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Background <p>While caregiver strain is established to be common among caregivers of children, adolescents and young adults with anxiety and obsessive-compulsive disorder (OCD), less is known about how caregiver strain severity may differ by patient characteristics; in particular, few data have described correlates of the same among families seeking treatment in virtual care delivery settings. The purpose of this study was to describe the prevalence and change in caregiver strain overall and by demographic and clinical subgroups, among caregivers of youth treated in a virtual specialty setting for moderate to severe anxiety and OCD.</p> Methods <p>This was a retrospective cohort study of <i>N</i> = 488 episodes of care among children, adolescents, and young adults with OCD aged 7–24 years, and their caregivers. Treatment was delivered between July 1, 2024 - September 30, 2025 by 3-person care teams (therapist, exposure coach, and psychiatrist); care comprised virtually delivered individual therapy, family sessions, groups (caregiver and patient), and exposure coaching, plus medication management if indicated. Objective and subjective components of caregiver strain, including missing work and feeling sad or unhappy, were measured by the Caregiver Strain Questionnaire-Short Form 7 (CGSQ-SF7) at admission and at discharge. Patient demographic and clinical history was measured by standardized questionnaires completed at intake. Baseline anxiety symptoms &amp; impairment and family accommodation were measured by the Overall Anxiety Severity &amp; Impairment Scale - Youth Caregiver Report (OASIS-Y-CG) and the Family Accommodation Scale Anxiety (FASA) respectively. Multivariate adjusted regression was utilized to evaluate the independent associations between patient characteristics and CGSQ-SF7 scores.</p> Results <p>The patient cohort was 41% male and mean age was 13.5 (+/- 3.6) years. More than 2 in 3 (67%) reported &gt; = 1 psychiatric medication prescription, 26% reported a comorbid medical condition, and 46% had difficulty attending school due to anxiety or other emotional challenges. At admission, the mean CGSQ-SF7 score was 5.5 (+/-1.7). Severity of caregiver strain at intake did not significantly differ by age group or sex; however, it was significantly higher among caregivers of patients prescribed psychiatric medication(s), with medical comorbidity, or presenting with school avoidance versus those without these conditions (<i>p</i>&lt;0.01), and directly associated with higher OASIS-Y-CG and FASA scores (<i>p</i> &lt; 0.0001). Following treatment, mean within-person reduction in total caregiver strain was significant (-1.6; Cohen’s d = 0.9; <i>p</i>&lt;0.0001); 58% of caregivers reported meaningful overall reductions &gt;= 1.13. Reduction in missing work and feeling unhappy or sad were reported by the majority of caregivers with quite a bit or very much strain at admission (94% and 81% respectively).</p> Conclusion <p>Caregiver strain was observed to (1) vary by clinical subgroup, and (2) decline following treatment among caregivers of youths treated in a virtual specialty care setting for anxiety and OCD.</p>

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Prevalence and change in caregiver strain by subgroup following youth treatment for moderate to severe anxiety and obsessive-compulsive disorder in a virtual specialty setting

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  • 发表日期：

    2026年6月18日

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  • Heidi Mochari-Greenberger,
  • Kathryn Boger

摘要

Background

While caregiver strain is established to be common among caregivers of children, adolescents and young adults with anxiety and obsessive-compulsive disorder (OCD), less is known about how caregiver strain severity may differ by patient characteristics; in particular, few data have described correlates of the same among families seeking treatment in virtual care delivery settings. The purpose of this study was to describe the prevalence and change in caregiver strain overall and by demographic and clinical subgroups, among caregivers of youth treated in a virtual specialty setting for moderate to severe anxiety and OCD.

Methods

This was a retrospective cohort study of N = 488 episodes of care among children, adolescents, and young adults with OCD aged 7–24 years, and their caregivers. Treatment was delivered between July 1, 2024 - September 30, 2025 by 3-person care teams (therapist, exposure coach, and psychiatrist); care comprised virtually delivered individual therapy, family sessions, groups (caregiver and patient), and exposure coaching, plus medication management if indicated. Objective and subjective components of caregiver strain, including missing work and feeling sad or unhappy, were measured by the Caregiver Strain Questionnaire-Short Form 7 (CGSQ-SF7) at admission and at discharge. Patient demographic and clinical history was measured by standardized questionnaires completed at intake. Baseline anxiety symptoms & impairment and family accommodation were measured by the Overall Anxiety Severity & Impairment Scale - Youth Caregiver Report (OASIS-Y-CG) and the Family Accommodation Scale Anxiety (FASA) respectively. Multivariate adjusted regression was utilized to evaluate the independent associations between patient characteristics and CGSQ-SF7 scores.

Results

The patient cohort was 41% male and mean age was 13.5 (+/- 3.6) years. More than 2 in 3 (67%) reported > = 1 psychiatric medication prescription, 26% reported a comorbid medical condition, and 46% had difficulty attending school due to anxiety or other emotional challenges. At admission, the mean CGSQ-SF7 score was 5.5 (+/-1.7). Severity of caregiver strain at intake did not significantly differ by age group or sex; however, it was significantly higher among caregivers of patients prescribed psychiatric medication(s), with medical comorbidity, or presenting with school avoidance versus those without these conditions (p<0.01), and directly associated with higher OASIS-Y-CG and FASA scores (p < 0.0001). Following treatment, mean within-person reduction in total caregiver strain was significant (-1.6; Cohen’s d = 0.9; p<0.0001); 58% of caregivers reported meaningful overall reductions >= 1.13. Reduction in missing work and feeling unhappy or sad were reported by the majority of caregivers with quite a bit or very much strain at admission (94% and 81% respectively).

Conclusion

Caregiver strain was observed to (1) vary by clinical subgroup, and (2) decline following treatment among caregivers of youths treated in a virtual specialty care setting for anxiety and OCD.