Skip to main content
Top
Published in: Social Psychiatry and Psychiatric Epidemiology 11/2005

01-11-2005 | Original Paper

Burden of care and general health in families of patients with schizophrenia

Authors: José Gutiérrez-Maldonado, PhD, Alejandra Caqueo-Urízar, cand. phil, David J. Kavanagh, PhD

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 11/2005

Login to get access

Abstract

Background

De-institutionalization of psychiatric patients has led to a greater emphasis on family management in the community, and family members are often overwhelmed by the demands that caring for a patient with schizophrenia involves. Most studies of family burden in schizophrenia have taken place in developed countries. The current study examined family burden and its correlates in a regional area of a medium income country in South America.

Method

Sixty-five relatives of patients with schizophrenia who were attending a public mental health out-patient service in the province of Arica, Chile, were assessed on Spanish versions of the Zarit Caregiver Burden Scale and SF-36 Health Survey (SF-36).

Results

Average levels of burden were very high, particularly for mothers, carers with less education, carers of younger patients and carers of patients with more hospitalisations in the previous 3 years. Kinship and number of recent hospitalisations retained unique predictive variance in a multiple regression. Burden was the strongest predictor of SF-36 subscales, and the prediction from burden remained significant after entry of other potential predictors.

Conclusions

In common with families in developed countries, family members of schizophrenia patients in regional Chile reported high levels of burden and related functional and health impact. The study highlighted the support needs of carers in contexts with high rates of poverty and limited health and community resources.
Literature
1.
go back to reference Alonso J, Prieto L, Antó J (1995) La versión española del SF-36 Health Survey (Cuestionario de Salud SF-36): un instrumento para la medida de los resultados clínicos. Med Clin (Barc) 104:771–776 Alonso J, Prieto L, Antó J (1995) La versión española del SF-36 Health Survey (Cuestionario de Salud SF-36): un instrumento para la medida de los resultados clínicos. Med Clin (Barc) 104:771–776
2.
go back to reference Baronet A (1999) Factors associated with caregiver burden in mental illness: a critical review of the research literature. Clin Psychol Rev 19(7):819–841CrossRefPubMed Baronet A (1999) Factors associated with caregiver burden in mental illness: a critical review of the research literature. Clin Psychol Rev 19(7):819–841CrossRefPubMed
3.
go back to reference Berlung N, Olof J, Edman A (2003) Family intervention in schizophrenia. Impact on family burden and attitude. Soc Psychiatry Psychiatr Epidemiol 38:116–121CrossRefPubMed Berlung N, Olof J, Edman A (2003) Family intervention in schizophrenia. Impact on family burden and attitude. Soc Psychiatry Psychiatr Epidemiol 38:116–121CrossRefPubMed
4.
go back to reference Butzlaff RL, Hooley JM (1998) Expressed emotion and psychiatric relapse: a meta-analysis. Arch Gen Psychiatry 55:547–551CrossRefPubMed Butzlaff RL, Hooley JM (1998) Expressed emotion and psychiatric relapse: a meta-analysis. Arch Gen Psychiatry 55:547–551CrossRefPubMed
5.
6.
go back to reference Castilla A, López M, Chavarría M, Sanjuán P, Canut P, Martínez M, Martínez J, Cáceres J (1998) La carga familiar en una muestra de pacientes esquizofrénicos en tratamiento ambulatorio. Rev Asoc Esp Neurología, XVIII (68):621–642 Castilla A, López M, Chavarría M, Sanjuán P, Canut P, Martínez M, Martínez J, Cáceres J (1998) La carga familiar en una muestra de pacientes esquizofrénicos en tratamiento ambulatorio. Rev Asoc Esp Neurología, XVIII (68):621–642
7.
