Family Burden Interview Schedule Research Articles

Cognitive–behavioral therapy for patients with somatoform disorders: A pilot preliminary randomized controlled trial

Background and objective: Cognitive–behavioral therapy (CBT) for somatoform disorders (SFDs) is understudied in China. Western findings may not be applicable to Chinese culture. This preliminary study evaluated the efficacy of CBT for patients in China, relative to treatment-as-usual (TAU). Methods: Seventy patients with SFDs randomly received either combined CBT and TAU (CBT + TAU), or TAU alone between January 2018 to May 2019. The CBT + TAU group received 12 weekly individual 50-minute CBT sessions. Participants were blindly assessed at 4 timepoints (baseline, week 6, end of treatment: week 12; 12 weeks post-treatment: week 24) using the following outcome measures: SQSS (Self-screening Questionnaire for Somatic Symptoms); PHQ-15 (Patient-Health-Questionnaire-15) and the WI (Whiteley Index); GAD-7 (General Anxiety Disorder-7); HAMD-17 (Hamilton Depression Rating Scale-17); Family Burden Interview Schedule (FBIS); Sheehan Disability Scale (SDS); and the Short Form of Quality-of-Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF). The primary endpoint was the difference between the SQSS total score at week 24 and the baseline. A mixed model for repeated measures was used to analyze inter- and intra-group changes from the baseline. Results: At week 24, The least-squares mean (LSM) change of the total score on the SQSS was −18.87 points and −9.69 points, respectively in the CBT + TAU group and in the TAU group (LSM difference, −9.18 points; 95% confidence interval, −15.72 to −2.64; P = 0.0068). At week 24, the LSM changes from baseline in the WI, HAMD, PHQ15, FBIS and SDS total scores were significantly different between the two groups, however, there was no significant difference in the Q-LES-Q-SF. The SQSS of group effect sizes were 0.63 at 24 weeks. The dropout rates of the CBT + TAU and TAU groups were comparable (22.9% and 19.3%). Conclusions: These preliminary findings suggest that CBT may be helpful for improving the symptoms of patients with SFDs in China.

Depression, Stress, Anxiety, and Family Burden in Caregivers of Patients with Preexisting Severe Mental Illness and Their Coping Strategies during Omicron Wave of COVID-19 Pandemic

Background and Aims: There is limited research on the impact of COVID-19 pandemic on caregivers of patients with severe mental illness (SMI) during its late phase when sufficient and widespread knowledge about management and preventive aspects existed. We aimed to assess the impact of COVID-19 pandemic on caregivers of patients with SMI during Omicron wave. Methodology: We assessed 100 caregivers of patients with preexisting SMI diagnosed on the Diagnostic and Statistical Manual of Mental Disorders-5, 50 each of schizophrenia and related psychotic disorders (SCZ) and bipolar disorder (BD) from December 14, 2021, to February 9, 2022. We assessed symptoms of depression, anxiety, stress, and family burden in caregivers and their coping strategies by the Depression, Anxiety, and Stress Scale-21 Hindi version, Family Burden Interview Schedule (FBIS), and Brief-Coping Orientation to Problem Experienced, respectively. Results: Caregivers of SMI experienced symptoms of depression (51%), anxiety (72%), and stress (13%), with significantly more symptoms of depression (P = 0.002) and anxiety (P = 0.025) in caregivers of SCZ. High caregiver burden (score: 25.76, > half of the total score on FBIS) was found with no significant difference in the two groups. Caregivers of SCZ used a greater number of emotion-focused coping strategies, whereas those with BD used more problem-focused coping, but the difference was not significant. A significant association was seen between coping strategies of substance use and depressed symptoms (P = 0.003), substance use and anxiety symptoms (P = 0.007); anxiety symptoms with denial (P = 0.001) anxiety symptoms and venting (P = 0.008) in caregivers of BD. Conclusion: Caregivers of patients with preexisting SMI experienced depression, anxiety, and high family burden during Omicron wave. They used both emotion- and problem-focused coping strategies.

