Skip to main content

Advertisement

SpringerLink
Log in

The Extent of Stigma Experienced by the Caregivers of Patients with OCD and its Association With Caregiver Burden and Coping

  • Original Article
  • Published:
Journal of Psychosocial Rehabilitation and Mental Health Aims and scope Submit manuscript

Abstract

Stigma related to psychiatric illness not only impact the patients but also have adverse consequences on the caregivers. Stigma can lead to poor quality of life, social restriction, and psychological morbidity. Not much data is available on the stigma among the caregivers of patients with Obsessive–Compulsive Disorder (OCD). To evaluate the extent of stigma experienced by the caregivers of patients with OCD and its association with caregiver burden and coping. In a cross-sectional study, 53 caregivers of patients with OCD were evaluated on the Stigma Scale for Caregivers of People with Mental Illness (CPMI), Family Burden Interview (FBI) Schedule, and Family Coping Questionnaire (FCQ). The mean age of the caregivers was 45.9 years, with the number of years of formal education was 8.6 (SD: 5.4) years. Majority of the caregivers were male and married, were the spouse of the patient with a mean duration caregiving at the time of assessment being 122.6 months. In terms of stigma, the highest level of stigma was seen in the affective domain, followed by behavioural domain and least in the cognitive domain of CPMI. On FBI the highest level of burden was seen in the domain of disruption of routine family activities, followed by disruption of family interaction, disruption of family leisure activities, financial burden, the effect on the physical health of others, and effect on mental health others. On FCQ, Positive communication and resignation were the most commonly used coping mechanisms. The least commonly used coping strategy was the patient's social involvement. All the domains of CPMI had a significant positive association with a total objective score of FBI. In terms of coping, a higher level of stigma was associated with lower use of social involvement (all domains of stigma), coercion (cognitive domain and total stigma), and avoidance (all domains except for affective domain) as coping mechanisms. Lower use of positive communication was associated with higher stigma in the behavioural domain. Those with a high objective burden had a higher level of stigma on the cognitive and behaviour domain of the CPMI. Caregivers of patients with OCD experience a high level of stigma. A higher level of stigma is associated with the more use of maladaptive coping like avoidance and higher caregiver burden. Accordingly, it can be said that there is a need to focus on the caregivers of patients with OCD to improve the overall outcome of the patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ociskova M, Prasko J, Sedlackova Z. Stigma and self-stigma in patients with anxiety disorders. Activitas Nervosa Superior Rediviva. 2013;55(1–2):12–8.

    Google Scholar 

  2. Corrigan PW, Rowan D, Green A, Lundin R, River P, Uphoff-Wasowski K, et al. Challenging two mental illness stigmas: Personal responsibility and dangerousness. Schiz Bulletin. 2002;28(2):293–309.

    Article  Google Scholar 

  3. Corrigan P. How stigma interferes with mental health care. Am Psychol. 2004a;59(7):614–25.

    Article  PubMed  Google Scholar 

  4. Anthony, W.A., Blanch, A. Supported employment for persons who are psychiatrically disabled: An historical and conceptual perspective. Psychosoc. Rehab. J. 1987;11(2):5.

  5. Sturm R, Gresenz CR, Pacula RL, Wells KB. Data points: Labor force participation by persons with mental illness. Psychiatr Serv. 1999;50(11):1407.

    Article  PubMed  Google Scholar 

  6. Corrigan PW. Target-specific stigma change: A strategy for impacting mental illness stigma. Psychiatr Rehab J. 2004b;28(2):113–21.

    Article  Google Scholar 

  7. Stigma in Obsessive-Compulsive Disorder. https://doi.org/10.5772/intechopen.83642105.

  8. Holmes EP, River LP. Individual strategies for coping with the stigma of severe mental illness. Cogn. Behav. Pract.. 1998;5(2):231–9.