go back to reference Clark R, Drake R (1994) Expenditures of time and money by families of people with severe mental illness and substance use disorders. Community Ment Health J 30:145–163CrossRefPubMed Clark R, Drake R (1994) Expenditures of time and money by families of people with severe mental illness and substance use disorders. Community Ment Health J 30:145–163CrossRefPubMed
8.
go back to reference Dillehay R, Sandys M (1990) Caregivers for Alzheimer's patients: what are learning from research. Int J Aging Hum Dev 30:263–285PubMed Dillehay R, Sandys M (1990) Caregivers for Alzheimer's patients: what are learning from research. Int J Aging Hum Dev 30:263–285PubMed
9.
go back to reference Dinos S, Stevens S, Serfaty M, Weich S, King M (2004) Stigma: the feelings and experiences of 46 people with mental illness. Br J Psychiatry 184:176–181CrossRefPubMed Dinos S, Stevens S, Serfaty M, Weich S, King M (2004) Stigma: the feelings and experiences of 46 people with mental illness. Br J Psychiatry 184:176–181CrossRefPubMed
10.
go back to reference Dwyer J, Lee R, Jankowski B (1994) Reciprocity, elder satisfaction, and caregiver stress and burden: the exchange of aid in the family caregiving relationship. J Marriage Fam 56:35–43 Dwyer J, Lee R, Jankowski B (1994) Reciprocity, elder satisfaction, and caregiver stress and burden: the exchange of aid in the family caregiving relationship. J Marriage Fam 56:35–43
11.
go back to reference Fadden G, Bebbington P, Kuipers L (1987) The burden of care: the impact of functional psychiatric illness on the patient's family. Br J Psychiatry 150:285–292PubMed Fadden G, Bebbington P, Kuipers L (1987) The burden of care: the impact of functional psychiatric illness on the patient's family. Br J Psychiatry 150:285–292PubMed
12.
go back to reference Falloon I, Pederson J (1985) Family management in the prevention of morbidity of schizophrenia: the adjustment of family unit. Br J Psychiatry 147:156–163PubMed Falloon I, Pederson J (1985) Family management in the prevention of morbidity of schizophrenia: the adjustment of family unit. Br J Psychiatry 147:156–163PubMed
13.
go back to reference Falloon I, Boyd J, McGill C (1984) Family care of schizophrenia. Guildford Press, New York Falloon I, Boyd J, McGill C (1984) Family care of schizophrenia. Guildford Press, New York
14.
go back to reference Kavanagh DJ (1992) Recent developments in expressed emotion and schizophrenia. Br J Psychiatry 160:601–620PubMed Kavanagh DJ (1992) Recent developments in expressed emotion and schizophrenia. Br J Psychiatry 160:601–620PubMed
15.
go back to reference Kuipers L (1993) Family burden in schizophrenia: implications for services. Soc Psychiatry Psychiatr Epidemiol 28:207–210PubMed Kuipers L (1993) Family burden in schizophrenia: implications for services. Soc Psychiatry Psychiatr Epidemiol 28:207–210PubMed
16.
go back to reference Kuipers L, Leff J, Lam D (1992) Family work for schizophrenia: a practical guide. Gastell, London Kuipers L, Leff J, Lam D (1992) Family work for schizophrenia: a practical guide. Gastell, London
17.
go back to reference Lauber C, Eichenberger A, Luginbühl P, Keller C, Rössler W (2003) Determinants of burden in caregivers of patients with exacerbating schizophrenia. Eur Psychiatry 18:285–289CrossRefPubMed Lauber C, Eichenberger A, Luginbühl P, Keller C, Rössler W (2003) Determinants of burden in caregivers of patients with exacerbating schizophrenia. Eur Psychiatry 18:285–289CrossRefPubMed
18.
go back to reference Levine J, Lawlor B (1991) Family counseling and legal issues in Alzheimer's disease. Psychiatr Clin North Am 14:385–396PubMed Levine J, Lawlor B (1991) Family counseling and legal issues in Alzheimer's disease. Psychiatr Clin North Am 14:385–396PubMed
19.
