A Cross-Sectional Comparative Study of Caregiving Burden, Coping, and Psychological Distress Among Caregivers of Patients with Schizophrenia Based on Illness Chronicity.

Jasleen Kaur Sandhu; Nitin Kumar; Harjot Singh; Gehlot Sanjay

doi:10.51168/wcbjy377

Authors

Dr. Jasleen Kaur Sandhu Senior Resident, Department of Psychiatry, SGRDIMSR. Consultant Psychiatrist (Part-time), Dr Harjot Neuropsychiatry Hospital.
Dr. Nitin Kumar Assistant Professor, Department of Psychiatry, Ananta Institute of Medical Sciences and Research Centre, Rajsamand, Rajasthan, India.
Dr. Harjot Singh Senior Staff Specialist Psychiatrist, Rockhampton Base Hospital, Queensland, Australia.
Dr. Sanjay Gehlot Professor and Head, Department of Psychiatry, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.

DOI:

https://doi.org/10.51168/wcbjy377

Keywords:

schizophrenia, caregiver burden, coping, psychological distress, chronicity, Family Burden Interview Schedule, 12-item General Health Questionnaire (GHQ-12)

Abstract

Background:

Schizophrenia imposes substantial caregiving demands on families. These demands may vary with illness chronicity, influencing caregiver burden, coping, and psychological distress.

Objective:

To compare caregiver burden, coping, and psychological distress between caregivers of patients with recent-onset and chronic schizophrenia.

Methods:

This hospital-based, cross-sectional, comparative study included 96 caregiver–patient dyads (48 per group) at Dr. S. N. Medical College, Jodhpur. Patients were grouped by illness duration: less than two years (Group B) and more than two years (Group A). Assessments included the Positive and Negative Syndrome Scale (PANSS), Family Burden Interview Schedule (FBIS), Brief COPE, and 12-item General Health Questionnaire (GHQ-12).

Results:

Caregivers were predominantly female (66.7%). Mean caregiving duration was 13.19 ± 9.62 years in Group A and 1.05 ± 0.47 years in Group B. Total PANSS scores were comparable (91.02 ± 6.45 vs. 88.63 ± 5.00), although positive symptoms were higher in Group B (29.81 vs. 23.85), whereas negative symptoms (22.80 vs. 19.80) and general psychopathology (44.90 vs. 39.00) were higher in Group A. Mean GHQ-12 scores were significantly higher in Group B than Group A (28.88 vs. 24.75); both indicated severe psychological distress. Total FBIS scores were significantly higher in Group A (25.85 vs. 19.15), particularly for financial burden (6.71 vs. 5.46), routine disruption (7.31 vs. 4.44), and mental-health impact (2.06 vs. 1.35). Brief COPE scores were higher in Group A (56.44 vs. 52.92). PANSS scores correlated significantly with psychological distress, whereas Brief COPE scores did not correlate significantly with GHQ-12 scores.

Conclusion and Recommendation:

Caregiver burden increased with illness chronicity, while psychological distress was greater in the recent-onset group. Routine caregiver screening, psychoeducation, coping-skills training, and appropriate psychosocial and financial support should be provided irrespective of illness duration.

References

1. Barbato A. Schizophrenia and public health. Geneva: World Health Organization; 1998.

2. Kate N, Grover S, Kulhara P, Nehra R. Scale for positive aspects of caregiving experience: development, reliability, and factor structure. East Asian Arch Psychiatry. 2012;22:62-9.

3. McCleery A, Addington J, Addington D. Family assessment in early psychosis. Psychiatry Res. 2007;152(2-3):95-102. https://doi.org/10.1016/j.psychres.2006.07.002

4. Kay SR, Fiszbein A, Opler LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13(2):261-76. https://doi.org/10.1093/schbul/13.2.261

5. Kay SR, Opler LA, Lindenmayer JP. Reliability and validity of the Positive and Negative Syndrome Scale for schizophrenics. Psychiatry Res. 1988;23(1):99-110. https://doi.org/10.1016/0165-1781(88)90038-8

6. Carver CS. You want to measure coping, but your protocol's too long: consider the Brief COPE. Int J Behav Med. 1997;4(1):92-100. https://doi.org/10.1207/s15327558ijbm0401_6

7. Jacobson AM. The Brief COPE: a psychometric study in an Indian context. J Health Psychol. 2005;10:673-82.

8. Goldberg DP, Williams P. A user's guide to the General Health Questionnaire. Windsor: NFER-Nelson; 1988.

9. Pai S, Kapur RL. The burden on the family of a psychiatric patient: development of an interview schedule. Br J Psychiatry. 1981;138:332-5. https://doi.org/10.1192/bjp.138.4.332

10. Montero I, Asencio A, Hernández I, Masanet MJ, Lacruz M, Bellver F, et al. Two strategies for family intervention in schizophrenia: a randomized trial in a Mediterranean environment. Schizophr Bull. 2001;27(4):661-70. https://doi.org/10.1093/oxfordjournals.schbul.a006905

11. Tandon R, Nasrallah HA, Keshavan MS. Schizophrenia, "just the facts": clinical features and conceptualization. Schizophr Res. 2009;110(1-3):1-23. https://doi.org/10.1016/j.schres.2009.03.005

12. Tennakoon L, Fannon D, Doku V, O'Ceallaigh S, Soni W, Santamaria M, et al. Experience of caregiving: relatives of people experiencing a first episode of psychosis. Br J Psychiatry. 2000;177:529-33. https://doi.org/10.1192/bjp.177.6.529

13. Lasebikan VO, Ayinde OO. Family burden in caregivers of schizophrenia patients: prevalence and socio-demographic correlates. Indian J Psychol Med. 2013;35(1):60-6. https://doi.org/10.4103/0253-7176.112205

14. Walke SC, Chandrasekaran V, Mayya SS. Caregiver burden among caregivers of mentally ill individuals and their coping mechanisms. J Neurosci Rural Pract. 2018;9(2):180-5. https://doi.org/10.4103/jnrp.jnrp_312_17

15. Onwumere J, Bebbington P, Kuipers E. Family interventions in early psychosis: specificity and effectiveness. Epidemiol Psychiatr Sci. 2011;20(2):113-9. https://doi.org/10.1017/S2045796011000187

16. Mehra A, Grover S, Bhalla A. Caregiver burden and its correlates in caregivers of patients with schizophrenia. Indian J Psychiatry. 2018;60(3):323-9.

17. Rebecca MV, Kumar N. Family burden among caregivers of patients with schizophrenia and its correlates. J Clin Diagn Res. 2016;10(2):VC01.