Family Accommodation in Caregiving Family Members of Patients with Obsessive-Compulsive Disorder and Its Associated Clinical and Demographic Factors

Abstract

Background: Family accommodation, a common behavior among relatives of patients with obsessive-compulsive disorder (OCD), may contribute to the persistence of the disorder and may hinder treatment response. Objectives: This study aimed to investigate family accommodation among family members who provide care for patients with OCD and to examine associated demographic and clinical factors. Methods: In this cross-sectional analytical study, 113 patients with OCD and 113 caregiving family members were recruited from two psychiatric clinics in Guilan Province, Iran, between 2022 and 2023. Data were obtained from psychiatric records, clinical interviews, and three instruments: the Global Assessment of Functioning, the self-rated Family Accommodation Scale, and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Results: Current OCD symptom severity at the time of assessment was positively correlated with family accommodation. Conversely, symptom improvement (the difference between initial and current Y-BOCS scores documented in the records) and overall patient functioning were negatively correlated with family accommodation (P < 0.01). Stepwise multiple linear regression analysis indicated that higher global functioning and male caregiver gender were independently and negatively associated with family accommodation, accounting for 16.4% of the variance (adjusted R2 = 0.164, P < 0.001). Independent-samples t tests and one-way analyses of variance showed no significant differences in family accommodation between groups (P > 0.05). Conclusions: Family accommodation is significantly associated with current patient functioning and caregiver gender among patients undergoing treatment for OCD. These findings underscore the importance of monitoring family accommodation and suggest that integrating family-focused strategies into clinical management may improve treatment outcomes.