Schizophrenia and family burden in Morocco: assessment in a sample of 150 caregivers

BackgroundThere have been few studies conducted in Africa about the burden on families of patients with schizophrenia. This study had two main objectives: assessing the burden of those families and identifying the socio-demographic factors associated with this one.MethodsWe included 300 participants: 150 were primary family caregivers of 150 patients with schizophrenia. A questionnaire was used to collect their sociodemographic and clinical characteristics, and their objective burden using the FBIS (Family Burden Interview Schedule).ResultsPatients were mostly men (n = 122, 81%), the mean age was 32.4 years ± 10.1, and more than half of the patients were psychoactive substance users. Participants (caregivers) were mostly women (n = 90, 60%). Their mean age was 51.9 ± 12.8 years, with a percentage of 62 (41%) illiteracy, while 98 (65%) were parents. The mean score of the family burden was 21.82 (0–48). The most affected categories were family routine, family interaction, and finances. The burden of families was associated with five sociodemographic variables: the female gender of the caregiver (p = 0.01), the male gender of the patient (p = 0.02), his young age (p = 0,004), his education level (p < 0.0001), and his psychoactive substance use (PAS) (p < 0.000 1).ConclusionThe three main constraints encountered by families caring for a patient with schizophrenia were disruption of daily activities, deterioration in the quality of family interactions with those around them, and lastly financial difficulties. These results highlighted the need to set up intermediary socio-medical structures, which would act as a link between conventional hospital services and families.

A cross-sectional study exploring the positive aspects of caregiving in opioid dependence and its relation with quality of life, social support, and caregivers' burden.

Despite a large body of research linking caregiver burden and social support in substance dependence, positive aspects of caregiving in these disorders have received very minimal attention. This exploratory observational study aimed to assess the positive aspects of caregiving for opioid dependence and evaluate the association of these positive aspects with caregiver quality of life, burden, and social support. This cross-sectional study included 199 caregivers of patients with opioid dependence recruited through purposive sampling. Participants were assessed using the Scale for Positive Aspects of Caregiving Experience (SPACE), World Health Organization Quality of Life-BREF version, Family Burden Interview Schedule (FBIS), and Social Support Questionnaire. Of the 199 caregivers recruited, a majority of the caregivers were middle-aged women. About two-thirds of the patients were currently using opioids (n = 135, 67.8%), while the remaining were abstinent. Among the SPACE domain scores, the mean was highest for motivation for the caregiving role (2.07), which was followed by self-esteem and social aspect of caring (2.04), caregiving personal gains (1.76), and caregiver satisfaction (1.65). Caregivers of patients currently abstinent experienced greater positive aspects of caregiving (SPACE mean item score 2.57 versus 1.62, P < 0.001), and lesser burden (FBIS mean score 13.4 versus 29.3, P < 0.001). Positive aspects of caregiving can be potentially utilized for better caregiver engagement in treatment and improved caregiver outcomes.

The burden of caregivers of schizophrenia outpatients during the COVID-19 pandemic: A same-sample comparison with the pre-pandemic burden.

The coronavirus disease 2019 (COVID-19) has affected the vulnerable Brazilian population. In this study, we investigated the burden of COVID-19 on caregivers for patients with schizophrenia. This study assessed objective and subjective burden of caregivers for patients with schizophrenia during the COVID-19 pandemic and compared the measurements obtained in the study to that before the pandemic. The study included 50 caregivers who were assessed using the Sociodemographic Questionnaire, and the Family Burden Interview Schedule, Brazilian version (FBIS-BR). An adaptation of the Clinical Global Impression-Improvement (CGI-I) was made, in which caregivers evaluated their 'clinical' impression about the patient during the COVID-19 pandemic in comparison to pre-pandemic mental status. Most caregivers were female, aged between 24 and 80 years, who were in contact with the patient for about 88.56 hours/week. In relation to caregiver burden, there was a significant increase in the total subjective burden (p < .001), but not in the total objective burden. The following subjective domains of the burden showed a significant increase: assistance in daily life (p < .001) and worries about patients' present and future life (p = .033). There was a decrease in the objective burden related to supervision of patients' problematic behaviors (p = .031). Although the caregiver's income did not change significantly during the COVID-19 pandemic, there was an increase in the percentage of caregivers who perceived the frequency of financial burden imposed by the patient as 'very frequent' and 'always or almost always'; conversely there was a significant decrease in the subjective perception of the caregiver that the patient imposed financially 'no burden' or a 'seldom burden' (from 34% to 4%). Although the objective burden of the caregivers, during the pandemic, was similar the pre-pandemic levels, caregivers' subjective burden increased reinforcing the need for special attention to the caregiver in this global emergency.