    Article  Google Scholar 

  9. Hayward P, Bright JA. Stigma and mental illness: A review and critique. J. Ment. Health. 1997;6(4):345–54.

    Article  Google Scholar 

  10. Vogel DL, Wade NG, Haake S. Measuring the self-stigma associated with seeking psychological help. J. Couns. Psychol. 2006;53(3):325–37.

    Article  Google Scholar 

  11. Vogel DL, Wade NG, Ascheman PL. Measuring perceptions of stigmatisation by others for seeking psychological help: Reliability and validity of a new stigma scale with college students. J. Couns. Psychol. 2009;56(2):301–8.

    Article  Google Scholar 

  12. Chang KH, Horrocks S. Lived experiences of family caregivers of mentally ill relatives. J. Adv. Nurs. 2006;53(4):435–43.

    Article  PubMed  Google Scholar 

  13. Steele A, Maruyama N, Galynker I. Psychiatric symptoms in caregivers of patients with bipolar disorder: A review. J. Affect Dis. 2010;121(1–2):10–21.

    Article  PubMed  Google Scholar 

  14. Mehta, S. I., Farina, A. Associative stigma: Perceptions ofthe difficulties of college-aged children of stigmatised fathers. J. Soc. Clin. Psychol. 1988;7, 192–202.

    Article  Google Scholar 

  15. Goffman E. Stigma: Notes on the management of spoiledidentity. New York, NY: Prentice Hall; 1963.

    Google Scholar 

  16. Helgason L. Twenty years’ follow-up of first psychiatric presentation for Schizophrenia: What could have been prevented? Acta Psychiatrica Scand. 1990;81:231–5.

    Article  Google Scholar 

  17. Loebel AD, Lieberman JA, Alvir JM, Mayerhoff DI, Geisler SH, Szymanski SR. Duration of psychosis and outcome in first-episode schizophrenia. Am. J. Psychiatry. 1992;149:1183–8.

    Article  PubMed  Google Scholar 

  18. Mak WW, Cheung RY. Affiliate stigma among caregivers of people with intellectual disability or mental illness. J. Appl. Res. Intellect. Disabil. 2008;21:532–45.

    Article  Google Scholar 

  19. Futh A, Simonds LM, Micali N. Obsessive-compulsive disorder in children and adolescents: parental understanding, accommodation, coping and distress. J. Anxiety. Disord. 2012;26(5):624–32.

    Article  PubMed  Google Scholar 

  20. Amir N, Freshman M, Foa E. Family distress and involvement in relatives of obsessive-compulsive disorder patients. J. Anxiety. Disord. 2000;14(3):209–17.

    Article  PubMed  Google Scholar 

  21. Wu MS, Hamblin R, Nadeau J, Simmons J, Smith A, Wilson M, et al. quality of life and burden in caregivers of youth with obsessive-compulsive disorder presenting for intensive treatment. Compr. Psychiatry. 2018;80:46–56.

    Article  PubMed  Google Scholar 

  22. Stengler-Wenzke K, Trosbach J, Dietrich S, Matthias C. Angermeyer. Experience of stigmatisation by relatives of patients with obsessive-compulsive disorder. Arch. Psychiatr. Nurs. 2004;18 (3), 88–96.

  23. Grover S, Dutta A. Perceived burden and quality of life of caregivers in obsessive–compulsive disorder. Psychiatry Clin. Neurosci. 2011;65:416–22.

    Article  PubMed  Google Scholar 

  24. Newth S, Rachman S. The concealment of obsessions. Behav. Res. Ther. 2001;39:457–64.

    Article  PubMed  Google Scholar 

  25. Thara R, Srinivasan TN. How stigmatising is schizophrenia in India? Int. J. Soc Psychiatry. 2000;46:135–41.

    Article  PubMed  Google Scholar 

  26. Grover S, Avasthi A, Singh A, Dan A, Neogi R, Kaur D, et al. Stigma experienced by patients with severe mental disorders: A nationwide multicentric study from India. Psychiatry Res. 2017;257:550–8.

