Zarit Caregiver Burden Interview Research Articles

Partial improvement in performance of patients with severe Alzheimer's disease at an early stage of fornix deep brain stimulation.

Deep brain stimulation is a therapy for Alzheimer's disease (AD) that has previously been used for mainly mild to moderate cases. This study provides the first evidence of early alterations in performance induced by stimulation targeted at the fornix in severe AD patients. The performance of the five cases enrolled in this study was scored with specialized assessments including the Mini-Mental State Examination and Clinical Dementia Rating, both before and at an early stage after deep brain stimulation. The burden of caregivers was also evaluated using the Zarit Caregiver Burden Interview. As a whole, the cognitive performance of patients remained stable or improved to varying degrees, and caregiver burden was decreased. Individually, an improved mental state or social performance was observed in three patients, and one of these three patients showed remarkable improvement in long-term memory. The conditions of another patient deteriorated because of inappropriate antipsychotic medications that were administered by his caregivers. Taken together, deep brain stimulation was capable of improving some cognitive aspects in patients with severe AD, and of ameliorating their emotional and social performance, at least at an early stage. However, long-term effects induced by deep brain stimulation in patients with severe AD need to be further validated. More research should focus on clarifying the mechanism of deep brain stimulation. This study was registered with ClinicalTrials.gov (NCT03115814) on April 14, 2017.

Clinical and demographic variables associated with coping and the burden of caregivers of schizophrenia patients

ObjectiveTo analyse the relationship between burden of illness and coping strategies and the demographic variables of caregivers, and the demographic and clinical variables of people diagnosed with schizophrenia. MethodsMulticentre correlational cross-sectional study including 70 people diagnosed with schizophrenia, or a schizoaffective disorder, and 70 primary informal caregivers. They were evaluated using the Zarit Caregiver Burden Interview, Family Coping Strategies Questionnaire, Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, and the brief Disability Assessment Scale. ResultsBurden of illness positively associated with patient impairment in occupational and social functioning, and negatively with education level. Avoidance, coercion and positive communication were positively associated with impairment in occupational and social functioning of patients. Social interest and friendships showed a positive association with the education level of caregivers. Spiritual assistance negatively correlated with impairment in social functioning and patient age, and resignation was negatively associated with length of the disorder and patient education level. ConclusionsBurden and dysfunctional coping strategies, such as avoidance and coercion, are associated with functional impairment of the patient. These findings suggest the need to provide support to caregivers, adjusted to the functional level of the patient, in order to prevent burden of care.

Determination of Care Burden of Caregivers of Patients with Multiple Sclerosis in Turkey.

The aim of this study was to determine the care burden of caregivers of patients with multiple sclerosis in Turkey. This descriptive study was conducted with 92 caregivers. To collect data, information form and Zarit Caregiver Burden Interview (ZCBI) were used. Most of the caregivers (65.2%) were females and 71.7% of them were married. The average age of caregivers was 38 and above. The mean ZCBI score of caregivers was 25.44 ± 9.50. The ZCBI score was significantly higher in caregivers providing care for more than six years (28.09 ± 10.16). Additionally, the ZCBI score was significantly higher in caregivers providing care 3-4 hours per day (32.23 ± 8.37) and providing physical care (29.28 ± 5.18).

The Efficacy and Safety of Yokukansankachimpihange for Treating Behavioral and Psychological Symptoms of Dementia in Patients with Alzheimer’s Disease: An Open-Label Pilot Study

