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Multicenter Study
. 2017 Mar;56(3):241-249.e3.
doi: 10.1016/j.jaac.2016.12.012. Epub 2016 Dec 27.

A Multisite Study of Family Functioning Impairment in Pediatric Obsessive-Compulsive Disorder

S Evelyn Stewart  1 , Yu-Pei Hu  2 , Aldrich Leung  3 , Elaine Chan  4 , Dianne M Hezel  5 , Sarah Yao Lin  6 , Laura Belschner  6 , Casey Walsh  7 , Daniel A Geller  8 , David L Pauls  8
Affiliations
Multicenter Study

A Multisite Study of Family Functioning Impairment in Pediatric Obsessive-Compulsive Disorder

S Evelyn Stewart et al. J Am Acad Child Adolesc Psychiatry. 2017 Mar.

Abstract

Objective: Familial aspects of pediatric obsessive-compulsive disorder (OCD), including accommodation and treatment, have received notable and warranted attention. However, individual perspectives of its repercussions on family functioning, including emotional and occupational parental burden, have not been closely examined. The present study details this topic using a large multicenter sample.

Method: Participants included 354 youth affected with OCD and their mothers and fathers ascertained through OCD programs in Boston, Massachusetts (n = 180) and Vancouver, British Columbia (n = 174). The validated OCD Family Functioning Scale and standard OCD measurements were completed. Descriptive, between-site, and cross-perspective comparative analyses were followed by regression model testing to predict family impairment.

Results: Family functioning was negatively affected from youth, mother, and father perspectives. Impairment was reportedly more extensive at the time of worst OCD severity and was greater from maternal versus paternal viewpoints. Most frequently affected family tasks and implicated OCD symptoms included morning and bedtime routines and intrusive thoughts. Emotional repercussions in all members included stress and anxiety, followed by frustration or anger in youth and sadness in parents. Nearly half of mothers and one third of fathers reported daily occupational impairment. Compared with youth self-report, parents perceived fewer social and academic effects on their child. Family accommodation most consistently predicted family impairment, especially from parent perspectives. OCD and compulsion severity, contamination and religious obsessions, and comorbidities also predicted various perspectives of family subdomain impairment.

Conclusion: This study quantitatively details the pervasive burden that pediatric OCD places on families, as reported from complementary relative perspectives. Further attention to this topic is warranted in clinical and research realms.

Keywords: emotional; family; obsessive-compulsive disorder; occupational; parents.

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Conflict of interest statement

Disclosure: Dr. Stewart serves on the Scientific and Clinical Advisory Board of the International OCD Foundation and served as a Medical Advisory Board Member of the Tourette Association of America between 2012–2016. Dr. Geller has received grant or research support from the National Institute of Mental Health, Pfizer, Eli Lilly and Co., GlaxoSmithKline, Otsuka, Forest, Shire, and Neurocrine. He has received honoraria from the American Academy of Child and Adolescent Psychiatry and the Massachusetts General Hospital Psychiatry Academy. He has served on the speakers’ bureau of Eli Lilly and Co. Drs. Hu, Leung, Pauls and Mss. Chan, Hezel, Lin, Belschner, Walsh report no biomedical financial interests or potential conflicts of interest.

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References

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