Top

Social Psychiatry and Psychiatric Epidemiology

Published in:

01-04-2012 | Original Paper

Family burden and functional assessment in the Swedish CLIPS-study: do staff and relatives agree on individuals with psychotic disorders’ functional status?

Authors: Fredrik Hjärthag, Lars Helldin, Anna-Karin Olsson, Torsten Norlander

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 4/2012

Abstract

Purpose

In this study, the individuals with psychotic disorders’ daily life function was investigated on six dimensions considering their relations to family burden. Functional ratings carried out by relatives and staff were also compared.

Methods

Totally 88 relatives, to as many individuals diagnosed with a psychotic disorder, participated in this study. Relatives were to rate their own perceived burden and their ill relatives’ physical functioning, personal care skills, interpersonal relationships, social acceptability, activities, and work skills. The outpatient staff, in all 24 case managers also rated the patients’ functional level on the same assessment tool as did the relatives.

Results

Most dimensions of patients’ everyday functioning were highly correlated to relatives’ burden. The two functional dimensions “interpersonal relationships” and “activities” were best at classifying burden when rated by relatives. Also, comparing independent functional ratings by relatives and staff showed that despite great agreements on most dimensions, they differed significantly on “social acceptability” where relatives rated the function to be poorer and “activities” where relatives rated the function to be better.

Conclusions

Relatives, who perceive individuals with a psychotic disorder to be limited in their ability to interpersonal relationships and limited in their ability to activate in everyday life, are more likely to perceive a higher burden. Even though staff and relatives mainly agree on the patients’ functional ability, they often differ in ratings regarding patients’ social acceptability and ability to activate in everyday life. This should be worth considering in clinical practice as well as in future research.

Awad AG, Voruganti LNP (2008) The burden of schizoprenia on caregivers—a review. Pharmacoeconomics 26:149–162PubMedCrossRef

Gutiérrez-Maldonado J, Caqueo-Urízar A, Kavanagh DJ (2005) Burden of care and general health in families of patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 40:899–904. doi:10.1007/s00127-005-0963-5 PubMedCrossRef

Roick C, Heider D, Toumi M, Angermeyer MC (2006) The impact of caregivers` characteristics, patients` conditions and regional differences on family burden in schizophrenia: a longitudinal analysis. Acta Psychiatr Scand 114:363–374. doi:10:1111/j.1600-0447.2006.00797.x PubMedCrossRef

Angermeyer MC, Kilian R, Wilms H-U, Wittmund B (2006) Quality of life of spouses of mentally ill people. Int J Soc Psychiatry 52:278–285. doi:10.1177/0020764006067186 PubMedCrossRef

Madianos M, Economu M, Dafni O, Koukia E, Palli A, Rogakou E (2004) Family disruption, economic hardship and psychological distress in schizophrenia: can they be measured? Eur Psychiatry 19:408–414. doi:10.1016/j.eurpsy.2004.06.028 PubMedCrossRef

Rose L, Mallinson RK, Walton-Moss B (2002) A grounded theory of families responding to mental illness. West J Nurs Res 24:16–36. doi:10.1177/019394590202400505

Sartorius N (2007) Stigma and mental health. Lancet 370:810–811. doi:10.1016/S0140-6736(07)61245-8 PubMedCrossRef

Hjärthag F, Helldin L, Karilampi U, Norlander T (2010) Illness related components for the family burden of relatives to patients with psychotic illness. Soc Psychiatry Psychiatr Epidemiol 45:275–283. doi:10.1007/s00127-009-0065-x PubMedCrossRef

Schene AH, van Wijngaarden B, Koeter MWJ (1998) Family caregiving in schizophrenia: domains and distress. Schizophr Bull 24:609–618PubMed

10.

Szmukler GI, Burgess P, Herrman H, Benson A, Colusa S, Bloch S (1996) Caring for relatives with serious mental illness: the development of the experience of caregiving inventory. Soc Psychiatry Psychiatr Epidemiol 31:137–148PubMedCrossRef

11.

Dyck DG, Short R, Vitaliano PP (1999) Predictors of burden and infectious illness in schizophrenia caregivers. Psychosom Med 61:411–419PubMed

12.

Mitsonis C, Voussoura E, Dimopoulos N, Psarra V, Kararizou E, Latzouraki E, Zervas I, Katsanou MN (2011) Factors associated with caregiver psychological distress in chronic schizophrenia. Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-010-0325-9 (in press)

13.

Provencher HL, Mueser KT (1997) Positive and negative symptom behaviours and caregiver burden in the relatives of persons with schizophrenia. Schizophr Res 26:71–80PubMedCrossRef

14.

Koukia E, Madianos MG (2005) Is psychosocial rehabilitation of schizophrenic patients preventing family burden? A comparative study. J Psychiatr Ment Health Nurs 12:415–422PubMedCrossRef

15.

Parabiaghi A, Lasalvia A, Bonetto C, Cristofalo D, Marrella G, Tansella M, Ruggeri M (2007) Predictors of changes in caregiving burden in people with schizophrenia: a 3-year follow-up study in a community mental health service. Acta Psychiatr Scand 116:66–76. doi:10.1111/j.1600-0447.2007.01094.x CrossRef

16.

Tarricone I, Leese M, Szmukler GI, Bassi M, Berardi D (2006) The experience of carers of patients with severe mental illness: a comparison between London and Bologna. Eur Psychiatry 21:93–101. doi:10.1016/j.eurpsy.2005.09.012 PubMedCrossRef

17.

Helldin L, Kane JM, Karilampi U, Norlander T, Archer T (2007) Remission in prognosis of functional outcome: a new dimension in the treatment of patients with psychotic disorders. Schizophr Res 93:160–168. doi:10.1016/j.schres.2007.01.014 PubMedCrossRef

18.