Previous clinical trials have demonstrated the efficacy of yokukansan, a traditional Japanese medicine, for the treatment of behavioral and psychological symptoms of dementia (BPSD). However, less evidence is available for the treatment of BPSD with yokukansankachimpihange (YKSCH), which consists of yokukansan and two additional herbal ingredients. The present study was conducted to investigate the efficacy and safety of YKSCH for treating BPSD in patients with Alzheimer’s disease (AD). We enrolled outpatients with mild-to-moderate AD who exhibited BPSD and obtained a Neuropsychiatric Inventory (NPI) score of >3 including subscale scores for “agitation”, “anxiety”, “irritability”, and “sleep and night-time behavior change”. A daily YKSCH dose of 7.5 g was administered for 12 weeks with concomitant administration of anti-dementia medication. BPSD was evaluated using the NPI at baseline and every 4 weeks during the intervention. We also examined apathy using the Japanese translation of the Apathy Scale, the short version of the Japanese version of the Zarit Caregiver Burden Interview, and the Modified Crichton Rating Scale for Predicting Activities of Daily Living. Cognitive dysfunction was evaluated using the Mini Mental State Examination and the AD Assessment Scale-Cognitive (Japanese version). Five participants were enrolled. The NPI total score tended to decrease between the baseline and 8-week evaluations during the YKSCH intervention (Wilcoxon signed rank test, P = 0.063). In terms of the NPI subscale scores, “apathy”, “agitation”, “delusions”, and “sleep and night-time behavior change” decreased after the intervention in those who exhibited each symptom at baseline. There were no significant differences in the other scores examined. No serious adverse events were observed. YKSCH could ameliorate BPSD in patients with mild-to-moderate AD with agitation, anxiety, irritability, and sleep and night-time behavior change, and it was well-tolerated.

Psychometric properties of the Zarit Caregiver Burden Interview administered to caregivers to patients with Duchenne muscular dystrophy: a Rasch analysis

Purpose: To explore the psychometric properties of the full 22-item English (UK and US) version of the Zarit Caregiver Burden Interview administered to caregivers to patients with Duchenne muscular dystrophy.Materials and methods: Caregivers to patients with Duchenne muscular dystrophy from the United Kingdom and the United States, recruited through the TREAT-NMD network, completed the Zarit Caregiver Burden Interview online. The psychometric properties of the Zarit Caregiver Burden Interview were examined using Rasch analysis.Results: A total of 475 caregivers completed the Zarit Caregiver Burden Interview. Model misfit was identified for 9 of 22 items (mean item fit residual 0.061, SD: 2.736) and 13 of 22 items displayed disordered thresholds. The overall item-trait interaction chi-square value was 499 (198 degrees of freedom, p < 0.001). The mean person fit residual was estimated at −0.213 (SD: 1.235). The Person Separation Index and Cronbach’s α were estimated at 0.902 and 0.914, respectively. Item dependency was low and we found no significant differential item functioning by country or sex.Conclusion: Our Rasch analysis shows that the Zarit Caregiver Burden Interview fails to fully operationalize a quantitative conceptualization of caregiver burden among caregivers to patients with Duchenne muscular dystrophy from the United Kingdom and the United States. Further research is needed to understand the psychometric properties of the Zarit Caregiver Burden Interview in other populations and settings.Implications for RehabilitationDuchenne muscular dystrophy is a terminal disease characterized by progressive muscle degeneration resulting in substantial disability and a significant burden on family caregivers.The Zarit Caregiver Burden Interview is one of the most widely applied measures of caregiver burden.Our Rasch analysis suggests that the Zarit Caregiver Burden Interview is not fit for purpose to measure burden in UK and US caregivers to patients with Duchenne muscular dystrophy.Clinicians and decision-makers should interpret Zarit Caregiver Burden Interview data from these populations with caution.

Caregiver burden, sleep quality, depression, and anxiety in dementia caregivers: a comparison of frontotemporal lobar degeneration, dementia with Lewy bodies, and Alzheimer's disease.

This study was carried out from March 2011 to January 2014. In total, 492 dyads of patient and caregiver (frontotemporal lobar degeneration, n = 131; dementia with Lewy bodies, n = 36; Alzheimer's disease, n = 325) participated in this study. We compared patients with respect to the Neuropsychiatric Inventory and caregivers with respect to the Zarit Caregiver Burden Interview, Pittsburgh Sleep Quality Index, Patient Health Questionnaire-9, and Generalized Anxiety Disorder scale. Frontotemporal lobar degeneration and dementia with Lewy bodies patients presented significantly more neuropsychiatric symptoms compared to Alzheimer's disease patients. Caregivers of frontotemporal lobar degeneration and dementia with Lewy bodies patients experienced significantly more burden compared to Alzheimer's disease caregivers. Furthermore, among caregivers of both frontotemporal lobar degeneration and dementia with Lewy bodies patients burden was predicted by the neuropsychiatric symptoms, PHQ-9 scores, and GAD-7 scores. The frequency and severity of behavioral disturbances in patient and caregiver stress accounted for the increased caregiver burden, which suggests that frontotemporal lobar degeneration and dementia with Lewy bodies caregivers should receive more support than is currently available.

