Examining the relationship between family accommodation and stigma in obsessive-compulsive disorder

Objective: This study aims to examine the relationship between family accommodation, which has gained increasing importance in recent treatment strategies for Obsessive-Compulsive Disorder (OCD), and internalized stigma among relatives sharing the same living space with individuals diagnosed with OCD. Our main hypothesis suggests a positive correlation between family accommodation and internalized stigma observed in patients' relatives. Materials and Methods: After obtaining written informed consent from all participants, patients were evaluated using the Sociodemographic Data Form, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Family Accommodation Scale for Obsessive-Compulsive Disorder Patient Version (FAS-PV), Internalized Stigma of Mental Illness Scale (ISMI), and Dimensional Obsessive-Compulsive Scale (DOCS), while relatives were assessed using the Parents Internalized Stigma of Mental Illness Scale (PISMI). Findings: The FAS-PV assessed the frequency of family accommodation behaviors over the past week. It was observed that all family members of the 64 participants exhibited at least one accommodation behavior. The most frequently reported behaviors were providing reassurance for obsessions (96.8%), providing reassurance for compulsions (89.0%), and waiting due to compulsions (79.6%). Spearman Correlation Analysis revealed statistically significant positive correlations between FAS-PV scores and Y-BOCS (r = 0.756, p < 0.01), BDI (r = 0.652, p < 0.01), BAI (r = 0.601, p < 0.01), ISMI (r = 0.350, p < 0.01), and PISMI (r = 0.762, p < 0.01) scores. Regression analysis demonstrated that the PISMI strongly predicted family accommodation behaviors. An increase in the family's perception of stigma was found to intensify accommodation behaviors. This relationship remained significant for the severity of OCD, anxiety, and depression symptoms. A statistically significant relationship was identified between FAS-PV scores and the contamination subscale of the Y-BOCS (r = 0.285, p < 0.05), while no significant relationships were found with the Responsibility, Symmetry, or Unacceptable Thoughts subscales (p > 0.05). Conclusion: The results of the study revealed a statistically significant relationship between family accommodation and internalized stigma observed in relatives of patients. As internalized stigma increased, family accommodation intensified. Family accommodation is a clinical feature that negatively impacts treatment effectiveness and disease progression in OCD. This study highlights the potential importance of strategies aimed at reducing stigma perception in relatives of OCD patients as a target for therapeutic intervention and provides valuable insights for future research. Keywords: Obsessive Compulsive Disorder, Family Accommodation, Stigmatization