Family Accommodation in Obsessive Compulsive Disorder and Its Association With Insight
Usha Devi1, Pragya Sharma2, Lokesh Singh Shekhawat3
1Dept. of Psychiatry, AIIMS, New Delhi, India.
Background:
Family accommodation (FA) is defined as a family members' involvement by doing certain behavior in response to the daily rituals of patients with obsessive-compulsive disorder (OCD). FA is associated with more severe symptoms of OCD. Similarly, poor insight is associated with high severity of OCD symptoms. FA and insight are also related to each other, as more accommodative behavior of family members is associated with poor insight.
Methods:
This cross-sectional observational study assessed 103 adult OCD patients with an illness duration of at least one year. Participants were assessed using Yale-Brown Obsessive Compulsive Scale (Y-BOCS) symptom checklist, Y-BOCS to assess severity, and Family Accommodation Scale-SR (Hindi) to evaluate FA. Insight was assessed with the 11th item of Y-BOCS.
Results:
FA was common in the families of our participants. The mean±SD Y-BOCS score was 28.72±5.09, and the mean FAS-SR score was 44.1±12.03. A significant positive correlation existed between the FA and YBOCS scores, that is, with the increase in FA, YBOCS scores also significantly increased. A considerable number reported poor insight, and had high scores on YBOCS and their caregiver had high FA scores.
Conclusion:
FA is indicative of high symptom severity of OCD and higher FA is associated with poor insight, so FA needs further research for its interplay with OCD symptomatology and role in the maintenance of symptoms.
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