Factors associated with health-related quality of life among family caregivers of disabled older adults: a cross-sectional study from Beijing.

Because of the aging population and the shortage of standardized institutional solutions for long-term care (LTC) in China, family caregivers in Beijing are increasingly called upon to provide home care for disabled older adults. Caregivers face a heavy care burden, and decreased physical and mental health (MH). This study aims to describe health-related quality of life (HRQoL) and to identify its predictors for Chinese family caregivers of disabled older adults.A total of 766 caregivers were recruited from 5 communities in the Dongcheng District of Beijing. Measures included the 36-item Short-Form Health Survey (SF-36), the Zarit Caregiver Burden Interview (ZBI) scales, and the Chinese Social Support Rating Scale (SSRS). Hierarchical multiple regression (HMR) analysis was used to identify the predictors.HMR analysis showed that each block of independent variables (demographic characteristics of disabled older adults, demographic characteristics of caregivers, caregiving context, and subjective caregiver burden) had contributed significantly to caregivers’ physical and mental quality of life. Subjective caregiver burden explained the greatest amount of total variance in all MH subscales and the 2nd greatest amount of variance in most physical subscales. Therefore, subjective caregiver burden was the strongest predictor of HRQoL.Our findings suggest that a decrease in caregiver burden can improve caregivers’ HRQoL, and additional social support is important in decreasing the impact of caregiving on HRQoL. Importantly, an LTC system should be established in China as soon as possible.

Post-stroke depression as a predictor of caregivers burden of acute ischemic stroke patients in China

Our aim was to explore the independent attribution of Post-stroke depression (PSD) to caregiver burden of acute ischemic stroke patients. A cross-sectional survey was performed with 271 acute ischemic stroke patients in the Huai-He Hospital and First People’s Hospital of Kaifeng City in China. PSD was assessed by Self-rating Depressive Scale, and caregiver burden was assessed by Zarit Caregiver Burden Interview. Clustered logistic regression was applied to identify the impact of PSD on caregiver burden. As results, female patients, normal muscle strength and PSD were associated with caregiver burden. PSD correlated with an independent influence of 17.2% on the risk of caregiver burden, The independent influence of PSD on caregiver burden was smaller than that of social-demographics of caregivers and clinical factors of stroke patients This study suggests that PSD may have a modest influence on caregiver burden.

Quality of life of family caregivers of patients with a left ventricular assist device in Japan

BackgroundThe role of caregivers is important for the successful support of left ventricular assist device (LVAD) patients. We aimed to (1) evaluate quality of life (QoL) of caregivers pre-and post-LVAD implant and (2) identify factors associated with caregivers’ QoL. MethodsThe caregivers’ QoL was assessed with the Short Form-8 before implant, at 3 and 6 months after LVAD implantation. The physical and mental component summary (PCS and MCS) scores were calculated. Caregiver burden was evaluated using the 8-item Zarit Caregiver Burden Interview. ResultsData were collected from LVAD patients as bridge-to-transplant and their family caregivers in Japan. No significant changes were found in caregivers’ PCS scores during the follow-up (before 52.7±7.1; at 3 months 49.7±6.5, and at 6 months 50.7±6.4, n=20). Compared with the scores before implant (38.9±9.3), the caregivers’ MCS scores improved after LVAD implantation at 3 months (44.2±7.7; p=0.03) and at 6 months (46.2±7.4, p=0.003), but they were still lower than those of the Japanese general population (p<0.01). In multiple regression analysis at 3 months (n=40), caregivers’ lower PCS scores were associated with older patient age [standard partial regression coefficients (sβ)=−0.36, p=0.02] and caregiver unemployment (sβ=0.30, p=0.04), whereas being female (sβ=−0.26, p=0.03), being the patient's spouse (sβ=−0.23, p=0.03), and having a mild to moderate caregiving burden (sβ=−0.63, p<0.001) were associated with lower MCS scores among caregivers. ConclusionsLVAD implantation improves caregivers’ mental QoL. Since caregivers’ MCS scores are lower than the general population, it is important to identify family caregivers at risk for low QoL and reduce their caregiving burden.

