Psychological Distress Among Caregivers of Individuals With a Diagnosis of Schizophrenia or Schizoaffective Disorder

Lerner, Debra; Chang, Hong; Rogers, William H.; Benson, Carmela; Lyson, Mercedes C.; Dixon, Lisa B.

doi:10.1176/appi.ps.201600422

Cited by 24 publications

(33 citation statements)

References 30 publications

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“…These findings may be related to a better adherence to medication associated with LAI use compared with oral antipsychotics [15][16][17] . Better adherence may relieve parental concerns over discontinuation of medication use by their offspring and reduce the need for monitoring of medication taking behaviour 29 . Our previous study showed that parents of patients with schizophrenia in general have a higher risk of psychiatric health care use compared with parents of patients with MS, rheumatoid arthritis, epilepsy or healthy controls 31 .…”

Section: Discussionmentioning

confidence: 99%

“…Subjective family burden of schizophrenia is higher when the patient has lower levels of functioning 21,24 , apparent psychotic symptoms or abnormal behaviour [25][26][27] , negative symptoms 28 , and when providing frequent caregiving assistance, monitoring medication and having limited social support 29 . In addition, risk of medication discontinuation and concerns about medication effectiveness are two significant indicators of caregivers' distress 29 . Poor adherence to antipsychotic treatment has been associated with caregiver burden and experience of anxiety by family caregivers 30 .…”

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confidence: 99%

“…Our recent observational studies have shown that LAIs were associated with lower risk of psychiatric re-hospitalizations compared with oral antipsychotics 32,33 although this is contrary to the results of randomized trials 34,35 . Due to the associated lower risk of relapses and non-adherence, LAIs could impact the health and wellbeing of parents of patients with schizophrenia as re-emergence of psychotic symptoms and non-adherence are also drivers of caregiver burden [25][26][27]29,30 . However, there has been no research to date investigating the potential effects of antipsychotic treatment on caregiver burden, particularly on the parents.…”

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confidence: 99%

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Health and work disability outcomes in parents of patients with schizophrenia associated with antipsychotic exposure by the offspring

Taipale

Rahman

Tanskanen

et al. 2020

Sci Rep

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This study aimed to identify if antipsychotic exposure in offspring is associated with psychiatric and non-psychiatric healthcare service use and work disability of their parents. this Swedish populationbased cohort study was based on data comprising 10,883 individuals with schizophrenia, who had at least one identifiable parent in the nationwide registers, and their parents (N = 18,215). The registerbased follow-up during 2006-2013 considered the level of antipsychotic exposure and persistence of use of the offspring, further categorized into first (FG) and second generation (SG) antipsychotics, and orals versus long-acting injections (LAIs). The main outcome measure was parental psychiatric healthcare service use, secondary outcomes were non-psychiatric healthcare use and long-term sickness absence. SG-LAI use was associated with a decreased risk (relative risks [RR] 0.81-0.85) of parental psychiatric healthcare use compared with not using SG-LAI, whereas oral antipsychotics were associated with an increased risk (RRs 1.10-1.29). Both FG-and SG-LAI use by the offspring were associated with a lower risk of long-term sickness absence (range of odds ratios 0.34-0.47) for the parents, compared with nonuse of these drugs. The choice of antipsychotic treatment for the offspring may have an impact on work disability and healthcare service use of their parents.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Health and work disability outcomes in parents of patients with schizophrenia associated with antipsychotic exposure by the offspring

Taipale

Rahman

Tanskanen

et al. 2020

Sci Rep

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“…The scree plot showed that the slope started to change and drop dramatically after the third factor. Thus factor analysis was repeated by Direct Oblimin with three factors and the items with factor value less than 0.45 (item numbers 1, 3,11,12,19) were removed. Thereby, the scale had 3 factors and 14 items.…”

Section: Construct Validitymentioning

confidence: 99%

“…On the one hand, family members feel responsible for their relatives' illnesses, on the other hand, they exposed to negativistic attitudes from their environment and start to blame themselves. Difficulties of being a relative of a patient with schizophrenia and the psychosocial troubles are revealed through qualitative and quantitative studies [15][16][17][18][19]. In fact, some family members feel as if they have committed a disgraceful act and steer away from their social environments.…”

Section: Introductionmentioning

confidence: 99%

Development of Self-Stigma Inventory for Families of the patients with schizophrenia (SSI-F): validity and reliability study

