Predictors of family accommodation in obsessive compulsive disorder

Family accommodation (FA) has been consistently recognized as a predictor of treatment outcome in obsessive-compulsive disorder (OCD). However, the factors determining FA are not clearly understood, especially in adult patients with OCD. We recruited a consecutive sample of predominantly adult subjects (n=100), who presented to the specialty OCD Clinic with a primary diagnosis of OCD along with a suitable caregiver. Patient and family members completed measurements assessing FA along with other clinical variables of interest. Clinical variables found statistically significant in bivariate analyses (p < 0.05) were examined in multivariate linear regression analysis to determine the predictors of FA. Age, gender and marital status of the patient, contamination symptom dimension, severity of avoidance, severity scores on Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and scores on work and social adjustment scale were associated with FA in bivariate analysis. In multiple regression analysis, contamination dimension, the severity of avoidance, relationship of caregiver and poorer work and social adjustment predicted FA. Patients with poor socio-occupational functioning, severe avoidance, caregiver being spouse and contamination related symptoms are accommodated more by family members. Screening and management of FA, particularly in patients with the contamination dimension may thus help improve treatment outcome.