Abstract
BackgroundIn previous years, research has focused on the situation of psychiatric patients' minor children. The aims of this qualitative study were to describe the experience of adult children of depressed and bipolar patients, including positive and negative factors as well as coping mechanisms, and to investigate possible predictors of burden in order to identify children in need of professional support.MethodsA total of 30 adult children were interviewed using a semi-structured interview. In addition, all children completed the Freiburg Questionnaire of Coping with Disease (Freiburger Fragebogen zur Krankheitsverarbeitung, FKV). Regression analysis indicated the most relevant predictors of burden.ResultsAll (100%) of the children reported emotional burden due to the illness of their parent, 90% suffered from impaired family life, and 77% experienced burden due to the parent's symptoms. Reward (positive experience) was reported regarding the intensification of the parent-child relationship. Linear regression analysis shows predictors for highly burdened children as well as for children who are more prone to maladaptive ways of coping. Higher burden was significantly associated with the child's age, severity of illness of the parent, and specific diagnosis.ConclusionsAlthough some positive aspects of parental affective disorder exist, this study underlines that children primarily suffer from their parent's disorder and that this burden does not stop in adulthood. Providing professional support to adult as well as to minor children of affected individuals should become standard of care in clinical settings.
Highlights
In previous years, research has focused on the situation of psychiatric patients' minor children
Burden experienced due to the parent's disorder The children's statements were summarized into 38 global statements and assigned to eight categories of burden: emotional burden, burden due to impaired family life (90%), burden due to the patient's symptoms (76.7%), burden due to dissatisfaction with the patient's therapy/professional staff (73.3%), burden due to impaired free-time activities (63.3%), burden due to impaired functioning in school/job (46.7%), burden due to own health problems (43.3%), and burden due to problems in the child's relationship/own family (30.0%)
This study found aspects of burden which are special to children in the role as caregivers of psychiatric patients
Summary
Research has focused on the situation of psychiatric patients' minor children. In studies exploring caregiver burden, children of psychiatric patients tend to comprise a small part of a heterogeneous subject group (e.g., Cleary et al 2005; Reinares et al 2006; Adewuya et al 2011). Chronic psychiatric disorders, such as bipolar and depressive disorder, often end in serious problems like loss of job, poverty, or decrease of social functioning - even in times when the patient is symptom-free (Bauer et al 2012a; Coryell et al 1993). No study has been conducted that describes the burden adult children experience as a consequence of parental psychiatric disorder.
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