worse self-evaluation of health with factors 1, 5 and 6, and occupational status (not working) with factors 1, 2, 5 and 6.
The dimensions of burden identified indicate the most affected aspects of a caregiver's life and could guide the planning of more specific interventions. Thus, the caregiver could participate more effectively in the OCD patient's treatment, with a lower impact on his/her life.

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Available from: Ana Teresa de Abreu Ramos-Cerqueira, Dec 16, 2014
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    ABSTRACT: Obsessive-compulsive disorder (OCD) impacts family functioning as family members modify their personal and family routines, participate in rituals, and provide reassurance. These behaviors have been identified as family accommodation (FA), a phenomenon that, if ignored, may facilitate OCD symptoms and lead to poorer prognosis. Because FA has been recognized as a predictor of treatment outcome, we examined the prevalence of FA and identified patient and family socio-demographic and clinical variables associated with FA in an outpatient sample. The study comprised 228 subjects, namely, 114 patients with OCD and 114 family members, assessed before the patients entered a 12-session cognitive-behavioral group therapy program. A multivariate linear regression model was used to control for confounding factors and to evaluate variables independently associated with FA. FA was evaluated using the Family Accommodation Scale for Obsessive-Compulsive Disorder - Interviewer Rated (FAS-IR). FA was found to be highly prevalent among family members. Two patient factors positively associated with FA were OCD severity as measured by the Clinical Global Impressions Scale (CGI) and higher scores on the Obsessions dimension of the Obsessive-Compulsive Inventory - Revised (OCI-R). Family members' characteristics positively associated with FA were higher scores on the OCI-R hoarding subscale and being the patient's spouse. Our findings suggest that the early identification of patients and family members who could benefit from interventions aimed at reducing FA could improve treatment outcomes.
    Psychiatry and Clinical Neurosciences 02/2014; 68(8). DOI:10.1111/pcn.12172 · 1.63 Impact Factor