Abstract
BackgroundThe difference of burden between caregivers of acute patients with schizophrenia and bipolar disorder has not been well studied in China, a culture where family responsibility has a very high value. Our aim is to compare family burden in these two categories diagnosis and to identify predictors of family burden in a large psychiatric hospital in China.MethodsTwo hundred forty-three schizophrenic patients and 200 bipolar patients were enrolled in a cross-sectional study. Patients were independently evaluated on symptoms, insight, attitudes toward medication, quality of life during the first week of their admissions. The prime caregiver for each patient was also evaluated with a standard measure of family burden within 1 week of patients’ admission.ResultsCaregiver perceptions of violent behavior and suicidal risk among patients with bipolar disorder were significantly greater than among families of those with schizophrenia. Hierarchical regression analyses demonstrated differential correlates of burden for all predictive factors with R2 values ranging from 0.14 to 0.27 in the five burden factors in schizophrenia families; and from 0.12 to 0.24 in bipolar disorder families. Symptoms severity explained the greatest proportion of variance, whereas patient and caregiver demographic variables explained much less variance.ConclusionFamily burden, especially the caregiver perceptions of violent and suicidal behaviors were greater in care givers of acute bipolar disorder patients than among caregivers of schizophrenia patients in the present sample. However, in families of patients with both disorders clinical features were the strongest predictor of caregiver burden.
Highlights
The difference of burden between caregivers of acute patients with schizophrenia and bipolar disorder has not been well studied in China, a culture where family responsibility has a very high value
Significant difference in insurance was noted between the schizophrenia group and bipolar disorder samples, with the schizophrenia sample including more patients covered by insurance (43.6 %, N = 106 vs. 34.0 %, N = 68, x2 = 4.258, p = 0.039)
This study showed that burden was greater in caregivers of acute bipolar disorder patients than among caregivers of schizophrenia patients
Summary
The difference of burden between caregivers of acute patients with schizophrenia and bipolar disorder has not been well studied in China, a culture where family responsibility has a very high value. Schizophrenia and bipolar disorder are two of the most serious and debilitating psychiatric disorders, each affecting approximately 1 % of the population worldwide [1]. For those living with a mental illness, especially in the developing world in which the availability of community support service is limited, family members are the major, if not the exclusive, sources of support and care. Caregiver studies have documented numerous adverse effects of caregiving for a mentally ill family member, impairing quality of life, causing time lost from work, financial stresses, limiting time for leisure and socializing, as well as causing adverse health effects such as elevated stress and depression, feelings of stigmatization, poorer self-rated health, chronic medical conditions, greater use of tranquilizers and antidepressants and increased risk of medical hospitalization [3,4,5].
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