    Article  PubMed  Google Scholar 

  27. Mehra A, Kumar A, Grover S, Chakrabarti S, Avasthi A. Relationship of stigma with burden and coping among caregivers of patients with severe mental disorders. Indian J. Soc. Psychiatry. 2020;36:11–8.

    Article  Google Scholar 

  28. Grover S, Aneja J, Hazari N, Chakrabarti S, Avasthi A. Stigmaand its correlates among caregivers of patients with bipolardisorder. Indian J. Psychol. Med. 2019;41:455–61.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Raguram R, Raghu TM, Vounatsou P, Weiss MG. Schizophrenia and the cultural epidemiology of stigma in Bangalore, India. J. Nerv. Ment. Dis. 2004;192:734–44.

    Article  PubMed  Google Scholar 

  30. Das PK, Maiti S, Roy P, Das S. A comparative study of stigma, quality of life and family burden in patients of Schizophrenia and obsessive-compulsive disorder. J. Neurol. Neurosci. 2019;5:287.

    Google Scholar 

  31. Garg R, Chavan BS, Arun P. Stigmatizing experiences of patients with psychiatric disorders and their caregivers. J. Mental Health Hum. Behav. 2014;2014(19):4–9.

    Article  Google Scholar 

  32. ICD-10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Disgnostic Guidelines. Geneva. World Health Organisation. 1992.

  33. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavas J, Hergueta T, et al. The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J. Clin. Psychiatr. 1998;59(20):22–33.

    Google Scholar 

  34. Singh A, Mattoo SK, Grover S. Stigma and its correlates among caregivers of schizophrenia: A study from North India. Psychiatry Res. 2016;241:302–8.

    Article  PubMed  Google Scholar 

  35. Pai S, Kapur RL. The burden on the family of a psychiatric patient: Development of an interview schedule. Br. J. Psychiatry. 1981;1981(138):332–5.

    Article  Google Scholar 

  36. Chien WT, Norman I. The validity and reliability of a Chinese version of the family burden interview schedule. Nurs. Res. 2004;53:314–22.

    Article  PubMed  Google Scholar 

  37. Martorell A, Pereda A, Salvador-Carulla L, Ochoa S, Ayuso-Mateos JL. Validation of the Subjective and Objective Family Burden Interview (SOFBI/ECFOS) in primary caregivers to adults with intellectual disabilities living in the community. J. Intellect. Disabil. Res. 2007;51:892–901.

    Article  PubMed  Google Scholar 

  38. Magliano L, Guarneri M, Marasco C, Tosini P, Morosini P, Maj M. A new questionnaire assessment coping strategies in relatives of patients with schizophrenia development and factor analysis. Acta Psychiatr. Scand. 1996;94:224–8.

    Article  PubMed  Google Scholar 

  39. Grover S, Pradyumna C, S. . Coping among the caregivers of patients with schizophrenia. Ind. Psychiatry J. 2015;24:5–11.

    Article  PubMed  PubMed Central  Google Scholar 

  40. King M, Dinos S, Shaw J, Watson R, Stevens S, Passetti F, et al. The stigma scale: Development of a standardised measure of the stigma of mental illness. Br. J. Psychiatry. 2007;190:248–54.

    Article  PubMed  Google Scholar 

  41. Girma E, Moller-Leimkuhler AM, Dehning S, Mueller N, Tesfaye M, Foreschl G. Self-stigma among caregviers of people with mental illness: toward caregivers’ empowerment. J. Multidisc. Healthcare. 2014;47:37–43.