The relationship between coping styles and family burden in chronic schizophrenic and bipolar type I patients’ caregivers

BackgroundCaregivers play an essential role in caring of patients with psychiatric disorders. It is important to focus on family burden and coping styles of chronic psychiatric disorders’ caregivers. In this survey, the aim was to measure coping styles’ of schizophrenic and bipolar type I patients’ caregivers, their burden and its relationship between these scales. In this cross-sectional study, 100 main caregivers of patients (50 schizophrenic patients, 50 bipolar type I patients) from both Razi psychiatric hospital were enrolled in the study in 2014. The instruments were family burden interview schedule (FBIS) and Weintraub coping orientations to problems experienced (COPE). Chi-square, Pearson correlation coefficient, and independent t-test were used for data analysis.ResultsThere was inverse correlation between burden and problem-focused coping strategy about caregivers of both groups (r = − 0.29, P < 0.01). There was a direct correlation between burden and emotional-oriented and less benefit and not effective coping strategies, but it was not significant. The independent t-test demonstrated caregivers’ burden is not significantly different between bipolar mood disorder and schizophrenia.ConclusionsSocial support and health services to caregivers of chronic schizophrenia and bipolar disorder are necessary. Training effective coping style reduces perceived caring burden.

A prospective observational study of change in caregiver burden and psychological distress in caregivers of patients with alcohol dependence.

Alcohol use disorder has a substantial impact on patients' caregivers, leading to burden and adverse effects on their psychological health. Currently, there is limited literature which is available to suggest whether the burden and psychological distress of the family members change when patients with alcohol dependence undergo treatment. This study aimed to longitudinally examine the change in burden, depression, anxiety, and stress experienced by caregivers of patients with alcohol dependence undergoing treatment. This prospective observational study recruited treatment-seeking men with alcohol dependence and their caregivers as dyads. The burden, depression, anxiety, and stress of caregivers were assessed at baseline and at six weeks, using the Family Burden Interview Schedule and Depression Anxiety Stress Scale, respectively. Pre and post values were compared using paired t-test. Interaction effects of resumption of drinking were assessed using repeated measures test. Of the 101 dyads recruited in the study, 60 could be followed up at six weeks. Significant decrements were seen in burden, depression, anxiety, and stress of caregivers at six weeks compared to baseline (mean 62.3%, 54.2%, 65.9%, and 53.4%, respectively, all P < 0.001). The decrement in burden and depression was lower in those caregivers where the patients had resumed alcohol use within the span of six weeks. Findings suggest that engagement in treatment by patients with alcohol dependence may reduce the burden and psychological distress among their caregivers, more so in situations where the patients had quit alcohol. However, the change in burden and psychological distress could be due to several other factors as well.

A Path Analysis Model Examining Factors Affecting the Caregiving Burden Experienced by the Family Caregivers of Drug Addicts in Egypt.