EFFICACY OF GROUP PSYCHOTHERAPY FOR CAREGIVERS OF DEMENTIA PATIENTS

In the field of dementia, growing evidence of non-pharmacologic therapy for the patients has been emerged; however, studies focusing on supporting their caregiver's mental stress are limited. Group psychotherapy has originally developed among psychology/psychiatry field, aiming the patients’ mutual interaction and communication, together with clinical psychologists and practitioners. It is unclear whether the applicability and the efficacy of this type of psychotherapy for caregivers of dementia patients. Therefore, we had started up the group psychotherapy team in 2007 including psychiatrist, nurse and clinical psychologist, and have continued to provide this therapy for a decade. The scheme of our group psychotherapy consists of mixture of counseling, psychoeducation and family association. The purpose of this study was to examine the efficacy of group psychotherapy. We recruited the caregivers of dementia patients who agreed with the informed consent with respect to the concept of this therapy and the purpose of this study. All individuals had been aware that they had some stresses in daily care of the patients at the enrollment. Our group psychotherapy was registration-based, biweekly 60 minutes five sessions. To assess the efficacy, the endpoint was determined as the score change between the initial and the last assessment of the series of psychological tests using Japanese version of Profile of Mood States-Brief (POMS), Self-rating Depression Scale (SDS) and Zarit Caregiver Burden Interview (ZBI). 142 caregivers (126 female (89%), mean age 60.7±11.5 years) were included in this study. In POMS, the tension-anxiety and fatigue were tend to be higher. For POMS and SDS, score change from the initial and the last assessment were not significantly different. By contrast, ZBI score decreased significantly (p <0.01) after five sessions. Regarding gender difference, there was no male dominancy among POMS, SDS and ZBI scores, although the sample size was small. The present study indicates that our present group psychotherapy could specifically ease the care burden of dementia caregivers. To compensate the potential problem such as hesitation for attending seen among males, the scheme should be updated continuously.

Benefit finding and its influencing factors for caregivers of patients with cancer

Objective To investigate the benefit finding for caregivers of patients with cancer and its influencing factors. Methods Totally 330 couples of cancer patients and caregivers were investigated from October 2014 to September 2015 by convenience sampling method. The cancer patients were investigated with the Hospital Anxiety and Depression Scale. The caregivers of cancer patients were investigated with Benefit Finding Scale, Zarit Caregiver Burden Interview, Medical Outcomes Study Social Support Survey. Results The total score of benefit finding was (59.65±11.12) points. Regression analysis indicated that caregivers′ education, religious, informational and emotional support, caregiver burden, patients′ depression symptom, cancer stage and self-caring were influencing factors of benefit finding for caregivers (t=-3.689-5.913, P<0.01 or 0.05), which explained 30.0% of the variance. Conclusions The caregivers of patients with cancer have a low level of benefit finding. Oriented by influencing factors of benefit finding, the health workers should enhance targeted interventions, promote positive perception in the process of caring, develop the quality of caring and life. Key words: Neoplasms; Caregivers; Benefit finding; Caregivers burden

Burden of care in primary caregivers of individuals with spinal cord injury in Iran: its association with sociodemographic factors.

A descriptive cross-sectional study. The burden of care among primary caregivers of individuals with spinal cord injury (SCI) is affected by different factors. We aimed to evaluate the level of burden among caregivers and the association between the caregiver burden and sociodemographic factors of SCI individuals and their caregivers. Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. The Zarit caregiver burden interview was used to evaluate the level of burden in caregivers through structured face-to-face interviews with 163 individuals with SCI, who were referred to receive outpatient rehabilitation, and their caregivers. The mean of caregivers' burden score was 38.9±15.2 and 11.7% reported no or little burden, 43.6% reported 'mild-to-moderate' burden, 33.1% reported 'moderate-to-severe' burden and 11.7% reported 'severe' burden of care. There was relationship between the level of injury (P=0.010) and occupational status (P=0.041) in SCI individuals and caregiver burden score. There was also a positive relationship between the caregiver burden score and duration of injury (r=0.176, P=0.025), the caregivers' age (r=0.350, P<0.001), and length of time that the current caregiver providing care (r=0.253, P=0.001). There was a negative relationship between the burden and caregiver's educational level (r=-0.235, P=0.002). The burden of care among the caregivers of SCI individuals is a multidimensional issue. The sociodemographic characteristics of individuals with SCI and their caregivers can affect the caregiver's burden. Many of these factors can be modified to reduce the burden of care.