    Article  Google Scholar 

  42. Steketee G. Disability and family burden in obsessive-compulsive disorder. Can. J. Psychiatry. 1997;42:919–28.

    Article  PubMed  Google Scholar 

  43. Lasebikan VO, Ayinde OO. Family burden in caregivers of Schizophrenia patients: prevalence and Socio-demographic correlates. Indian J. Psychol. Med. 2013;35(1):60–6.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Kate, N., Grover, S., Kulhara, P., Nehra, R. Relationship of caregiver burden with coping strategies, social support, psychological morbidity, and quality of life in the caregivers of schizophrenia. Asian J. Psychiatry 2013; 6:380–8.

  45. Gupta A, Solanki RK, Koolwal GD, Gehlot S. Psychological well-being and burden in caregivers of patients with schizophrenia. Int. J. Med. Sci. Public Health. 2015;4:70–6.

    Article  Google Scholar 

  46. Yu Y, Liu ZW, Tang BW, Zhao M, Liu XG, Xiao SY. Reported family burden of schizophrenia patients in rural China. PLoS ONE. 2017;12:e0179425.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Calvocoressi L, Lewis B, Harris M, Trufan S, Goodman W, McDougle C, Price L. Family accommodation in obsessive-compulsive disorder. Am. J. Psychiatry. 1995;52:441–3.

    Google Scholar 

  48. Ramos-Cerqueira ATA, Torres AR, Torresan RC, Negreiros APM, Vitorino CN. Emotional burden in caregivers of patients with obsessive-compulsive disorder. Depress Anxiety. 2008;25:1020–7.

    Article  PubMed  Google Scholar 

  49. Grover S, Chakrabarti S, Ghormode D, Dutt A, Kate N, Kulhara P. Clinicians’ versus caregivers’ ratings of burden inpatients with schizophrenia and bipolar disorder. Int J. Soc. Psychiatry. 2014;60:330–6.

    Article  PubMed  Google Scholar 

  50. Chakrabarti S, Raj L, Kulhara P, Avasthi A, Verma SK. Comparison of the extent and pattern of family burden in affective disorders and schizophrenia. Indian J. Psychiatry. 1995;37:105–12.

    PubMed  PubMed Central  Google Scholar 

  51. Magliano L, Fadden G, Madianos M, de Almeida JM, Held T, Guarneri M, et al. Burden on the families of patients with schizophrenia: Results of the BIOMED I study. Soc. Psychiatry Psychiatr. Epidemiol. 1998;33:405–12.

    Article  PubMed  Google Scholar 

  52. Roick C, Heider D, Toumi M, Angermeyer MC. The impact of caregivers’ characteristics, patients’ conditions and regional differences on family burden in schizophrenia: A longitudinal analysis. Acta Psychiatr. Scand. 2006;114:363–74.

    Article  PubMed  Google Scholar 

  53. Creado DA, Parkar SR, Kamath RM. A comparison of the level of functioning in chronic schizophrenia with coping and burden in caregivers. Indian J. Psychiatry. 2006;48:27–33.

    Article  PubMed  PubMed Central  Google Scholar 

  54. El-am EE, Raya YM, Zaki AS. Depressive disorders among caregivers of schizophrenic patients in relation to burden of care and perceived stigma. Curr. Psychiatry. 2010;17:15–25.

    Google Scholar 

  55. Magaña SM, RamírezGarcía JI, Hernández MG, Cortez R. Psychological distress among latino family caregivers of adults with schizophrenia: The roles of burden and stigma. Psychiatr. Serv. 2007;58:378–84.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Aseem Mehra, Ajit Avasthi & Sandeep Grover

Authors
  1. Aseem Mehra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ajit Avasthi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sandeep Grover
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sandeep Grover.

Ethics declarations

Conflicts of interest

There are no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mehra, A., Avasthi, A. & Grover, S. The Extent of Stigma Experienced by the Caregivers of Patients with OCD and its Association With Caregiver Burden and Coping. J. Psychosoc. Rehabil. Ment. Health 8, 125–135 (2021). https://doi.org/10.1007/s40737-020-00209-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40737-020-00209-1

Keywords

Search

Navigation