Burden Of Care and Depression in Caregivers of Patients with Schizophrenia

Authors

  • Mubeen Taj ACS medical college and hospital, Chennai, India
  • Maithreyi Poguri ACS Medical college and hospital, Chennai, India
  • Glady Mariyana Dr MGR Educational and research institute, Chennai, India
  • Sujitha Jebarose Dr MGR Educational and research institute, Chennai, India
  • christina Mary Paul Indra medical college and Hospital, Chennai, India

DOI:

https://doi.org/10.55489/njcm.131020222228

Keywords:

Schizophrenia, caregivers, depression, burden

Abstract

Background: Schizophrenia, a chronic psychiatric disorder affecting all major domains of a patient’s life, leads to significant disability. Since the deinstitutionalization policy, the onus of care is on families especially the primary caregiver who experiences physical and emotional burden. Depression among caregivers has been estimated to be higher than the general population. This cross-sectional study aimed to assess burden of care and depression in primary caregivers and associated caregiver variables.

Methods: 75 consenting primary caregivers of patients with ICD-10 diagnosis of schizophrenia were assessed for burden of care and depression using the Burden Assessment Schedule and the Patient Health Questionnaire - 9 after collecting socio-demographic and caregiving details.

Results: All the caregivers, 49 females and 26 males, had moderate to high levels of burden with a majority having moderate to severe levels of depression. Spouses (p=0.0038), older caregivers (p=0.01) and those with lower educational levels (p=0.01) experienced more burden. There was a significant positive correlation between burden of care and depression (p=0.000).

Conclusion: In one of India’s largest metropolitan cities, though psychiatric services are easily available, caregivers continue to feel burdened and depressed. This can impact not just the caregiver but also care being provided to the patient and illness outcome.

References

World Health Organisation: Home/ Newsroom/ Fact sheets/ Detail/ Schizophrenia. Available at: http://who.int/news-room/fact-sheets/detail/schizophrenia#

Sadock BJ, Sadock VA, Ruiz P. Schizophrenia spectrum and other psychotic disorders. Synopsis of Psychiatry. 11th ed India: Wolters Kluwer; 2015.

Tandon R, Nasrallah HA, Keshavan MS. Schizophrenia, "Just the facts" Clinical features and conceptualization. Schizophrenia Res 2009; 110: 1-23. Doi: https://doi.org/10.1016/j.schres.2009.03.005 PMid:19328655

Global, regional and national incidence, prevalence and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390(10100): 1211-59. Doi: https://doi.org/10.1016/S0140-6736(17)32154-2

Tandon R, Keshavan MS, Nasrallah HA. Schizophrenia, "Just the Facts": What we know in 2008, Part 1: Overview. Schizo-phrenia Res 2008; 100: 4-9. Doi: https://doi.org/10.1016/j.schres.2008.01.022 PMid:18291627

Harvey PD, Strassnig MT, Silberstein J. Prediction of disability in schizophrenia: Symptoms, cognition and self-assessment. J Exp Psychopathol 2019; 10(3): 1-20. Doi: https://doi.org/10.1177/2043808719865693

India State-Level Disease Burden Initiative Mental Disorders Collaborators. The Burden of mental disorders across the states of In-dia: The Global Burden of Disease Study 1990-2017. Lancet Psychiatry 2020; 7(2): 148-61.

Desai PR, Lawson KA, Barner JC, Rascati KL. Estimating the direct and indirect costs for community-dwelling patients with schizo-phrenia. J Pharm Health Serv Res 2013; 4(4): 187-94. Doi: https://doi.org/10.1111/jphs.12027

Chakrabarti S, Raj L, Kulhara P, Avasthi A, Verma SK. Comparison of the extent and pattern of family burden in affective disorders and schizophrenia. Indian J Psychiatry 1995; 87(3): 105-12.

Jagannathan A, Hamza A, Thirthalli J, Hariprasad VR, Nagendra HR, Gangadhar BN. A qualitative study on the needs of caregivers of in-patients with schizophrenia in India. Int J Soc Psychiatry 2010; 57(2): 180-94. Doi: https://doi.org/10.1177/0020764009347334 PMid:20159934

Janardhana N, Raghunandan S, Naidu DM, Saraswathi L, Seshan V. Care giving of people with severe mental illness: An Indian experi-ence. Indian J Psychol Med 2015; 37(2): 184-94. Doi: https://doi.org/10.4103/0253-7176.155619 PMid:25969605 PMCid:PMC4418252

Thara R, Padmavathi R, Kumar S, Srinivasan L. Burden Assessment Schedule: Instrument to assess burden on caregivers of chroni-cally mentally ill. Indian J Psychiatry 1998; 40(1): 21-9.

