Quality of life and associated risk factors in relatives of patients with obsessive compulsive disorder

Introduction: Obsessive compulsive disorder (OCD) is chronic disease that affects family and social relationships, occupational and academic performance for both the patients and their relatives due to cognitive, emotional and behavioral aspects of the disease. OCD may affect patients' family members, friends and society. Disease burden and deterioration in quality of life in relatives of patients with OCD have been previously reported and compared to relatives of patients with other psychiatric conditions. However, there are few studies available in the literature regarding causality of quality of life in relatives of patients with OCD. Objective: We aimed to evaluate quality of life, burden of disease in relatives of patients with OCD and factors that negatively effect their lives. Material and methods: Sixty-eight patients with OCD and their 68 relativeswere included in the study. Following SCID-I/CV psychiatric evaluation, sociodemographic data form, Yale-Brown obsessive-compulsive scale (Y-BOCS), Y-BOCS symptom checklist, Hamilton depression rating scale (HDRS) and World Health Organization quality of life questionnaire brief form (WHOQOL-BREF TR) were completed in the patient group. In patients' relatives group, following SCID-I/CV psychiatric evaluation, sociodemographic data form, burden assessment scale (BAS) and WHOQOL-BREF TR were completed. The dependent variables were "quality of life in patients' relatives"and "burden in patients' relatives". In single variable analyses, Student's t test, ANOVA and Pearson correlation, Kruskal Wallis ANOVA and Mann Whitney U, Spearman's Rho correlation tests were performed. In multiple variable analyses, linear multiple regression test was used. Results: Linear regression analysis showed that the quality of life in relatives of patients with OCD may be affected by their education levels, gender, occupational factors, quality of life in the patient, severity of the disease and type of compulsions. However, the most important variable effecting the quality of life in the relatives was burden of the disease. Moreover, we found that burden was also effecting their quality of life as an intervening variable due to patient characteristics. Factors that can be observed by the relatives such as duration of treatment, severity of compulsions (Y-BOCS compulsion score), patient's insight, avoidance behaviour, degree of instability appeared to cause extra burden and negatively effect their quality of life. Also, patient's occupation status and environmental quality of life were the most important factors that effected burden of disease, suggesting that lower socioeconomic level is associated with increased burden. Discussion:Disease burden is the most important variable effecting quality of life in relatives of patients with OCD and contributes as an intervening variable. Perceived burden among relatives was evaluated to be effected by compulsions and lower socioeconomic level due to their occupational status. Our findings suggest that OCD effects both the patient and their relatives. Therefore, it is essential to inform the relatives, to examine their needs and allow their participation in treatment procedures while evaluating the patients with OCD. To decrease the disease burden may be the most importantpreventive mental health attempt to improve quality of life in relatives of patients with OCD. Key words: Obsessive compulsive disorder, quality of life in patients with obsessive compulsive disorder, burdenin patients' relatives