Caregiver burden in older adults with bipolar disorder: relationship to functionality and neuropsychiatric symptoms.

There are few studies addressing caregivers of bipolar disorder (BD) patients, especially patients who are older adults with an increased need for care, often given by a relative. The aim of this study was to describe which factors increase caregiver burden among caregivers of elderly BD outpatients. Patients were older than 60 years and met the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, criteria for BD. They were evaluated for current mood, cognitive and other neuropsychiatric symptoms, functionality, medical comorbidities, quality of life, years since BD diagnosis, and number of psychiatric admissions. The caregiver who spent the greatest time with each patient was evaluated with the Zarit Caregiver Burden Interview. The caregivers' global health, mood symptoms, quality of life, and tasks performed for the patient were also assessed. Thirty-six BD patients and their caregivers were assessed. The Zarit Caregiver Burden Interview was positively correlated with patients' neuropsychiatric symptoms (r = 0.508, P = 0.002) and functional impairment (r = 0.466, P = 0.004). The Zarit Caregiver Burden Interview was also correlated with caregivers' own depression (r = 0.576, P < 0.001), anxiety (r = 0.360, P = 0.031), quality of life (r = -0.406, P = 0.014), medical comorbidities (r = 0.387, P = 0.020), and number of tasks that they completed for the patient (r = 0.480, P = 0.003). In this group of elderly BD patients, caregiver burden was more associated with symptoms frequently seen in others diseases as in dementia than with depressive, manic, or anxiety symptoms, which are often used as treatment outcomes measures goals in BD. Potential treatable and modifiable factors associated with caregiver burden could be caregivers' depression, anxiety, and medical comorbidities, as well as support for caregivers in terms of services and social relationships.

Deep brain stimulation for treatment of severe Alzheimer's disease: Study protocol for a prospective, self-controlled, phase I trial (case observation)

Background: With the aging of the global population, an increasing number of people are at risk of developing Alzheimer's disease. There is currently no effective treatment to hinder or postpone the progression of Alzheimer's disease. Cholinesterase inhibitors and the N-methyl-D-aspartate receptor antagonist Memantine are the commonly prescribed drugs for this disease, but their therapeutic effects are still unsatisfactory. Therefore, there is an urgent need to investigate novel treatment methods. Many animal experiments have suggested that deep brain stimulation benefits Alzheimer's disease, but clinical trials investigating this are still in their infancy. This study aims to investigate the safety and effectiveness of deep brain stimulation in the treatment of severe Alzheimer's disease. Methods/Design: This study is a prospective, self-controlled, phase I trial (case observation), which will be performed in the Department of Neurosurgery, Chinese PLA General Hospital (Beijing, China). Six patients with severe Alzheimer's disease will be enrolled to receive continuous bilateral deep brain stimulation of the fornix. Evaluations will be performed at baseline (prior to surgery) and at 1, 6, and 12 months after surgery. The primary outcome measures are disability and mortality rates during the 12-month deep brain stimulation trial period. Secondary outcome measures include the incidence of complications and Clinical Dementia Rating scale, Zarit Caregiver Burden Interview, Mini-Mental State Examination, and Barthel Index of Activities of Daily Living Scale scores. Patient recruitment will begin in August 2017, the analysis of primary outcome measures will be completed in October 2018, and the study will finish in June 2019. Discussion: The results of this study will help to determine the safety of deep brain stimulation for the treatment of severe Alzheimer's disease. We will also assess whether deep brain stimulation can improve the cognition, symptoms, and activities of daily living of patients with Alzheimer's disease. If the study succeeds, a novel option for patients with Alzheimer's disease who respond poorly to current treatments may be provided. Trial registration: The study protocol is registered with ClinicalTrials.gov (identifier: NCT03115814). Ethics: The study protocol was approved by the Ethics Committee of Chinese PLA General Hospital (approval No. S2015-013-02) and will be performed in accordance with the Declaration of Helsinki formulated by the World Medical Association in 2013. Informed consent: Written informed consent will be obtained from each patient's legal representative.

