Review of Literature
Gururaj GP et.al (2008) in their study they assessed the family burden, quality of life (QoL) and disability in patients suffering from at least moderately ill OCD and then to compare them with schizophrenia patients of comparable severity. Overall family burden, financial burden and disruption of family routines were significantly higher in schizophrenia patients compared to OCD although the groups did not differ with respect to other domains of family burden. Severe OCD is associated with significant disability, poor QoL and high family burden, often comparable to schizophrenia.
Katarina Stengler-Wenzke et.al (2006) in their study they compared the quality of life (QoL) of relatives of patients with OCD with that of the general German population. Compared with that of the general population, the QoL of relatives of patients with OCD was significantly lower in the domains physical well-being, psychological well-being, and social relationship. Obsessive-compulsive disorder has an adverse effect on the subjective QoL of relatives of patients with OCD. Therefore, these findings suggest that professionals working with relatives must focus not only on the care given to persons with an illness but also on their relatives’ situation and personal QoL.
Harsh Oza et.al (2017) in their study they assessed and compare the burden of care and psychiatric morbidity in caregivers of patients with schizophrenia and obsessive–compulsive disorder (OCD), and to study the burden of care in relation to socio-demographic characteristics and disease-related factors. Burden of care was higher in caregivers of schizophrenia patients in 5 domains – financial burden, disruption of family routine, disruption of family leisure, disruption of family interaction and effect on physical health. They found that the extent of burden of care and psychiatric morbidity was higher in caregivers in the schizophrenia group, caregivers in the OCD group also had considerable burden of care as well as psychiatric morbidity.
Talia I. Zaider et.al (2010) in their study its reported that adults with anxiety disorders often report interpersonal distress, the degree to which anxiety is linked to the quality of close relationships remains unclear. Analyses revealed significant associations between wives’ daily anxiety and both partners’ perceptions of relationship quality. Associations were moderated by anxiety-specific support. And it indicated that significant concordance between wives’ daily anxiety and husbands’ distress. Concordance was stronger for husbands who reported frequent accommodation of wives’ anxiety symptoms.
Chirumamilla Kavitha et.al (2014) in their study they attempted to find that Cognitive Behavioural Therapy (CBT) improves the quality of life of participants with anxiety disorders and if marital adjustment of couples with anxiety disorders can be improved with Behavioural Marital Therapy (BMT), relative to standard care of pharmacotherapy and psycho education. And the results were found to be CBT for the partner with anxiety disorder and BMT for couples with anxiety disorders and marital discord and involvement of the spouse in the therapy will be a useful addition to the management of a couple where one partner has an anxiety disorder with great improvement.
Analise de Souza Vivan et.al (2013) were done a study to compare adolescents with and without obsessive-compulsive disorder (OCD) with regard to quality of life and to investigate the association between quality of life and clinical characteristics. The sample comprised 75 adolescents with OCD and 150 without the disorder, aged between 14 and 18 years. Participants were assessed using the following instruments: Schedule for Affective Disorders and Schizophrenia for School Aged Children – Present and Lifetime Version (K-SADS-PL), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), World Health Organization Quality of Life Assessment – Abbreviated Version (WHOQOL-BREF), Beck Anxiety Inventory (BAI), and Beck Depressive Inventory – II (BDI-II). The two groups showed significant differences in relation to depression symptoms, anxiety symptoms, and quality of life (all domains), with a poorer performance among adolescents with OCD when compared to those without the disorder. Stepwise regression analysis revealed a significant association between BDI-II scores and quality of life, in all domains. Their findings suggest that adolescents with OCD, especially those with depression symptoms, have a poorer quality of life when compared with adolescents without OCD.
Saboor Zafar Hamdani et.al (2015) the main objective of their descriptive study was to find out the attitudes of the caregivers (parents and spouses) towards the patients of OCD. An interview schedule was used for data collection, which was constructed in two phases. The initial form was prepared on the basis of literature review, and some caregivers were interviewed. The final form was then constructed with the help of responses of the caregivers (parents and spouses); further assistance was taken from Parental Attitude and Belief Scale 11. Survey method was used for data collection. Sample included caregivers (parents and spouses) of 30 diagnosed OCD patients and was taken from Services Hospital and Mayo Hospital, Lahore. The responses of the respondents were recorded on the spot. Analysis indicated that a higher percentage of the caregivers (parents and spouses) had a positive attitude towards the OCD patients. Increase in financial and household responsibilities was also reported by majority of the caregivers.
Mauro V. Mendlowicz, M.D, Murray B. Stein, M.D. (2000) this studies reviewed portray an almost uniform picture of anxiety disorders as illnesses that markedly compromise quality of life and psychosocial functioning. Significant impairment can also be found in individuals with sub threshold forms of anxiety disorders. Effective pharmacological or psychotherapeutic treatment has been shown to improve the quality of life for patients with panic disorder, social phobia, and posttraumatic stress disorder. Limitations in current knowledge in this area are identified, and suggestions for needed future research are provided.
Guy Doron, Danny Derby et.al (2016) in the present study, they compared levels of interference, OCD, and mood symptoms between clinical participants with ROCD, OCD, and com-munity controls. They also examined group differences in maladaptive beliefs previously linked with OCD and ROCD. Participants included 22 ROCD clients, 22 OCD clients, and 28 community controls. The Mini International Neuropsychiatric Interview was used to attain clinical diagnoses of OCD and ROCD. The Yale–Brown Obsessive–Compulsive Scale was used to evaluate primary-symptoms severity. All participants completed measures of symptoms and dysfunctional beliefs. The result was found to be ROCD clients reported more severe ROCD symptoms than the OCD and control groups. ROCD and OCD clients did not differ in severity of their primary-symptoms. ROCD clients scored higher than the other groups on maladaptive OCD-related and relationship-related beliefs. Finally, ROCD clients showed more severe depression symptoms than community controls.
