The Dimensions of Caregiver Burden in Schizophrenia: The Role of Patient Functionality

Amaç: Bu çalışmada şizofreni hastalarının işlevsellikleri ve hastalığın belirtileri ile bakım veren yükünün alt boyutları arasındaki ilişkilerin araştırılması amaçlanmıştır. Yöntem: Çalışmaya 92 şizofreni hastası ve onların bakım verenleri dahil edilmiştir. Hastaların işlevselliği Şizofreni Hastalarında İşlevsel İyileşme Ölçeği ile, belirti şiddeti ve tipi Pozitif-Negatif Sendrom Ölçeği ile, bakım verenin yükü ise Zarit Bakıcı Yük Ölçeği ile değerlendirilmiştir. Bulgular: Bulgularımıza göre, hastaların pozitif belirtileri bakım verenin yüküyle ilişkisizdir. Öte yandan, negatif belirtiler, özellikle bakım verenlerin bağımlılık ve ekonomik yük boyutlarıyla doğrusal yönde korelasyon göstermiştir. Hastaların işlevsellikleri bakım verenin hemen hemen tüm yük boyutlarıyla (toplumsal ilişkilerde bozulma boyutu hariç) anlamlı derecede ters korelasyon göstermiştir. En yüksek korelasyonun ruhsal gerginlik ve özel yaşamın bozulması yük boyutu arasında olduğu bulunmuştur. Sonuç: Sonuç olarak, hastaların negatif belirtilerinin az ve işlevsellik düzeylerinin iyi olması ile bakım veren yükü arasında daha az bağıntı olduğu, bu bağıntının bağımlılık, ekonomik yük, ruhsal gerginlik ve özel yaşamın bozulması gibi bazı yük boyutlarında daha belirgin olduğu görülmüştür

Şizofrenide bakım veren yükünün boyutları: Hastaların işlevselliğinin rolü

Objective: The purpose of this study was to investigate the relationship between schizophrenia patients’ functionalities and symptoms and caregiver burden subdimensions. Method: Ninety-two schizophrenia patients and their caregivers were included. Patient functionality was evaluated using the Functional Remission of General Schizophrenia Scale; symptom severity and type were evaluated using the Positive and Negative Syndrome Scale and caregiver burden was evaluated using the Zarit Caregiver Burden Scale. Results: According to our findings, while patients’ positive symptoms were uncorrelated with caregiver burden, negative symptoms exhibited a direct linear correlation with the dependency and economic burden dimensions in particular. Patients’ functionalities exhibited a significant reverse correlation with almost all caregiver burden dimensions (except for impairment in social relationships). The highest correlation was with the psychological tension and impairment of private life burden dimension. Conclusion: In conclusion, a small number of negative symptoms and a good level of functionality are associated with less caregiver burden, and this correlation is more pronounced in certain burden dimensions, such as dependency, economic burden, psychological tension and impairment of private life