Investigation of the efficacy of a psychiatric-social rehabilitation performed on individuals with schizophrenia in a community mental health center: Controlled study

Objective: The holistic approach in schizophrenia treatment recommends the practice of psychosocial treatments in addition to medical treatment. In the present study we aimed to assess the effectiveness of psychosocial rehabilitation (psychosocial rehabilitation and pharmacotherapy) and care requirements performed in a Community Mental Health Center (CMHC) compared with patients treated as usual (pharmacotherapy) in the outpatient clinic. Methods: The study included patients who were regularly followed up because of schizophrenia for at least one year in CMHCs (n=100) and polyclinics (n=50). A Sociodemographic Data Form was used to question housing, economic status, working and social rights, and the Brief Psychiatric Rating Scale, Scale for the Assessment of Negative Symptoms, Scale for the Assessment of Positive Symptoms, Calgary Depression Scale for Schizophrenia, Functional Activities Questionnaire, Functioning Assessment Short Test, Schedule for Assessing the Three Components of Insight, and the Medication Adherence Rating Scale were applied to both groups, and the Zarit Caregiver Burden Interview was administered to caregivers. Results: Although there was no difference regarding sociodemographic variables between the groups, the caregiver burden was higher in the polyclinic group. Lower scores indicating significant difference in the CMHC group in positive and negative symptoms, were similar for depression, and a positively significant difference was detected in functionality, insight, and adherence to treatment. The CMHC group was found to be better in ‘autonomy,’ ‘cognitive functionality,’ and ‘spare time activities’ in functionality areas; however, patients were found as similar regarding ‘occupational functionality,’ ‘financial issues,’ and ‘interpersonal relations’. Conclusion: The term ‘recovery’ in schizophrenia currently relates with patients having a role in society, improving independent life skills, and contributing to production by working. We detected the positive effect of CMHC practices in primary (functionality, insight, adherence to treatment, caregiver burden) and secondary (positive, negative schizophrenia symptoms) outcome indicators. However, no difference was detected in the areas of occupational functionality and interpersonal relations. The results are important because they emphasize the importance of concentrating on the improvement of independent life skills, particularly professional adaptation in adaptive studies.

Mentally ill caregivers: Reverse burden of care and its relationship with medication adherence among women in India - an exploratory study.

Background: Caregivers are often less adherent to medication due to burden of caregiving and women are often the main family caregiver. Level of burden of care and medication adherence in mentally ill women caregiver is unexplored. Aims: This study aimed to find out the levels of burden of care and its relationship with medication adherence in mentally ill women caregiver in remission. Material and Method- In this hospital based cross sectional study, 100 mentally ill women in remission were recruited as per the selection criteria and assessed with sociodemographic proforma, Zarit caregiver burden interview and Morisky medication adherence scale. Results- More than half participants experienced burden (27% mild-moderate burden, 19 % moderate to severe burden, and 7% have severe burden). Thirty nine percent of the participants had high adherence, while the rest had medium to low adherence (36% medium & 25% low). In multiple linear regression analysis, score on the role strain significantly predicted the value of score on medication adherence score. Conclusions- Among mentally ill women caregivers, higher level of burden of care and low medication adherence is common. Role strains are positively associated with medication adherence.

