Symptom accommodation in obsessive-compulsive and major depression disorder: Effects on relationship quality

Abstract

Accommodation processes often sustain the disorder and affect the relationship between patients and their close others. However, the current evidence on the interplay between accommodation behaviour (AB) and relationships is contradictory, partly because studies usually consider either the patient or the relative. The present study addresses this gap by examining the association between AB and various relationship aspects in 50 dyads, consisting of 25 patients with obsessive-compulsive disorder (OCD) or 25 patients with major depression (MDD) and their respective close others. After the dyads recalled a shared disorder-specific emotional experience, they responded to various questionnaires assessing family accommodation, OCD symptoms, depression, relationship satisfaction, subjective closeness, and conflict frequency based on an individually described relationship context. The results of the actor-partner interdependence models point to similarities and disorder-specific differences. For both groups, AB represents a challenge in the relationship. Although AB is associated with more frequent conflict, lower subjective closeness, and lower relationship satisfaction in dyads with OCD and close others of MDD, patients with MDD are more likely to experience AB as supportive. This suggests differences in the functionality of AB across various disorders, with potential disorder-maintaining effects in both OCD and MDD. Clinically, the results highlight the importance of interventions targeting interpersonal dynamics, such as family therapy and psychoeducation, to balance support while reducing symptom-maintaining behaviours. Future research should explore tailored interventions to optimize relationship functioning while minimizing the negative effects of AB.