C.Jayakumar, K.Jagadheesan & A.N.Verma (2002), in the present study compared burden of care between the key relatives of patients with obsessive compulsive disorder (OCD) and schizophrenia. For this study, consecutive key relatives of patients with either OCD (n=30) or schizophrenia (n=41) were evaluated with 40-item burden assessment schedule (BAS). In comparison with schizophrenia group, caregivers in OCD group had significantly high mean scores for the domains, spouse-related factor and caregiver’s strategy of BAS. The degree of burden, evidenced by mean scores, was comparable between groups for other domains of BAS. Spouses and unemployed caregivers in OCD group had significantly elevated mean total burden scores. The present findings suggest that caregiver’s burden imposed by OCD is either excess or nearly comparable to that of schizophrenia.
Chirumamilla Kavitha et.al (2014) in this present study the effect of the anxiety disorder on the spouse and the impact of including the spouse in therapy are not well studied. To determine if Cognitive Behavioural Therapy (CBT) improves the quality of life of participants with anxiety disorders and if marital adjustment of couples with anxiety disorders can be improved with Behavioural Marital Therapy (BMT), relative to standard care of pharmacotherapy and psychoeducation. An open label randomised controlled trial. Participants were randomly assigned to CBT+BMT or standard of care. Final assessments were carried out at 3.5 months after baseline. Quality of life was assessed using the WHOQOL-Bref instrument and Marital adjustment was measured using a marital quality scale. CBT for the partner with anxiety disorder and BMT for couples with anxiety disorders and marital discord and involvement of the spouse in the therapy will be a useful addition to the management of a couple where one partner has an anxiety disorder.
Talia I. Zaider et.al (2010) in this study the authors examined the relational impact of anxiety by sampling the daily mood and relationship quality of 33 couples in which the wife was diagnosed with an anxiety disorder. Use of a daily process design improved on prior methodologies by capturing relational processes closer to their actual occurrence and in the setting of the diagnosed partner’s anxiety. Analyses revealed significant associations between wives’ daily anxiety and both partners’ perceptions of relationship quality. Associations were moderated by anxiety-specific support. Results also indicated significant concordance between wives’ daily anxiety and husbands’ distress. Concordance was stronger for husbands who reported frequent accommodation of wives’ anxiety symptoms.
Shu-Ying Hou et.al (2010) The purpose of this study was to compare the level of QOL between patients with and without OCD, and to examine the associations between QOL and socio demographic data, course of illness, psychopathology, perceived social support, and treatment characteristics. The QOL levels measured with the Taiwan version of the Short Form of the World Health Organization Questionnaire on Quality of Life were compared between 57 subjects with OCD and 106 subjects without OCD. The correlates of QOL were examined among subjects with OCD. The analysis revealed that QOL scores for the general, physical, psychological and social relationship domains were lower in the OCD group than in the control group; however, no difference in the environmental domain was found. Multiple factors were associated with poor QOL in subjects with OCD, including comorbid depression, severe obsession symptoms, perceived low social support, severe adverse effects of medication, combined use of mood stabilizers, and low social status. Different domains of QOL are differently affected by OCD. The QOL of subjects with OCD was correlated to multiple factors that were specific to individual subjects and influenced by interactions with treatment and the social environment.
Emmelkamp PM, et al.(1990) In this study fifty obsessive-compulsives were treated by behavioural therapy (self-exposure in vivo and response prevention) either with their partner directly involved in all aspects of treatment or without their partner. The two treatment formats were equally effective. Although a substantial number of obsessive-compulsives were found to have marital problems, behavioural treatment directed at the obsessive-compulsive disorder resulted in improvement irrespective of marital quality and partner involvement in the therapy. The effects of treatment led neither to a deterioration of the marriage nor to adjustment problems in the partner.
Caryn R. Staebler M.S.et.al (1993), This study investigated the relationship between obsessive compulsive disorder and variables related to the individual’s sexual history, present life, sexual satisfaction, and marital adjustment. Of inpatient admissions, 363 who met criteria for obsessive compulsive disorder, panic disorder, and depressive disorder completed a standard history questionnaire and the Marital Adjustment Test. Findings showed that obsessive compulsive individuals cannot be distinguished from either depressive or panic disordered groups by a particular sexual history.
David S.Riggs et,al (1992), This study examined the relationship of marital distress to obsessive compulsive symptoms among 54 married subjects who were treated with exposure and response prevention for severe Obsessive Compulsive Disorder. Forty-two percent of the individuals who were maritally distressed prior to treatment were no longer distressed following treatment. Subjects who were maritally satisfied prior to treatment showed no significant change in marital distress. All subjects reported a reduction in their level of demandingness and dependency on their spouses. Initial levels of marital distress and depression were not related to the efficacy of the behavioral treatment for reducing symptoms of Obsessive Compulsive Disorder.
Need for the study
Many research has been investigated the occurrence and the consequences of obsessive compulsive disorder and other anxiety patient. The main need for the study is examine the prevalence rate of the spouses whose partner is diagnosed with obsessive compulsive disorder and other anxiety disorder. Perceived stress, Marital Adjustment, Quality of life are taken as variable to assess the level of severity or how far it affects the patient as well as their spouses.