___

  • 1. Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 1980; 20:649-655.
  • 2. Gulseren L, Cam B, Karakoc B, Yigit T, Danaci AE, cubukcuoglu Z, Tas C, Gulseren S, Mete L. The Perceived Burden of Care and its Correlates in Schizophrenia. Turk Psikiyatri Derg 2010; 21:203-212.
  • 3. Awad GA, Voruganti LNP. The burden of schizophrenia on caregivers. Pharmacoeconomics 2008; 26:149-162.
  • 4. Aydin A, Eker SS, Cangur S, Sarandol A, Kirli S. The Association of the Level of Caregiver Burden with the Sociodemographic Variables and the Characteristics of the Disorder in Schizophrenic Patients. ARchieves of Neuropsychiatry 2009; 46:10-14.
  • 5. Ak M, Yavuz KF, Lapsekili N, Turkcapar MH. Evaluation of burden in a group of patients with chronic psychiatric disorders and their Caregivers. Düşünen Adam Journal of Psychiatry and Neurological Disorders 2012; 25:330-337.
  • 6. Ukpong D. Burden and psychological distress among Nigerian family caregivers of schizophrenic patients: The role of positive and negative symptoms. Turk Psikiyatri Derg 2012; 23:40-45.
  • 7. Arslantas H, Adana F. The Burden of Schizophrenia on Caregivers. Current Approaches in Psychiatry 2011; 3:251-277.
  • 8. Lowyck B, De Hert M, Peeters E, Wampers M, Gilis P, Peuskens J. A study of the family burden of 150 family members of schizophrenic patients. Eur Psychiat 2004; 19:395-401.
  • 9. Roick C, Heider D, Bebbington PE, Angermeyer MC, Azorın JM, Brugha TS, Kilian R, Johnson S, Toumi M, Kornfeld A. Burden on caregivers of people with schizophrenia: comparison between Germany and Britain. Br J Psychiatry 2007; 190:333-338.
  • 10. Wong DFK. Stress factors and mental health of carers with relatives suffering from schizophrenia in Hong Kong: implications for culturally sensitive practices. Br J Soc Work 2000; 30:365-382.
  • 11. Schene AH, Van Wijngaarden B, Koeter MWJ. Family caregiving in schizophrenia: domains and distress. Schizophrenia Bull 1998; 4:609-618.
  • 12. Gibbons JS, Horn SH, Powell JM ve Gibbons JL. Schizophrenic patients and their families: a survey in a psychiatric service based on a DGH unit. Br J Psychiatry 1984; 144:70-77.
  • 13. Wolthaus JE, Dingemans PM, Schene AH, Linszen DH, Wiersma D, Van Den Bosch RJ, Cahn W, Hijman R. Caregiver burden in recent-onset schizophrenia and spectrum disorders: the influence of symptoms and personality traits. J Nerv Ment Dis 2002; 190:241-247.
  • 14. Provencher HL, Mueser KT. Positive and negative symptom behaviors and caregiver burden in the relatives of persons with schizophrenia. Schizophr Res 1997; 26:71-80.
  • 15. Dyck DG, Short R, Vitaliano PP. Predictors of burden and infectious illness in schizophrenia caregivers. Psychosom Med 1999; 61:411-419.
  • 16. Raj L, Parmanand K, Ajit A. Social burden of positive and negative schizophrenia. Int J Soc Psychiatry 1991; 37:242-250.
  • 17. Lefley HP. The consumer recovery vision: will it alleviate family burden? Am J Orthopsychiatry 1997; 67:210-219.
  • 18. Magliano L, Fadden G, Economou M, Held T, Xavier M, Guarneri M, Malangone C, Marasco C, Maj M. Family burden and coping strategies in schizophrenia: 1-year follow-up data from the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol 2000; 35:109-115.
  • 19. Perlick DA, Rosenheck RA, Kaczynski R, Swartz MS, Cañive JM, Lieberman JA. Components and correlates of family burden in schizophrenia. Psychiatr Serv 2006; 57:1117-1125.
  • 20. Koukia E. Madianos MG. Is psychosocial rehabilitation of schizophrenic patients preventing family burden? A comparative study. J Psychiatr Ment Health Nurs 2005; 12:415-422.
  • 21. Magliano L, Fiorillo A, Malangone C, De Rosa C, Maj M, Family Intervention Working Group. Patient functioning and family burden in a controlled, real-world trial of family psychoeducation for schizophrenia. Psychiatr Serv 2006; 57:1784-1791.
  • 22. Giron M, Fernandez-Yanez A, Molina-Habas A, Nolasco A, Gomez-Beneyto. Efficacy and efectiveness of individual family intervention on social and clinical functioning and family burden in severe schizophrenia: a 2-year randomized controlled study. Psychol Med 2010; 40:73-84.
  • 23. Hjarthag F, Helldin L, Karilampi U, Norlander T. Illness-related components for the family burden of relatives to patients with psychotic illness. Soc Psychiat Epidemiol 2010; 45:275-283.
  • 24. Danaci AE, Karaca N, Deveci A. Evaluation of the relationship between the social functioning and family functioning in schizophrenia. Psychiatry in Turkey 2005; 7:103-108.
  • 25. Schene AH, van Wijngaarden B, Koeter MWJ. Family caregiving in schizophrenia: domains and distress. Schizophrenia Bull 1998; 24:609-618.
  • 26. Guy W. ECDEU assessment manual for psychopharmacology: Clinical Global Impressions. Rockwille, MD: National Institute of Mental Health, 1976; 218-221.
  • 27. Kay SR, Flszbein A, Opfer LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bull 1987; 13:261-76.
  • 28. Kostakoglu AE, Batur S, Tiryaki A. Pozitif ve Negatif Sendrom Ölçeği’nin (PANSS) Türkçe uyarlamasının geçerlilik ve güvenilirliği. Türk Psikoloji Dergisi 1999; 14:23-32. (Turkish)
  • 29. Llorca PM, Lancon C, Lancrenon S. The Functional Remission of General Schizophrenia (FROGS) Scale: development and validation of a new questionnaire. Schizoph Res 2009; 113:218- 25.
  • 30. Emiroglu B, Karadayi G, Aydemir O, Ucok A. Validation of the Turkish version of the Functional Remission of General Schizophrenia (FROGS) Scale. Archives of Neuropsychiatry 2009; 46:15-24.
  • 31. Setsuko Hanzawa S, Tanaka G, Inadomi H, Urata M, Ohta Y. Burden and coping strategies in mothers of patients with schizophrenia in Japan. Psychiat Clin Neuros 2008; 62:256-263.
  • 32. Ozlu A, Yildiz M, Aker T. A Reliability and Validity Study on the Zarit Caregiver Burden Scale. Archives of Neuropsychiatry 2009; 46:38-42.
  • 33. Gopinath PS, Chaturvedi SK. Distressing behaviour of schizophrenics at home. Acta Psychiatr Scand 1992; 86:185-188.