Comparison of family functioning and social support between families with a member who has obsessive-compulsive disorder and control families in Shanghai

BACKGROUND: Family functioning plays an important role in the etiology and course of obsessive-compulsive disorder (OCD) so understanding the types of problems families with OCD patients have will help in the creation of OCD-specific family interventions. OBJECTIVE: Compare family functioning and social support of OCD patients and their co-resident parents to that of community controls and their co-resident parents. METHODS: Thirty-two psychiatric outpatients at the Affiliated East Hospital of Tongji University (in Shanghai) who met DSM-IV criteria for OCD and one of their co-resident parents and 31 community controls matched for age and years of education with the patients and one of their co-resident parents independently completed Chinese versions of the self-administered McMaster Family Assessment Device (FAD), which assesses seven dimensions of family functioning, and the Multidimensional Scale of Perceived Social Support (MSPSS), which assesses perceived support from family members, from friends and from other associates. RESULTS: All of the FAD dimension scores for both patients and their parents were in the unhealthy range (based on cut-off scores used in the Western version of the scale). With the exception of the Affective Involvement dimension of the FAD, patients with OCD and their parents reported significantly more poor family functioning and more poor social support than community controls and their parents. The concordance of patients FAD scores of and their parents scores was significantly stronger than that of controls and their parents for the Problem Solving, Communication and Affective Involvement dimensions (all p<0.001) but significantly weaker for the Behavioral Control dimension (p=0.009). For all four groups of respondents the four measures of perceived social support were all positively correlated with each of the seven measures of family functioning, though several of the correlation coefficients did not reach statistical significance. CONCLUSIONS: OCD, like several other psychiatric illnesses, is an illness that profoundly affects families in China. Interventions for OCD need to integrate family-based psychosocial approaches (e.g., family therapy) with individual-based biological and psychological interventions. Our finding that perceived social support—from family members and from others—are closely related to family functioning in all types of respondents highlights the central role of families in the personal identity and social networks of individuals in China.