Although the caregiving burden experienced by the family caregivers of drug addicts is receiving increased attention, there is still a need to study the possible predictors of the care burden, especially with the increasing numbers of addicts in Egypt and the important role of family caregivers in the support and treatment of addicts. A cross-sectional study. This study was conducted at Minia Hospital for Mental Health and Addiction Treatment, Egypt. Data was collected during interviews with addicts and their family caregivers. The caregiver burden was assessed using the Family Burden Interview Schedule (FBIS). The path analysis was used to assess the interrelationships between the burden and characteristics of addicts and caregivers. Based on the results, 96.7% of addicts were males, and their mean age was 28.8 ± 8.1 years, while their caregivers aged 39.7 ± 10.4 years and included 58.7% males. The caregivers reported a severe burden of care which was predicted by the addict's drug-related problems (B = 0.25, P = 0.0003), financial hardship (B = 0.46, P < 0.0001), and the caregiver's occupation (B = -0.16, P = 0.017). Financial hardship had an indirect association with the burden of care (B = 0.06, P = 0.041) mediated through drug-related problems score, which was predicted by the severity of dependence, admission for treatment, and the level of social support. The burden of caring for addicts depends on patient-related problems, as well as caregivers' situations and income. Strategies to provide social support, financial aid, and problem-solving skills should be provided to the addicts and their caregivers as a part of treatment programs to help reduce the caregiving burden.

Title: Significant co-dependency, anxiety, depression and family burden among the caregivers of patients with opioid dependence syndrome: an observational study

Background: The opioid dependence syndrome impacts patients and affects their caregivers. In India, the caregivers tie a strong bond with patients and play a significant role in their treatment. However, the caregivers suffer adverse effects like violence, anxiety, depression symptoms, and other psychological stress due to the opioid use of those they care for. Especially, spouses of opioid users experience a greater rate of co-dependency (excessive emotional or psychological dependency on their partner) and family burden. Aim: This study measured the co-dependency, depression, anxiety, and family burden and their association among caregivers of patients with opioid dependence syndrome. Method: A cross-sectional study was conducted among 132 caregivers of patients with opioid dependence syndrome at a tertiary care unit of Lucknow, Uttar Pradesh using the MINI 6.0 for co-morbidities, Span Fischer co-dependency scale for co-dependency, Patient Health Questionnaire-9 for depression, Generalized Anxiety Disorder-7 for anxiety, and Family Burden Interview Schedule for family burden tools. The data were collected and analyzed using SPSS version 16. Result: The study demonstrated that caregivers of opioid dependence syndrome patients reported severe co-dependency (50%), severe anxiety (75.6%), and moderately severe depression (54.5%). All participants reported a high burden (100%). A positive correlation was found between variables like- co-dependency and anxiety, co-dependency and depression, co-dependency and family burden, anxiety and depression, anxiety and family burden, and depression and family burden. A significant association was found among variables like co-dependency and anxiety, depression, and family burden which is the following hypothesis. Conclusion: The present study illustrated that all the caregivers experienced anxiety, depression, co-dependency, and family burden. Preventive measures need to address these issues of caregivers during the treatment of patients with opioid use disorder. Keywords: Caregivers; Opioid Dependence Syndrome; Co-Dependency; Anxiety; Depression; Family Burden

Effects of Disability Severity on the Family Burden of Home-Dwelling Uygur and Kazakh Aged in Rural Western China: Family Function as a Mediator.

Caring for the disabled elderly puts heavy burdens on their families. This study aimed to explore family function (FF) as a mediator in the relationship between disability severity (DS) and family burden (FB) of the Uygur and Kazakh home-dwelling disabled elderly cared for by informal caregivers in China. A cross-sectional design with multistage sampling was used to recruit 431 families with Uygur and Kazakh disabled elderly in Bortala, Xinjiang, China. Data were collected using the Activities of Daily Living Scale, Family Burden Interview Schedule, and Family Adaptation, Partnership, Growth, Affection, and Resolve Index Scale and then analyzed using hierarchical regression. FF had a partial mediating effect on the relationship between DS and FB (β = 0.131; 95% confidence interval [CI] = [0.074, 0.197]; p < .01); the effective rate was 41.46%. Multidisciplinary care teams should implement targeted interventions to improve FF of the disabled elderly to alleviate FB.

