ABSTRACT
Relatives frequently accommodate patients' obsessive-compulsive symptoms and clinicians hypothesize that such accommodations adversely affect patient outcome. This study's purpose was to develop a valid and reliable measure, the Family Accommodation Scale for Obsessive-Compulsive Disorder (FAS), and to investigate the family accommodation construct. We administered the FAS and additional family and patient measures to 36 adult obsessive-compulsive patients and their primary caregivers. The FAS demonstrated excellent interrater reliability and good internal consistency and performed well on assessment of its convergent and discriminant validity. Family accommodation was significantly associated with patient symptom severity and functioning, and with relatives' own obsessive-compulsive symptoms. Although most relatives accommodated patient symptoms, many did not believe that such accommodations improved the patient's clinical status. The FAS will provide researchers and clinicians with a useful tool for assessing family accommodation and for identifying families who may benefit from interventions aimed at developing more adaptive coping strategies.
Subject(s)
Family Relations , Obsessive-Compulsive Disorder/diagnosis , Psychiatric Status Rating Scales/statistics & numerical data , Adaptation, Psychological , Adult , Caregivers/psychology , Family Health , Family Therapy , Humans , Obsessive-Compulsive Disorder/psychology , Obsessive-Compulsive Disorder/therapy , Psychometrics , Reproducibility of Results , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
A chart review was conducted to compare the social, occupational, and daily functioning of 17 inpatients with obsessive-compulsive disorder, 17 with major depression, and 17 with schizophrenia. Current Global Assessment of Functioning (GAF) scores of patients with schizophrenia were significantly lower than those of patients with depression and with obsessive-compulsive disorder. However, on work performance, daily living skills, and past-year GAF scores, patients with obsessive-compulsive disorder and those with schizophrenia did not differ significantly, and both groups were significantly more impaired than patients with depression. Results show that inpatients with obsessive-compulsive disorder may exhibit severe and chronic functional impairments requiring extensive supportive and rehabilitative services.
Subject(s)
Depressive Disorder, Major/diagnosis , Obsessive-Compulsive Disorder/diagnosis , Patient Admission , Schizophrenia/diagnosis , Activities of Daily Living/psychology , Adult , Depressive Disorder, Major/psychology , Depressive Disorder, Major/rehabilitation , Female , Humans , Male , Middle Aged , Obsessive-Compulsive Disorder/psychology , Obsessive-Compulsive Disorder/rehabilitation , Psychiatric Status Rating Scales , Rehabilitation, Vocational , Schizophrenia/rehabilitation , Schizophrenic Psychology , Social AdjustmentABSTRACT
Seasonality of mood disorders might involve alterations in the rhythmicity of serotonin [5-HT] function. We examined seasonal effects on the neuroendocrine and mood responses to L-tryptophan (L-TRP) in depressed patients and healthy subjects. In this study, 126 drug-free patients with DSM-III-R major depression and 58 healthy subjects received in i.v. infusion of L-TRP. Serum prolactin (PRL) and plasma tryptophan levels were measured. Mood was assessed with visual analogue scales. Cosinor analysis revealed seasonal variation in peak change (delta) PRL and baseline tryptophan levels in the combined depressed and in unipolar, nonmelancholic, and nonpsychotic patients. Peak delta PRL and tryptophan levels were inversely correlated in combined depressed and unipolar patients. Seasonality was more evident in female than in male patients. These data support previous evidence that 5-HT function is abnormal in depression and further suggest a seasonal variability of such abnormalities that is absent in healthy subjects.
