The impact of obsessive-compulsive disorder on the family: Preliminary findings
The impact of obsessive-compulsive disorder on the family: Preliminary findings
复制标题
DOI：
10.1097/00005053-199807000-00010
复制
发表时间：
1998-07-01
影响因子：
1.9
通讯作者：
Gabel, J
中科院分区：
文献类型：
--
作者：
Black, DW;Gaffney, G;Gabel, J
精神疾病患者的家人常常受到困扰。例如，Miller等人（1986）报告说，患有重度抑郁症、酒精依赖和适应障碍的患者的家庭比对照家庭的功能障碍更严重，这主要是因为沟通障碍。家庭功能也被证明与精神分裂症等几种精神疾病的发病、病程和结果密切相关（Falloon 等，1985）。探索强迫症（OCD）的家庭和婚姻调整的工作相对较少。流行病学区域调查显示，患有强迫症的人比没有强迫症的人更有可能离婚或分居（Karno 等，1988）。最近对 419 名强迫症基金会成员进行的一项调查发现，73% 的人报告该疾病会干扰家庭关系（Hollander 等，1996）。另一项由强迫症基金会赞助的对 450 名家庭成员（他们本身没有强迫症）的调查发现，85% 的家庭成员对其亲属的仪式感到困扰，75% 的家庭成员对其亲属的自我参与感到不安，63% 的家庭成员报告称被患病亲属卷入仪式化行为（Cooper, 1994）。布朗大学对 114 个完成家庭评估装置的家庭进行的一项更系统的研究（Epstein 等，1983）表明，超过 50% 的强迫症家庭在沟通、情感反应、行为控制和一般功能方面的得分处于“不健康”范围内（Van Noppen 等，1993）。因此，来自多个来源的数据表明，一个或多个成员患有强迫症的家庭往往会在多个方面受到干扰或功能失调，并且婚姻不和谐在同一家庭中相对常见。家庭和婚姻功能问题并非微不足道。它不仅被患者及其亲属认为很重要，而且可能会影响疾病的发作、病程或结果。例如，家庭生活不正常的强迫症患者可能对治疗反应较差。我们最近有机会探讨参加一项针对强迫症高危儿童的研究的患者及其配偶的家庭功能。结果是初步的，但表明强迫症家庭的家庭动态研究值得更密切的关注。
Families of patients with psychiatric disorders are often disturbed. For example, Miller et al.(1986) reported that the families of patients with major depression, alcohol dependence, and adjustment disorders were more dysfunctional than control families, mainly because of impaired communication. Family functioning has also been shown to be intimately involved in the onset, course, and outcome of several psychiatric disorders such as schizophrenia (Falloon et al., 1985). There has been relatively little work exploring family and marital adjustment in obsessive-compulsive disorder (OCD). The Epidemiologic Catchment Area survey showed that individuals with OCD are more likely to be divorced or separated than individuals without OCD (Karno et al., 1988). A recent survey of 419 Obsessive-Compulsive Foundation members found that 73% reported the illness to interfere with family relationships (Hollander et al., 1996). Another survey sponsored by the Obsessive-Compulsive Foundation of 450 family members (who themselves were not obsessional) found that 85% of family members were bothered by their relatives' rituals, 75% were disturbed by their relatives' self-involvement, and 63% reported being drawn into ritualizing behavior by the ill relative (Cooper, 1994). A more systematic study at Brown University on 114 families completing the Family Assessment Device (Epstein et al., 1983) showed that more than 50% of OCD families had scores in the" unhealthy" range for communication, affective responsiveness, behavior control, and general functioning (Van Noppen et al., 1993). Thus, data from several sources indicate that families in which one or more members have OCD tend to be disturbed or dysfunctional in several respects and that marital discord is relatively common in the same families.The issue of family and marital functioning is not trivial. Not only is it considered important by patients and their relatives, but it may potentially affect the onset, course, or outcome of the disorder. For example, patients with OCD whose family life is dysfunctional may respond less well to treatment. We recently had an opportunity to explore family functioning among patients and their spouses enrolled in a study of children at high risk for OCD. The results are preliminary but indicate that the study of family dynamics in OCD families merits closer attention.