Empathy and perceived burden in caregivers of patients with schizophrenia spectrum disorders

Abstract

Background Caregivers of patients load different kinds of burdens, including emotional distress. Aims of this study were to evaluate both burden and empathy of caregivers who assist patients with schizophrenia spectrum disorders. Methods We selected a sample of 60 caregivers (34 women and 26 men), who assisted patients with schizophrenia spectrum disorders treated in our local Community Mental Health Center for a 1-year minimum period. We administered two scales to our sample, Zarit Burden Interview (ZBI) and Balanced Emotional Empathy Scale (BEES), and collected data of caregivers and their assisted patients in a 3-month period. Data were statistically analyzed. Results We reported a mean ZBI score of 49.68 (±15.03 SD) and a mean BEES score of 14.35 (±9.05 SD), indicating the perception of moderate-severe burden and low level of empathy, respectively. The analysis of internal consistency confirmed the good reliability of both ZBI (Cronbach’s alpha = 0.90) and BEES (Cronbach’s alpha = 0.77). The correlation between the two scales was not statistically significant at Spearman test. At our multiple linear regression, many variables of both caregiver and patient showed a significant correlation with the ZBI score. In particular, not living with the assisted patient and female gender of caregiver potentially decreased the burden, whereas clinical severity of assisted patient and two caregiver conditions, middle school education and spouse relationship with patient, could worsen the burden. We highlighted two positive statistically significant correlations between the total score of BEES and caregiver characteristics: being spouse and not living with assisted patient. Conclusions Our study highlights that the caregiver burden of patients with severe psychiatric disorders is high and is associated with low emotional empathy experienced by caregivers, probably due to a defensive psychological mechanism. The conditions of spouse and cohabitation can concomitantly increase both empathy and burden in caregivers.

Does emotional empathy moderate the association between caregiver burden and burnout among Arab family caregivers of older relatives?

“…These results partially confirmed the third hypothesis and were compatible with previous studies of familial caregivers (Hua et al, 2021;Jütten et al, 2019;Lee et al, 2001;Maximiano-Barreto et al, 2021) regarding the adverse impact of emotional empathy on their well-being. However, these results also contradict findings from previous studies in the general population and in caregivers of psychiatric patients, where emotional empathy in general was perceived as a beneficial defensive psychological mechanism in different stressful life situations (Di Lorenzo et al, 2021;Kerem et al, 2001;Shim et al, 2012;Sutter et al, 2014). It is possible that caregivers in the current study who have high emotional empathy may become overly enmeshed, taking on the added burden of feeling the distress and suffering experienced by a loved one who is dealing with the deterioration of old age.…”

Caregiver Burden among Caregivers of Patients with Mental Illness: A Systematic Review and Meta-Analysis

“…A total of 5034 caregivers from 23 countries were included in the analysis. Six studies were conducted in Nigeria [ 18 , 40 , 41 , 42 , 43 , 44 ], five studies in Brazil [ 45 , 46 , 47 , 48 , 49 ], three studies each in Nepal [ 50 , 51 , 52 ] and Turkey [ 53 , 54 , 55 ], two studies each in Hong Kong [ 56 , 57 ], the USA [ 58 , 59 ], and Taiwan [ 60 , 61 ], and one study each in Africa [ 62 ], China [ 63 ], Chile [ 64 ], Egypt [ 65 ], Greece [ 66 ], India [ 67 ], Ireland [ 68 ], Italy [ 69 ], Japan [ 70 ], Jordan [ 71 ], Kuwait [ 72 ], Poland [ 73 ], Portugal [ 74 ], Singapore [ 75 ], Spain [ 76 ], and the Netherlands [ 77 ]. In terms of study setting, 11 studies were conducted in the community, 18 studies in the hospital, and nine studies in the clinic (refer to Table S2 ).…”

“… Pooled prevalence of caregiver burden among caregivers of patients with mental illness [ 18 , 40 , 41 , 44 , 48 , 49 , 50 , 51 , 52 , 54 , 55 , 56 , 58 , 59 , 60 , 62 , 63 , 64 , 65 , 68 , 69 , 70 , 71 , 72 , 75 , 77 ]. …”

“… Subgroup forest plot on the study setting (Community: [ 50 , 58 , 64 , 68 , 69 , 70 , 75 , 77 ]; Clinic: [ 40 , 49 , 54 , 56 , 59 , 71 ]; Hospital: [ 18 , 41 , 44 , 48 , 51 , 52 , 55 , 60 , 62 , 63 , 65 , 72 ]). …”

Perceived mental health and emotional trajectories of long-term family caregivers of persons with mental conditions: A mixed-methods study

“…Family caregiving for individuals with mental disorders is a source of burden that has been studied since the psychiatric reform that led to deinstitutionalisation in the early 1980s, when psychiatric care was shifted towards the community, and still receives researchers' attention (Di Lorenzo et al, 2021;Koç et al, 2021;Ribé et al, 2018;Tamizi et al, 2020). This burden differs from other health conditions, as for families it implies not only a deterioration in physical and mental health (Thunyadee et al, 2015) but also stigma (Allerby et al, 2015;Yin et al, 2020) and a perceived lack of information and support from the mental health services (Graneheim and Åström, 2016;Olasoji et al, 2017;Ribé et al, 2018;Cheng et al, 2020;Liu and Zhang, 2020).…”