Singh M, De Sousa A. Factors affecting depression in caregivers of patients with schizophrenia. J Mental Health Hum Behav 2011; 16(2): 87-94.

Derajew H, Tolessa D, Feyissa GT, Addisu F, Soboka M. Prevalence of depression and its associated factors among primary caregiv-ers of patients with severe mental illness in southwest Ethiopia. BMC Psychiatry 2017; Doi: https://doi.org/10.1186/s12888-017-1249-7 PMid:28274223 PMCid:PMC5343306

Garg K, Kumar CN, Chandra PS. Number of psychiatrists in India: Baby steps forward, but a long way to go. Indian J Psychiatry 2019; 61(1): 104-5.

Kroenke K, Spitzer RL, Williams JBW. The PHQ-9. Validity of a Brief Depression Severity Measure. J Gen Intern Med 2001; 16(9): 606-13. Doi: https://doi.org/10.1046/j.1525-1497.2001.016009606.x PMid:11556941 PMCid:PMC1495268

Grandon P, Jenaro C, Lemos S. Primary caregivers of schizophrenia outpatients: Burden and predictor variables. Psychiatry Res 2008; 158(3): 335-43. Doi: https://doi.org/10.1016/j.psychres.2006.12.013 PMid:18280584

Jenkins JH, Schumacher JG. Family burden of schizophrenia and depressive illness. Br J Psychiatry 1999; 174: 31-8. Doi: https://doi.org/10.1192/bjp.174.1.31 PMid:10211148

Padmavathi R, Rajkumar S, Srinivasa TN. Schizophrenic patients who were never treated - A study in an Indian urban community. Psychol Med 1998; 28: 1113-7. Doi: https://doi.org/10.1017/S0033291798007077 PMid:9794018

Ali RM, Bhatti RS. Social support system and family burden due to chronic schizophrenia in rural and urban background. Indian J Psychiatry 1998; 30: 349-53.

Kaya Y, Oz F. Global social functioning of patients with schizophrenia and care burden of caregiving relatives. J Psychiatr Nurs. 2019; 10(1): 28-38.

Kuchhal AK, Kuchhal A, Arya V, Pardal PK, Sharma CS, Sharma M. A study of psychological stress and burden on caregivers of schiz-ophrenic patients. Int J Contemp Med Res 2019; 6(8): 111-5. DOI: https://doi.org/10.21276/ijcmr.2019.6.8.2

Winefield HR, Harvey ES. Needs of family caregivers in chronic schizophrenia. Schizophr Bull 1994; 20(3): 557-66. Doi: https://doi.org/10.1093/schbul/20.3.557 PMid:7973471

Rammohan A, Rao K, Subbakrishna DK. Burden and coping in caregivers of persons with schizophrenia. Indian J Psychiatry 2002; 44(3): 220-227.

Roychoudhuri J, Mondal D, Boral A, Bhattacharya A. Family burden among long term psychiatric patients. Indian J Psychiatry 1995; 37: 81-5.

Kumar S, Mohanty S. Spousal burden of care in schizophrenia. J Indian Acad Appl Psychol 2007; 33(2): 189-94.

Ruchika A, Kumar R, Varghese A. Depression and quality of life in family caregivers of individuals with psychiatric illness. Int J Community Med Public Health 2019; 6(2): 715-20. Doi: https://doi.org/10.18203/2394-6040.ijcmph20190196

Downloads

Published

2022-10-31

How to Cite

1.
Taj M, Poguri M, Mariyana G, Jebarose S, Paul christina M. Burden Of Care and Depression in Caregivers of Patients with Schizophrenia. Natl J Community Med [Internet]. 2022 Oct. 31 [cited 2022 Dec. 9];13(10):717-23. Available from: https://njcmindia.com/index.php/file/article/view/2228

Issue

Section

Original Research Articles