Helldin L, Kane JM, Hjärthag F, Norlander T (2009) The importance of cross-sectional remission in schizophrenia for long-term outcome; a clinical prospective study. Schizophr Res 115:67–73. doi:10.1016/j.schres.2009.07.004 PubMedCrossRef

19.

American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington DC

20.

Schneider LC, Struening EL (1983) SLOF: a behavioral rating scale for assessing the mentally ill. Soc Work Res Abstr 19:9–21PubMed

21.

Hjärthag F, Helldin L, Norlander T (2008) Family burden: psychometric properties of the burden inventory for relatives of persons with psychotic disturbances (BIRP). Psychol Rep 103:323–335. doi:10.2466/PR0.103.2.323-335 PubMed

22.

Patterson DA, Lee MS (1995) Field trial of the Global Assessment of Functioning Scale-Modified. Am J Psychiatry 152:1386–1388PubMed

23.

Yamauchi K, Ono Y, Baba K, Ikegami N (2001) The actual process of rating the global assessment of functioning scale. Compr Psychiatry 42:403–409. doi:101053/comp200126268 PubMedCrossRef

24.

Tang VWK, Leung SK, Lam LC-W (2008) Clinical correlates of the caregiving experience for Chinese caregivers of patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 43:720–726. doi:10.1007/s00127-008-0357-6 PubMedCrossRef

25.

Ochoa S, Vilaplana M, Haro JM, Villalta-Gil V, Martínez F, Negredo MC, Casacuberta P, Paniego E, Usall J, Dolz M, Autonell J et al (2008) the NEDES Group. Do needs, symptoms or disability of outpatients with schizophrenia influence family burden? Soc Psychiatry Psychiatr Epidemiol 43:612–618. doi:10.1007/s00127-008-0337-x PubMedCrossRef

26.

Bowie CR, Twamley EW, Anderson H, Halpern B, Patterson TL, Harvey PD (2007) Self-assessment of functional status in schizophrenia. J Psychiatr Res 41:1012–1018. doi:10.1016/j.jpsychires.2006.08.003 PubMedCrossRef

27.

Perlick DA, Rosenheck RA, Kaczynski R, Swartz MS, Cañive JM, Lieberman JA (2006) Components and correlates of family burden in schizophrenia. Psychiatr Serv 57:1117–1125PubMedCrossRef

28.

Sjöblom L-M, Pejlert A, Asplund K (2005) Nurses view of the family in psychiatric care. J Clin Nurs 14:562–569PubMedCrossRef

29.

Winefield HR, Burnett PL (1996) Barriers to alliance between family and professional caregivers in chronic schizophrenia. J Ment Health 5:223–232CrossRef

30.

Foldemo A, Ek A-C, Bogren L (2004) Needs in outpatients with schizophrenia, assessed by the patients themselves and their parents and staff. Soc Psychiatry Psychiatr Epidemiol 39:381–385. doi:10.1007/s00127-004-0750-8 PubMedCrossRef

31.

Leifker FR, Bowie CR, Harvey PD (2009) Determinants of everyday outcomes in schizophrenia: The influences of cognitive impairment, functional capacity, and symptoms. Schizophr Res 115:82–87. doi:10.1016/j.schres.2009.09.004 PubMedCrossRef

32.

Kozma CM, Dirani RG, Canuso CM, Mao L (2010) Predicting hospital admission and discharge with symptom or function scores in patients with schizophrenia: pooled analysis of a clinical trial extension. Ann Gen Psychiatry 9:24. doi:10.1186/1744-859X-9-24 PubMedCrossRef

33.

Cohen AN, Glynn SM, Murray-Swank AB, Barrio C, Fischer EP, McCutcheon SJ, Perlick DA, Rotondi AJ, Sayers SL, Sherman MD, Dixon LB (2008) The family forum: directions for the implementation of family psychoeducation for severe mental illness. Psychiatr Serv 59:40–48PubMedCrossRef

34.

Adewuya AO, Owoeye OA, Erinfolami, AR (2011) Psychopathology and subjective burden amongst primary caregivers of people with mental illness in South-Western Nigeria. Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-010-0293-0 (in press)

35.

Ohaeri JU (2003) The burden of caregiving in families with a mental illness: a review of 2002. Curr Opin Psychiatry 16:457–465. doi:10.1097/01.yco.0000079212.36371.c0

36.

Harvey PD, Helldin L, Bowie CR, Heaton RK, Olsson A-K, Hjärthag F, Norlander T, Patterson TL (2009) Performance-based measurement of functional disability in schizophrenia: a cross-national study in the United States and Sweden. Am J Psychiatry 166:821–827. doi:101176/appiajp200909010106 PubMedCrossRef

Title: Family burden and functional assessment in the Swedish CLIPS-study: do staff and relatives agree on individuals with psychotic disorders’ functional status?
Authors: Fredrik Hjärthag
Lars Helldin
Anna-Karin Olsson
Torsten Norlander
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 4/2012
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-011-0358-8

At a glance: The STEP trials

Springer Medicine

Family burden and functional assessment in the Swedish CLIPS-study: do staff and relatives agree on individuals with psychotic disorders’ functional status?

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2012

Treatment prevalence and incidence of schizophrenia in Quebec using a population health services perspective: different algorithms, different estimates

Chronic medical conditions mediate the association between depression and cardiovascular disease mortality

Prevalence and predictors for post-traumatic stress disorder, depression and general health in a population from six villages in South Lebanon

Prevalence of suicidal behaviours in two Australian general population surveys: methodological considerations when comparing across studies

Quality of life and illness beliefs in individuals with early psychosis

Predicting community violence from patients discharged from acute mental health units in England