Reliability and Validity of the Abbreviated Turkish Version of the Zarit Caregiver Burden Interview

Reliability and Validity of the Abbreviated Turkish Version of the Zarit Caregiver Burden Interview

Influencia de la estimulación cerebral profunda en la carga de cuidadores de pacientes con enfermedad de Parkinson

IntroductionOur aim is to assess the burden on caregivers of patients with Parkinson's disease treated with deep brain stimulation (DBS) compared to those caring for patients at advanced stages and undergoing other treatments. We have also assessed the variables associated with presence of caregiver overload. Material and methodsWe included consecutive patients with Parkinson's disease treated with DBS. Our control group included patients in advanced stages of Parkinson's disease undergoing other treatments. Patients were assessed with the following scales: UPDRS-II, UPDRS-III, UPDRS-IV, Hoehn and Yahr, Schwab & England, Barthel, PDQ-39, MoCA, Apathy Evaluation Scale, HADS, and the abbreviated QUIP. Caregiver burden was evaluated with the Zarit caregiver burden interview and their moods were assessed with the HADS scale. ResultsWe included 11 patients treated with DBS and 11 with other treatments. For patients treated with DBS, we observed a better quality of life according to the PDQ-39 questionnaire (P=.028), and a lower score on the HADS anxiety subscale (P=.010). Caregiver overload was observed in 54.5% of the caregivers of patients in both groups (P=1.000); Zarit scores were similar (P=.835). Caregiver overload was associated with higher scores on the caregiver's Apathy Evaluation Scale (P=.048) and on the HADS anxiety subscale (P=.006). ConclusionAccording to our results, treatment with DBS is not associated with lower caregiver burden. Apathy in patients and anxiety in caregivers are factors associated with the appearance of overload.

Burden on Caregivers of Patients with Schizophrenia and Related Factors.

Caregivers of patients with schizophrenia are under the burden of continuous and difficult processes. Determination of the factors related to caregiver burden in schizophrenia may help find strategies to decrease the burden. This study aimed at investigating the factors associated with caregiver burden among relatives of patients with schizophrenia. Eighty-eight caregivers of patients under treatment for schizophrenia for at least 1 year were included in the study. The Zarit Caregiver Burden Interview was used for the assessment of caregiver burden. Sociodemographical data, the level of knowledge about schizophrenia, clinical impression scale, and global assessment of functioning were used to evaluate the related factors. Caregiver burden was negatively correlated with income level and functionality of the patient and was positively correlated with the age of the caregiver, the daily time spent with the patient, and the number of hospitalizations of the patient (p<0.05). There was no significant correlation between the caregivers' knowledge about schizophrenia and caregiver burden (p<0.05). Living in the same house with the patient was a positive predictor, whereas functionality and income level of the patient and education level of the caregiver were negative predictors (p<0.05). This study highlighted the importance of setting targets for improving the functionality of patients in the design and implementation of rehabilitation and support programs for patients with schizophrenia. Additionally, providing higher income for patients, creating conditions for an independent life, and increasing incentives for younger caregivers with a higher educational level may help decrease caregiver burden.

Caregiver burden and fatigue in caregivers of people with dementia: Measuring human herpesvirus (HHV)-6 and -7 DNA levels in saliva

PurposeWe examined chronic fatigue, which has not been investigated in detail, in family caregivers for people with dementia. Methods and materialsForty-four community-dwelling family caregivers (the caregiver group: CG) and 50 elderly control participants (the non-caregiver group: NCG) participated in this study. We measured salivary human herpesvirus (HHV)-6 and -7 DNA levels and the Chalder fatigue scale (CFS) to assess levels of fatigue; we also measured the Center for Epidemiologic Studies-Depression Scale, Physical Activity Scale for the Elderly, Zarit Caregiver Burden Interview, Mini-Mental State Examination, Assessment of Motor and Process Skills, and Dementia Behavior Disturbance Scale. ResultsFor CG, the salivary HHV-6 DNA levels and CFS scores were significantly higher than those in NCG. The salivary HHV-6 DNA levels in CG were significantly correlated with depressive symptoms, the cognitive function of the patients, and the activities of daily living/instrumental activities of daily living (ADL/IADL) abilities of the patients. The CFS scores in CG significantly correlated with caregiver burden, depression symptoms, leisure physical activity, the number of other family caregivers, and the hours spent for caregiving per week, as well as with behavior disturbances and ADL/IADL abilities. ConclusionsThe salivary HHV-6 DNA levels may be added as a new biomarker for caregiver exhaustion. We concluded that fatigue assessments should be performed by not only a questionnaire, such as the CFS, but also by a biomarker search, such as HHV-6, when estimating the caregiver burden for family caregivers of people with dementia.