Comparison of Early Maladaptive Schemas in Obsessive-Compulsive Disorder Patients, Their Siblings, and Controls

The aim of this study was to determine the levels of early maladaptive schemas in obsessive-compulsive disorder patients, their siblings, and healthy controls to evaluate the association between genetic and environmental factors and early maladaptive schemas.

The study group included 42 obsessive-compulsive disorder patients who were admitted to and diagnosed with obsessive-compulsive disorder at the outpatient psychiatry clinic of Karadeniz Technical University Medical School between December 2017 and November 2018 and their 24 siblings who were born to and raised by the same parents and 42 volunteers. Diagnoses were based on the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. The patients filled out the Young Schema Questionnaire Short Form-3 and the Yale-Brown Obsession-Compulsion Scale.

The groups were similar in terms of age, sex, marital status, occupation, presence of comorbidity, and income level. The comparison of the scores of Young Schema Questionnaire Short Form-3 subscales revealed significant differences among the groups in failure, pessimism, social isolation/alienation, approval-seeking, enmeshment, abandonment, punishment, and defectiveness schemas. The post hoc analysis revealed that pessimism and defectiveness were significantly different between the patient and sibling groups, and approval-seeking, enmeshment, and abandonment were significantly different between the control and the sibling groups. The comparison of the Yale-Brown Obsession-Compulsion Scale and the Young Schema Questionnaire Short Form-3 results revealed that the subscales of enmeshment, failure, approval-seeking, and unrelenting standards were significantly correlated with the obsession and compulsion subscales and the total score in the Yale-Brown Obsession-Compulsion Scale.

We found similarities between early maladaptive schemas in the obsessive-compulsive disorder patients and their healthy siblings. We also found differences between the siblings and the healthy controls. These findings suggest a familial and genetic basis for the early maladaptive schemas in obsessive-compulsive disorder patients, which should be further evaluated in future studies with larger samples.