IMPACT OF FAMILY STIGMA AND CAREGIVER BURDEN ON QUALITY OF LIFE AMONG WIVES OF PATIENTS WITH ALCOHOL AND OPIOID USE DISORDER

Objectives: Spouses of patients with alcohol use disorder (AUD) and opioid use disorder (OUD) suffer from burden, stigma, and low quality of life (QoL). The present study assessed the impact of stigma and burden on QoL among wives of patients with AUD and OUD. Methods: 90 wives of in-patients with severe AUD (n=54) and OUD (n=36) as per DSM-5 were assessed using socio-demographic pro forma, WHO QoL Bref Hindi, Hindi family stigma scale and Family Burden Interview Schedule. Statistical Package for the Social Sciences Inc., Chicago, IL, version 25.0 for Windows was used for analysis. Appropriate statistical tests including Kolmogorov–Smirnov tests of normality, Mann–Whitney test, and Kruskal–Wallis test were used. To see the relationship between two variables Pearson Correlation coefficient was calculated. All statistical tests were two-sided and performed at a significance level of α=.05. Results: Majority of the wives were more than 30 years old, literate and belonged to rural areas. Higher financial burden reduced overall QoL (p=0.001**), satisfaction with physical health (0.006**), psychological health (p=0.032*), and environment (p=0.001**). There was a negative correlation of satisfaction with environment with disruption of family interaction (p=0.003**), burden on mental health (p=0.001**), overall burden (p=0.000**), and discrimination (p=0.032*). Conclusion: QoL of spouses of patients with AUD and OUD reduces significantly due to stigma and burden. Enhancing QoL of spouses should be a part of management of AUD and OUD.

Burden on caregivers of schizophrenia outpatients in Brazil: Relationship to symptomatology and functioning.

To investigate the objective and subjective burden on caregivers of schizophrenia outpatients and their associations with sociodemographic factors, symptomatology, and functioning. This study included 60 schizophrenic outpatients aged 18 to 65 years who were clinically stable for at least 6 months, and 60 caregivers aged 18 to 80 years who were in contact with the patient for ⩾30 hours/week. The patients were assessed using a sociodemographic questionnaire, the Clinical Global Impression Scale for Schizophrenia (CGI-SCH), and the Personal and Social Performance scale (PSP). The caregivers were assessed using a sociodemographic questionnaire and the Family Burden Interview Schedule, Brazilian version (FBIS-BR). The objective burden was positively correlated with CGI-SCH cognitive symptom scores (p = .032) and number of hours spent weekly with the patient (p = .028), and negatively correlated with PSP score (r = -.346, p = .007). The subjective burden showed a negative correlation with age of disease onset (r = -.338, p = .08). The independent variables included in the regression model were family income (p = .005), PSP score (p = .009), patient marital status (p = .012), patient gender (p = .046), and reception of financial benefit (p = .027) for objective burden; and disease duration (p = .045) and father/mother or sibling relationship (p = .001) for subjective burden. The coefficient of determination (R2) of the linear regression model for objective burden was 39.4%; subjective burden, 21.6%. Caring for female, single patients with longer disease duration, more severe cognitive symptoms, impaired functioning, and more caregiving time required per week were associated with higher caregiver burden levels.

A comparative study of family burden between alcohol dependent patients and patients with schizophrenia