go back to reference Magliano L, Fadden G, Economou M, Held T, Xavier M, Guarneri M, Malangone C, Marasco C, Maj M (2000) Family burden and coping strategies in schizophrenia: 1-year follow-up data from the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol 35:109–115CrossRefPubMed Magliano L, Fadden G, Economou M, Held T, Xavier M, Guarneri M, Malangone C, Marasco C, Maj M (2000) Family burden and coping strategies in schizophrenia: 1-year follow-up data from the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol 35:109–115CrossRefPubMed
20.
go back to reference Magliano L, Fadden G, Madianos M, Caldas de Alemaría J, Held T, Guarneri M (1998) Burden of the families of patients with schizophrenia: result of the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol 33:405–412CrossRefPubMed Magliano L, Fadden G, Madianos M, Caldas de Alemaría J, Held T, Guarneri M (1998) Burden of the families of patients with schizophrenia: result of the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol 33:405–412CrossRefPubMed
21.
go back to reference Martín M, Salvadó I, Nadal S, Miji L, Rico J (1996) Adaptación para nuestro medio de la Escala de Sobrecarga del Cuidador (caregiver burden interview) de Zarit. Rev Gerontol 6:338–346 Martín M, Salvadó I, Nadal S, Miji L, Rico J (1996) Adaptación para nuestro medio de la Escala de Sobrecarga del Cuidador (caregiver burden interview) de Zarit. Rev Gerontol 6:338–346
22.
go back to reference Martínez A, Nadal S, Beperet M, Mendióroz P, Grupo Psicost (2000) Sobrecarga de los cuidadores familiares de pacientes con esquizofrenia: factores determinantes. An Sist Sanit Navar 23:101–110 Martínez A, Nadal S, Beperet M, Mendióroz P, Grupo Psicost (2000) Sobrecarga de los cuidadores familiares de pacientes con esquizofrenia: factores determinantes. An Sist Sanit Navar 23:101–110
23.
go back to reference Ohaeri J (2001) Caregiver burden and psychotic patient's perception of social support in Nigerian setting. Soc Psychiatry Psychiatr Epidemiol 36:86–93CrossRefPubMed Ohaeri J (2001) Caregiver burden and psychotic patient's perception of social support in Nigerian setting. Soc Psychiatry Psychiatr Epidemiol 36:86–93CrossRefPubMed
24.
go back to reference Oldridge M, Hughes I (1992) Psychological well-being in families with a member suffering from schizophrenia. An investigation into long-standing problems. Br J Psychiatry 161:249–251PubMed Oldridge M, Hughes I (1992) Psychological well-being in families with a member suffering from schizophrenia. An investigation into long-standing problems. Br J Psychiatry 161:249–251PubMed
25.
go back to reference Pilling S, Bebbington P, Kuipers E, Garety P, Geddes J, Orbach G, Morgan C (2002) Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy. Psychol Med 32:763–782CrossRefPubMed Pilling S, Bebbington P, Kuipers E, Garety P, Geddes J, Orbach G, Morgan C (2002) Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy. Psychol Med 32:763–782CrossRefPubMed
26.
go back to reference Raune D, Kuipers E, Bebbington P (2004) Expressed emotion at the first-episode psychosis: investigating a carer appraisal model. Br J Psychiatry 184:321–326CrossRefPubMed Raune D, Kuipers E, Bebbington P (2004) Expressed emotion at the first-episode psychosis: investigating a carer appraisal model. Br J Psychiatry 184:321–326CrossRefPubMed
27.
go back to reference Scazufca M, Kuipers E (1998) Stability of expressed emotion in relatives of those with schizophrenia and its relationship with burden of care and perception of patients' social functioning. Psychol Med 28:453–461CrossRefPubMed Scazufca M, Kuipers E (1998) Stability of expressed emotion in relatives of those with schizophrenia and its relationship with burden of care and perception of patients' social functioning. Psychol Med 28:453–461CrossRefPubMed
28.
go back to reference Schene AH (1990) Objective and subjective dimensions of family burden. Towards an integrative framework for research. Soc Psychiatry Psychiatr Epidemiol 25:289–297CrossRefPubMed Schene AH (1990) Objective and subjective dimensions of family burden. Towards an integrative framework for research. Soc Psychiatry Psychiatr Epidemiol 25:289–297CrossRefPubMed
