Is the Hygiene (Microbial) Hypothesis Related to Maternal Contamination Obsessions and Washing Compulsions?


  • Günseli Şefika Pancar
  • Enise Özic
  • Öznur Eyüpoglu
  • Aytul Karabekiroğlu

J Turk Acad Dermatol 2019;13(1):0-0


Atopic dermatitis (AD) is a common skin condition and is a member of the atopic disease group along with allergic rhinoconjunctivitis and asthma. The pathogenesis are not fully understood. In hygiene hypothesis is that environmental factors are thought to play a crucial role in the etiology together with westernization phenomenon. Thus their parents, especially their mothers, create the major environmental factors for Atopic Children. Therefore, an understanding of maternal characteristics is critical for determining the environmental factors of atopic children.

Material and Methods:

This study used a comparative design to evaluate differences in obsessivecompulsive variables and parenting attitudes between mothers of children with atopic dermatitis (atopic dermatitis group) and mothers of children who did not have atopic dermatitits (non atopic-control group). We evaluated 50 mothers in the atopic dermatitis group and 50 mothers in the nonatopic dermatitis group. Demographic characteristics were retrieved. The mothers completed questionnaires including the obsessive-compulsive questionnaire form (Padua Inventory) and family attitude scale (Parental Attitude Research Instrument; PARI).


In the disease group, 80% of children had a history of atopy in one first-degree family member, while 20% of children in the control group did. The total score of the contamination subscale of the Padua Inventory was 40 ± 19.64 in the disease group and 35 ± 15.90 in the control group. The result was statistically higher in the disease group (p=0.012) maternal overprotection was 39.56 ± 8.8 in the disease group and 37.61 ± 7.2 in the control group (p=0.2). The total score of this subscale did not show a statistically significant difference between groups. In addition, democratic attitude ( 24.96 ± 3.5 disease and 24.59 ± 3.8 control; p=0.5), rejecting attitude (25.23 ± 6.61 disease and 28.20 ± 6.1 control; p=0.2), misunderstanding attitude (12.21 ± 3.90 disease and 14.02 ± 3.30 control; p=0.3), and authoritarian attitude (32.35 ± 7.5 disease and 34.37 ± 7.17 control; p=0.1) were not statistically different.


This was the first study investigating the parental and environmental factors using the Padua Inventory and PARI instruments. Having a parental history of allergic diseases and having a mother with contamination obsession-compulsion are the main predictors for the child’s AD.

Keywords: Atopic Dermatitis, Padua, PARI (Parental Attitude Research Instrument), Hygiene Hypothesis, Obsessions, Compulsions, Contamination-Washing, Maternal behaviour