Predittori del coinvolgimento dei familiari nel Disturbo Ossessivo Compulsivo: ruolo dei domini cognitivi.

Family accommodation is the term used to indicate the process whereby family members of patients with obsessive-compulsive disorder (OCD) assist or participate in the patients' rituals. Family members can, further resist and oppose OCD behaviors such as ingnoring the ritual, attempting to stop the patient from performing compulsion or forced traumatic exposure to the fear-including stimuli. Besides being directly involved in the patient's symptoms, family members frequently suffer from the consequences of living with and caring for people with a cronic and disabling disease (Steketee, 1997). The negative impact of this situation can influence interaction between patients and their relatives, causing exacerbation of quality of life in both patients and their relatives. Family accommodation is a relatively under-researched phenomenon in OCD but an important one because it may be predictive of poor treatment outcome. This study systematically examined several socio-demographic and clinical variables that are associated with family accommodation in a well-characterized sample of adult patients and their healthy family members. Experienced clinicians administered the Family Accommodation Scale (FAS) to 203 psychopathology-free family members cohabiting with 136 patients with OCD. The FAS total score (1-9 item) was introduced as dependent variables in a series of multiple regression models assessing the relationship between family accommodation and a wide range of clinical variables, including symptom dimensions derived from the Yale-Brown Obsessive-Compulsive Scale (YBOCS) Symptom Checklist and belief domain of the Obsessive Beliefs Questionnaire-44 (OBQ-44). The study used the OBQ-44 and OBQ-TRIP to assess if a specific cognitive vulnerability in family memers and in patient can be a predictor of Family Accommodation. In fact the OBQ-44 was developed to measure beliefs considered important un the development and maintenance of OCD. Multiple linear regression analyses showed that the metacognitive dimension of importance and control of thoughts (OBQ I/C), the age of onset and the female sex in parents emerged as consistent predictors of family accommodation. Our study confirms that family accommodation is frequent and distressing in psychopathology-free family members cohabiting with adult OCD patients. Family accommodation is particularly frequent and distressing in female cargiver, when the patient has an early onset and when he has a high score at the obsessive belief of importance and control of thoughts (OBQ-44). Such families may be more likely to benefit from family-based interventions.