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Determinants of burden in caregivers of patients with exacerbating schizophrenia

Published online by Cambridge University Press:  16 April 2020

Christoph Lauber ,
Adrian Eichenberger ,
Peter Luginbühl ,
Christian Keller  and
Wulf Rössler
Christoph Lauber*
Affiliation:
Psychiatric University Hospital, Militärstrasse 8, P.O. Box 19030, 8021 Zurich, Switzerland
Adrian Eichenberger
Affiliation:
Psychiatric University Hospital, Militärstrasse 8, P.O. Box 19030, 8021 Zurich, Switzerland
Peter Luginbühl
Affiliation:
Psychiatric University Hospital, Militärstrasse 8, P.O. Box 19030, 8021 Zurich, Switzerland
Christian Keller
Affiliation:
Psychiatric University Hospital, Militärstrasse 8, P.O. Box 19030, 8021 Zurich, Switzerland
Wulf Rössler
Affiliation:
Psychiatric University Hospital, Militärstrasse 8, P.O. Box 19030, 8021 Zurich, Switzerland
*
*Corresponding author. E-mail address: [email protected] (C. Lauber).
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Abstract

Purpose

Restriction in involuntary hospital admission and reduced lengths of inpatient stay increase burden on relatives of individuals with schizophrenia. This study aims at assessing the relationship between caregiver burden and behavioural disturbances of the affected, e.g. threats, nuisances, but also substance use and aggression. Two weeks before the last hospitalisation of the affected are considered as being the most burdensome period for relatives.

Subjects and methods

Sixty-four relatives of schizophrenic patients were assessed by the semi-structured “Interview for Measuring the Burden on the Family”. Subscales and total scales of burden were calculated. Predictors were identified by regression analyses.

Results

The most important predictor of burden is burden in the relationship between caregiver and the affected representing the changes in the relationship occurring in acute illness. Threats, nuisances, time spent with the affected, and burden due to restricted social life and leisure activities were additional predictors, but not aggression or substance abuse. Eighty-five percent of the cases could be assigned correctly.

Discussion and conclusions

To better encounter burden, relatives should learn to cope with disturbing behaviour of and altered relationship to the affected, but also with their own needs. Finally, relatives must be included in the decision whether or not an affected person should be hospitalised.

Keywords

BurdenCaregiverSchizophreniaSubstance useAggression
Type
Original article
Information
European Psychiatry , Volume 18 , Issue 6 , October 2003 , pp. 285 - 289
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2003