Background: Alcohol dependence and Schizophrenia are two major psychiatric illnesses posing considerable burden on the families and caregivers. Alcohol dependence, like Schizophrenia, tends to run a chronic and erratic course causing a significant burn out on the families.&#x0D; Aims and Objectives: 1. To describe the Socio-demographic characteristics of Alcohol dependent patients and patients with Schizophrenia. 2. To compare the family burden in patients with Alcohol dependence and patients with Schizophrenia.&#x0D; Materials and Methods: The study was conducted in the Department of Psychiatry of a tertiary institute of north eastern India over a period of one year. A total of 100 cases (50 each of Alcohol dependence and Schizophrenia) constituted the study sample. A Semi-structured proforma was used for socio-demographic variables. The assessment of family burden was done using Pai and Kapur Family Burden Interview Schedule.&#x0D; Results: The two groups differed significantly from each other with respect to most of the sociodemographic variables. The overall family burden in the alcohol dependent patients was significantly higher than in schizophrenia patients.&#x0D; Conclusion: The families of both Schizophrenia and alcohol dependent patients suffer from moderate to severe amount of burden in various dimensions of their lives and the burden experienced by the families of alcohol dependent patients is in no way lesser than a chronic debilitating illness like Schizophrenia.

Caregivers of schizophrenic patients in Calabar: Extent and predictors of burden

Objectives: Caregivers of people with mental disorders usually experience consequences which might generate burden and have an effect on each aspect of their life. This study aimed to assess the extent and associated factors of burden on caregivers of schizophrenic patients seen at the Federal Psychiatric Hospital Calabar, Nigeria. Material and Methods: A hospital-based cross-sectional study design was used to study 100 consecutive caregivers of patients with schizophrenia seen at the outpatient clinic of the hospital between 15 December 2019 and 21 April 2020. Data were collected from the study participants using socio-demographic questionnaire, Patient Health Questionnaire-9, Brief Psychiatric Rating Scale (BPRS), and Family Burden Interview Schedule. Quantitative data were presented as mean (standard deviation) and categorical data as frequency/percentages. Statistical analysis was performed using independent sample t-test. Multivariate analysis was performed to determine the predictors of burden on caregivers. All values of P &lt; 0.05 were considered significant. Results: Ninety percent and 88% of the caregivers, respectively, had some level of objective and subjective burden. The factors associated with objective burden on the caregivers were employment status of the patient, BPRS score, number of suicide attempts, and number of hours per week the caregiver was in contact with the patient. The subjective burden was associated with BPRS score, number of hospitalization, number of relapses, monthly income of the caregiver, and caregiver’s level of education. The employment status of the patient significantly predicted objective burden on the caregiver (P &lt; 0.001). Conclusion: This study showed that caregivers of patients with schizophrenia experience high level of burden. The study also identified factors which might guide clinicians to institute intervention programs aimed toward reducing burden on the caregivers of schizophrenic patients.

Family functionality and burden of family caregivers of users with mental disorders.

to verify the difference of mean or median in the scores of family functionality and burden of family caregivers of people with mental disorders. cross-sectional study carried out in a Psychosocial Care Center with 61 family caregivers. Instruments were used for sociodemographic characterization, care process, Family Apgar Index and Family Burden Interview Schedule. Mean/median difference tests were adopted. women with mental disorders and the presence of children in the home decreased the median of the family Apgar score. Difficulty in the relationship between caregiver/user, nervousness/tension, physical aggression and agitation of patients increased the global average of subjective burden. nursing interventions to reduce burden and promote family functionality should prioritize caregivers of women with mental disorders, assist them in managing troublesome behaviors and raising awareness of family nucleus to co-responsibility for caring for sick people, especially in families with children who demand daily care.

Burden and Quality of Life Among Primary Caregiver of Alcohol Dependence Syndrome

