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

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.