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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    • "Empirical data have shown that accommodation correlates with the severity of the obsessive-compulsive symptomatology (Storch et al. 2007, Peris et al. 2008, Stewart et al. 2008, Flessner et al. 2011, Lebowitz et al. 2012), with family distress (Amir et al. 2000), with greater attitudes of rejection towards the patient (Calvacoressi 1999), and with a worse quality of life in relatives (Steketee and Pruyn 1998; de Abreu Ramos- Cerqueira et al. 2008, Torres et al. 2012, Gururaj et al. 2008, Albert et al. 2009). For clinical purposes, it must be noted that family accommodation predicts a worse therapeutic response of the patient with regard to pharmacological treatments and to cognitivebehavioural ones such as Exposure and Response Prevention (Steketee and Van Noppen 2003, Renshaw et al. 2005, Ferrão et al. 2006, Storch et al. 2007, Garcia et al. 2010). "
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