<i>Background</i>: Alcohol Dependence syndrome is one of the common psychiatric illnesses in the society. It not only affects the individual but also has major impact on the family members especially the primary caregiver. There are minimum studies regarding impact of the alcohol dependence patients on the primary caregiver in Nepal. The objective of this study was to study the burden and quality of life among primary caregiver of alcohol dependence syndrome. <i>Material and Methods</i>: This is a cross-sectional study conducted among the primary caregiver of alcohol dependent patient. This study is conducted in the in-patient and out-patient unit of Psychiatric Department of National Medical College and Teaching Hospital, Birgunj, Nepal. The total sample size was 123 taken by non-probability homogenous purposive sampling method. The diagnosis of alcohol dependence syndrome was made using International Classification of Disease-10 (ICD-10) criteria. The socio-demographic profile of alcohol dependence patients and their primary caregivers were assessed using semi-structured proforma. The burden and quality of life of the primary caregiver of the alcohol dependent patient were determined using Family Burden Interview Schedule (FBIS) and World Health Organization Quality of Life- BREF version. The data were entered and analyzed using SPSS 21. <i>Result</i>: In this study, it was found that caregiver of Alcohol Dependence Syndrome patient faced moderate to severe burden according to the different domains of Family Burden Interview Schedule. In quality of life assessment, the mean score on perception of quality of life was 2.78 (±0.66) and the mean score on overall perception of health was 3.57 (±0.64). Similarly, the mean score on physical health was 23.40 (±3.04), the mean score on psychological health was 18.91 (±2.36), the mean score on social relationships was 10.63 (±1.39), the mean score on the environment was 25.58 (±2.80) which indicates the poorer quality of life in the caregiver of alcohol dependent patient. <i>Conclusion</i>: The study concluded that burden level on the primary caregiver of alcohol dependent patient was moderate to severe. The quality of life of the caregiver of alcohol dependent patient had poorer quality of life.

Burden of care among caregivers of patients with bipolar affective disorder at the Federal Neuropsychiatric Hospital, Calabar

Background: The advent of community-based care and de-institutionalization of persons with mental disorders have led to a progressive shift of care from formal health-care systems to informal care providers such as the family. This shift of care, from hospitals to the families, has led to a significant level of the burden on the family caregiver. This study aimed to identify factors which are associated with burden of care among caregivers of patients with bipolar affective disorder (BAD) seen at the Federal Psychiatric Hospital, Calabar. Materials and Methods: A simple random sampling technique of “yes or no” balloting was utilized to select 105 caregivers of bipolar patients seen at the outpatient clinic of the hospital. The selected caregivers (those who picked “yes”) were recruited along with their respective patients after obtaining their consent. They were assessed using a set of five questionnaires, of which three (Patient Health Questionnaire-9 [PHQ-9], Young Mania Rating Scale [YMRS] and Brief Psychiatric Rating Scale [BPRS]) were administered by the researchers on the patients whereas the remaining two (sociodemographic questionnaire and Family Burden Interview Schedule) were self-completed by the caregivers. Results: One hundred out of the 105 caregivers who were recruited completed the study procedure and returned properly filled questionnaires. The rates of objective and subjective burden on the caregivers were 79% and 74%, respectively. While the objective burden was associated with the patient's educational attainment and his/her scores on the YMRS and BPRS, the subjective burden was associated with the caregiver's monthly income and marital status, the patient's gender, number of suicide attempts, and scores on PHQ-9, YMRS, and BPRS. Of all the variables, the patients' scores on YMRS (P = 0.025) and PHQ-9 (P = 0.011) were the significant predictors of objective and subjective burden, respectively. Conclusion: This study identified the extent and factors associated with burden of care on caregivers of patients with BAD. Awareness of those factors might guide clinicians in instituting treatment strategies toward reducing the burden on caregivers.

A comparative study of caregiver burden and stigma among the caregivers of patients with dementia and schizophrenia

Aim: This study aimed to assess the level of stigma faced by the caregivers of patients with dementia. The secondary objective was to evaluate the association of stigma faced by the caregivers with caregiver burden and compare the stigma and caregiver burden encountered by the caregivers of patients with dementia and schizophrenia. Methodology: This was a cross-sectional study, 50 patients with dementia and their caregivers and 50 patients with schizophrenia and their caregivers. Diagnosis of both the disorders was made as per the Diagnostic and Statistical Manual, Fifth Revision. The study participants were assessed on the Stigma Scale for caregivers of people with mental illness and family burden interview schedule. Results: Caregivers of patients with schizophrenia had been in the caregiver role for a longer duration and were not on paid employment. Caregivers of patients with dementia were more often children of the patients. Caregivers of patients with dementia reported a significantly lower level of stigma in all the domains as well as reported lower total stigma score. The significant difference persisted even after controlling for demographic and caregiving variables. Similarly, caregivers of patients with schizophrenia reported a significantly higher level of burden on all the domains, except for effect on the domain of mental health of others which persisted even after controlling for demographic and caregiving variables. Conclusion: Caregivers of patients with dementia experience a lower level of stigma and caregiver burden, compared to patients with schizophrenia even after controlling for different confounding variables.