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References

[1]Barak, Y, Szor, H, Kimhi, R, Kam, E, Mester, R, Elizur, A. Survey of patient satisfaction in adult psychiatric outpatient clinics. Eur Psychiatry 2001;16:131–3.CrossRefGoogle ScholarPubMed
[2]Beauford, JE, McNiel, DE, Binder, RL. Utility of the initial therapeutic alliance in evaluating psychiatric patients’ risk of violence. Am J Psychiatry 1997;154:1272–6.Google Scholar
[3]Björkman, T, Hansson, L. Predictors of improvement in quality of life of long-term mentally ill individuals receiving case management. Eur Psychiatry 2002;17:33–40.CrossRefGoogle ScholarPubMed
[4]Boye, B, Bentsen, H, Ulstein, I, Notland, TH, Lersbryggen, AB, Lingjærde, O, et al. Relatives’ distress and patients’ symptoms and behaviours: a prospective study of patients with schizophrenia and their relatives. Acta Psychiatr Scand 2001;104:42–50.CrossRefGoogle ScholarPubMed
[5]Budd, RJ, Oles, G, Hughes, IC. The relationship between coping style and burden in the carers of relatives with schizophrenia. Acta Psychiatr Scand 1998;98:304–9.CrossRefGoogle ScholarPubMed
[6]Cassidy, E, Hill, S, O’Callaghan, E. Efficacy of a psychoeducational intervention in improving relatives’ knowledge about schizophrenia and reducing rehospitalisation. Eur Psychiatry 2002;16:446–50.CrossRefGoogle Scholar
[7]Derogatis, LR, Lipman, RS, Rickels, K, Uhlenhuth, EH, Covi, L. The Hopkins Symptom Checklist (HSCL). A self-report symptom inventory. Behav Sci 1974;19:1–15.Google Scholar
[8]Fadden, G, Bebbington, P, Kuipers, L. The burden of care: the impact of functional psychiatric illness on the patient's family. Br J Psychiatry 1987;150:285–92.CrossRefGoogle ScholarPubMed
[9]Gigantesco, A, Picardi, A, Chiaia, E, Balbi, A, Morosini, P. Patients’ and relatives’ satisfaction with psychiatric services in a large catchment area in Rome. Eur Psychiatry 2002;17:139–47.CrossRefGoogle Scholar
[10]Hoenig, J, Hamilton, MW. The schizophrenic patient in the community and his effects on the household. Int J Soc Psychiatry 1966;12:165–76.CrossRefGoogle Scholar
[11]Honkonen, T, Saarinen, S, Salokangas, RK. Deinstitutionalization and schizophrenia in Finland II: discharged patients and their psychosocial functioning. Schizophr Bull 1999;25:543–51.Google ScholarPubMed
[12]Kaltiala-Heino, R, Laippala, P, Joukamaa, M. Has the attempt to reduce psychiatric inpatient treatment been successful in Finland? Eur Psychiatry 2001;16:215–21.CrossRefGoogle ScholarPubMed
[13]Kluiter, H, Kramer, JJAM, Wiersma, D. Interview for measuring the burden on the family (IBF). University of Groningen, The Netherlands: Department of Social Psychiatry; 1998.Google Scholar
[14]Kramer, JJAM. Family under pressure. The development and psychometric assessment of the interview for the burden of the family. PhD-Thesis. Groningen: The Netherlands: Faculty of Medicine of the University of Groningen; 1998.Google Scholar
[15]Magliano, L, Fadden, G, Madianos, M, Caldas, de Almeida JM, Held, T, Guarneri, M, et al. Burden on the families of patients with schizophrenia: results of the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol 1998;33:405–12.CrossRefGoogle ScholarPubMed
[16]Magliano, L, Fadden, G, Fiorillo, A, Marangone, C, Sorrentino, D, Robinson, A, et al. Family burden and coping strategies in schizophrenia: are key relatives really different to other relatives? Acta Psychiatr Scand 1999;99:10–5.CrossRefGoogle ScholarPubMed
[17]Magliano, L, Fadden, G, Economou, M, Held, T, Xavier, M, Guarneri, M, et al. Family burden and coping strategies in schizophrenia: 1-year follow-up data from the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol 2000;35:109–15.Google ScholarPubMed
[18]Magliano, L, Marasco, C, Fiorillo, A, Marangone, C, Guarneri, M, Maj, M, Working Group of the Italian National Study on Families of Persons with Schizophrenia. The impact of professional and social network support on the burden of families of patients with schizophrenia in Italy. Acta Psychiatr Scand 2002;106:291–8.CrossRefGoogle Scholar
[19]Middelboe, T, Mackeprang, T, Hansson, L, Werdelin, G, Hansson, L, Karlsson, H, et al. The Nordic study on schizophrenic patients living in the community. Subjective needs and perceived help. Eur Psychiatry 2001;16:207–14.CrossRefGoogle Scholar
[20]Mueser, KT, Drake, RE, Ackerson, TH, Alterman, AI, Miles, KM, Noordsy, DL. Antisocial personality disorder, conduct disorder, and substance abuse in schizophrenia. J Abnorm Psychol 1997;106: 473–7.CrossRefGoogle Scholar
[21]Östmann, M, Hansson, L, Anderson, K. Family burden, participation in care and mental health—an 11-year comparison of the situation of relatives to compulsorily and voluntarily admitted patients. Int J Soc Psychiatry 2000;46:191–200.CrossRefGoogle Scholar
[22]Östman, M, Hansson, L. Children in families with a severely mentally ill member: prevalence and needs for support. Soc Psychiatry Psychiatr Epidemiol 2002;37:243–8.CrossRefGoogle ScholarPubMed
[23]Rössler, W, Salize, HJ, Cucchiaro, G, Reinhard, I, Kernig, C. Does the place of treatment influence the quality of life of schizophrenics? Acta Psychiatr Scand 1999;100:142–8.CrossRefGoogle ScholarPubMed
[24]Schene, AH. Objective and subjective dimensions of family burden. Towards an integrative framework for research. Soc Psychiatry Psychiatr Epidemiol 1990;25:289–97.CrossRefGoogle ScholarPubMed
[25]Schene, AH, van Wijngaarden, B, Koeter, MWJ. Family caregiving in schizophrenia: domains and distress. Schizophr Bull 1998;24:609– 18.CrossRefGoogle ScholarPubMed
[26]Vaddadi, KS, Soosai, E, Gilleard, CJ, Adlard, S. Mental illness, physical abuse and burden of care on relatives: a study of acute psychiatric admission patients. Acta Psychiatr Scand 1997;95:313–7.CrossRefGoogle ScholarPubMed
[27]Van Sonderen, E. Measuring social support by means of the social support list-interactions (SSL-I) and social support list-discrepancies (SSL-D).A manual. Groningen: The Netherlands: Noordelijk Centrum voor Gezondheidsvraagstukken; 1993.Google Scholar
[28]Van, Wijngaarden B, Schene, AH, Koeter, M, Vazquez-Barquero, JL, Knudsen, HC, Lasalvia, A, et al. Caregiving in schizophrenia: development, internal consistency and reliability of the involvement evaluation questionnaire—European version. EPSILON Study 4. Br J Psychiatry 2000;39(Suppl):S21–s27.Google Scholar
[29]Winefield, HR, Harvey, EJ. Determinants of psychological distress in relatives of people with chronic schizophrenia. Schizophr Bull 1993;19:619–25.CrossRefGoogle ScholarPubMed
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