29.
go back to reference Schene AH, van Wijngaarden B, Koeter M (1998) Family caregiving in schizophrenia: domains and distress. Schizophr Bull 24:609–618PubMed Schene AH, van Wijngaarden B, Koeter M (1998) Family caregiving in schizophrenia: domains and distress. Schizophr Bull 24:609–618PubMed
30.
go back to reference Sheng M, Xiang M, Wan Chan C, Leff J, Simpson P, Huang M, Shan Y, Li S (2003) Effectiveness of psychoeducational intervention for rural Chinese families experiencing schizophrenia. A randomised controlled trial. Soc Psychiatry Psychiatr Epidemiol 38:69–75CrossRefPubMed Sheng M, Xiang M, Wan Chan C, Leff J, Simpson P, Huang M, Shan Y, Li S (2003) Effectiveness of psychoeducational intervention for rural Chinese families experiencing schizophrenia. A randomised controlled trial. Soc Psychiatry Psychiatr Epidemiol 38:69–75CrossRefPubMed
31.
go back to reference Stam H, Cuijpers P (2001) Brief report: effects of family interventions on burden of relatives of psychiatric patients in the Netherland: a pilot study. Community Ment Health J 37:179–187CrossRefPubMed Stam H, Cuijpers P (2001) Brief report: effects of family interventions on burden of relatives of psychiatric patients in the Netherland: a pilot study. Community Ment Health J 37:179–187CrossRefPubMed
32.
go back to reference Szmukler I, Burgess P, Herrman H, Henson A, Colusa S, Bloch S (1996) Caring for relatives with serious mental illness: the development of the experience of careging inventory. Soc Psychiatry Psychiatr Epidemiol 31:137–148CrossRefPubMed Szmukler I, Burgess P, Herrman H, Henson A, Colusa S, Bloch S (1996) Caring for relatives with serious mental illness: the development of the experience of careging inventory. Soc Psychiatry Psychiatr Epidemiol 31:137–148CrossRefPubMed
33.
go back to reference Thara R, Kamath S, Kumar S (2003) Women with schizophrenia and broken marriages—doubly disadvantaged? Part II: family perspective. Int J Soc Psychiatry 49:233–240CrossRefPubMed Thara R, Kamath S, Kumar S (2003) Women with schizophrenia and broken marriages—doubly disadvantaged? Part II: family perspective. Int J Soc Psychiatry 49:233–240CrossRefPubMed
34.
go back to reference Tucker C, Barker A, Gregorie A (1998) Living with schizophrenia: caring for person with a severe mental illness. Soc Psychiatry Psychiatr Epidemiol 33:305–309CrossRefPubMed Tucker C, Barker A, Gregorie A (1998) Living with schizophrenia: caring for person with a severe mental illness. Soc Psychiatry Psychiatr Epidemiol 33:305–309CrossRefPubMed
35.
go back to reference Ware J, Snow K, Kosinski M, Gandek B (1993) SF-36 Health survey. Manual and interpretation guide. The Health Institute, New England Medical Center Boston, Boston MA Ware J, Snow K, Kosinski M, Gandek B (1993) SF-36 Health survey. Manual and interpretation guide. The Health Institute, New England Medical Center Boston, Boston MA
36.
go back to reference Yarrow M, Schwart C, Murphy H et al (1955) The psychological meaning of mental illness in the family. J Soc Issues 11:12–24 Yarrow M, Schwart C, Murphy H et al (1955) The psychological meaning of mental illness in the family. J Soc Issues 11:12–24
37.
go back to reference Zarit SH, Reever KE, Bach-Peterson J (1980) Relatives of impaired elderly: correlates of feelings of burden. Gerontologist 20:649–655PubMed Zarit SH, Reever KE, Bach-Peterson J (1980) Relatives of impaired elderly: correlates of feelings of burden. Gerontologist 20:649–655PubMed
Metadata
Title
Burden of care and general health in families of patients with schizophrenia
Authors
José Gutiérrez-Maldonado, PhD
Alejandra Caqueo-Urízar, cand. phil
David J. Kavanagh, PhD
Publication date
01-11-2005
Publisher
Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 11/2005
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-005-0963-5

Other articles of this Issue 11/2005

Social Psychiatry and Psychiatric Epidemiology 11/2005 Go to the issue