Correlates of Quality of Life in Caregivers of Patients with Schizophrenia and Bipolar Affective Disorder: A Study From Southwestern Nigeria

Quality of life and its correlates were studied in two groups of family caregivers of patients with major mental disorders-Schizophrenia (SZ) and Bipolar Affective Disorder (BPAD). Family caregivers of SZ and BPAD patients were consecutively recruited to the study (n=100 for each group). Caregivers were screened for quality of life (QOL) measures, caregiver burden, symptoms of anxiety and depression, using the World Health Organization Quality of Life Scale (WHOQOL-BREF), the Pai and Kapur Family Burden Interview Schedule (FBIS) and the Hospital Anxiety and Depression Inventory (HADS) respectively. When compared to the caregivers of the BPAD patients, the caregivers of the SZ patients had lower QOL scores in two out of the 4 WHOQOL-BREF domains (physical and psychological domains) (p=0.001), and higher overall total caregiver burden (p=0.001). On the other hand, caregivers of the BPAD patients had higher levels of depressive symptoms (p=0.001). Increased depressive symptoms were associated with lower QOL for both groups, comprising all WHOQOLBREF domains for BPAD and 3 domains for SZ caregivers. Higher caregiver burden was associated with lower QOL for both groups. There is a need for intervention and caregiver support for the relatives of patients with bipolar disorder and schizophrenia.

The Extent of Stigma Experienced by the Caregivers of Patients with OCD and its Association With Caregiver Burden and Coping

Stigma related to psychiatric illness not only impact the patients but also have adverse consequences on the caregivers. Stigma can lead to poor quality of life, social restriction, and psychological morbidity. Not much data is available on the stigma among the caregivers of patients with Obsessive–Compulsive Disorder (OCD). To evaluate the extent of stigma experienced by the caregivers of patients with OCD and its association with caregiver burden and coping. In a cross-sectional study, 53 caregivers of patients with OCD were evaluated on the Stigma Scale for Caregivers of People with Mental Illness (CPMI), Family Burden Interview (FBI) Schedule, and Family Coping Questionnaire (FCQ). The mean age of the caregivers was 45.9 years, with the number of years of formal education was 8.6 (SD: 5.4) years. Majority of the caregivers were male and married, were the spouse of the patient with a mean duration caregiving at the time of assessment being 122.6 months. In terms of stigma, the highest level of stigma was seen in the affective domain, followed by behavioural domain and least in the cognitive domain of CPMI. On FBI the highest level of burden was seen in the domain of disruption of routine family activities, followed by disruption of family interaction, disruption of family leisure activities, financial burden, the effect on the physical health of others, and effect on mental health others. On FCQ, Positive communication and resignation were the most commonly used coping mechanisms. The least commonly used coping strategy was the patient's social involvement. All the domains of CPMI had a significant positive association with a total objective score of FBI. In terms of coping, a higher level of stigma was associated with lower use of social involvement (all domains of stigma), coercion (cognitive domain and total stigma), and avoidance (all domains except for affective domain) as coping mechanisms. Lower use of positive communication was associated with higher stigma in the behavioural domain. Those with a high objective burden had a higher level of stigma on the cognitive and behaviour domain of the CPMI. Caregivers of patients with OCD experience a high level of stigma. A higher level of stigma is associated with the more use of maladaptive coping like avoidance and higher caregiver burden. Accordingly, it can be said that there is a need to focus on the caregivers of patients with OCD to improve the overall outcome of the patients.