Yıldız

İncedere

Kiras

et al. 2018

Psychiatry and Clinical Psychopharmacology

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OBJECTIVE: It is known that relatives of the patients with schizophrenia tend to hide the illness from other people, are ashamed of their patients, and feel excluded from society. This situation is referred as self-stigmatization of families, and it may negatively affect the family functioning and therapeutic alliance. Assessing and evaluating the self-stigma of families are essential concerning family therapies and treatment of their patients. The purpose of this study is to develop a culturally sensitive inventory for the assessment of self-stigmatization for families of patients with schizophrenia in Turkey. METHODS: After examining the studies in the related field and conducting a focus group interview with the families of the patients with schizophrenia, a 19-item inventory was formed. One hundred and six relatives of the patients with schizophrenia and schizoaffective disorder were given a sociodemographic form, Self-Stigma Inventory for Families (SSI-F), Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), Rosenberg Self-Esteem Scale (RSES), and Zarit Caregiver Burden Scale (ZCBS). Explanatory factor analysis and convergent validity were assessed as validity analysis, and internal consistency coefficient, item-total correlation, and test-retest reliability were calculated for reliability analysis. RESULTS: The sample consisted of 106 relatives whose 52% were female, 77% were married, mean age was 51 years, and level of education was 9 years. In explanatory factor analysis, three factors (social withdrawal, concealment of the illness, and perceived devaluation) with 14 items were detected, and the factors could explain 66.8% of the total variance. SSI-F was significantly correlated with Beck Depression Inventory (r = 0.48, P < 0.01), Beck Hopelessness Scale (r = 0.27, P < 0.01), Zarit Caregiver Burden Scale (r = 0.54, P < 0.01), and Rosenberg Self-Esteem Scale (r = −0.35, P < 0.01). Cronbach's alpha coefficient for SSI-F total score was calculated as 0.88, and test-retest reliability coefficient of SSI-F was 0.93. CONCLUSIONS: This study shows that the SSI-F is a valid and reliable instrument for assessing self-stigmatization in the families of patients with schizophrenia. It can be considered as a valuable instrument to use for research and therapeutic purposes. ARTICLE HISTORY

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Early Maladaptive Schemas and Depression in Caregivers of Individuals With Schizophrenia Spectrum and Bipolar Disorders

Karambelas,

Byrne,

Allott

et al. 2024

Clin Psychology and Psychoth

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ObjectivesEarly maladaptive schemas represent unhelpful frameworks of cognitions, emotions and subsequent behavioural responses and can be associated with depressive symptoms. Caregivers of individuals with serious mental illness (SMI) frequently report experiencing depressive symptoms. It is unclear whether depressive symptoms in caregivers are influenced by schemas. We aimed to compare activated schemas in caregivers of people with schizophrenia spectrum (SSD) and bipolar disorder (BD) diagnoses and to determine whether they were differentially related to depressive symptoms.Design and MethodsCaregivers completed validated measures of depression and schemas. Independent samples t‐tests and multivariate generalised linear models were used to assess differences in schemas and depressive symptoms between caregiver groups. Interrelationships between schema domains and caregiver depressive symptoms were delineated using correlational analyses and forward stepwise regressions.ResultsOne hundred eight caregivers participated in the study (SSD n = 68, BD n = 40). No differences in depressive symptom severity or activated schemas were observed between caregiver groups. All schemas were significantly associated with depressive symptoms, and the Disconnection‐Rejection schema domain explained the most variance in depressive symptoms in both caregiver groups.ConclusionsSchemas contribute to the severity of caregiver depression regardless of whether the person receiving care is diagnosed with SSD or BD. Schema therapeutic frameworks may be beneficial for use with caregivers to address schemas within the Disconnection‐Rejection domain and alleviate depressive symptoms by reducing experiences of social isolation and alienation.

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Psychological Distress Among Caregivers of Individuals With a Diagnosis of Schizophrenia or Schizoaffective Disorder

Abstract: Caregiver distress was relatively high and related to multiple variables, some of which are potentially modifiable.

Cited by 24 publications

References 30 publications

Health and work disability outcomes in parents of patients with schizophrenia associated with antipsychotic exposure by the offspring

Health and work disability outcomes in parents of patients with schizophrenia associated with antipsychotic exposure by the offspring

Development of Self-Stigma Inventory for Families of the patients with schizophrenia (SSI-F): validity and reliability study

Early Maladaptive Schemas and Depression in Caregivers of Individuals With Schizophrenia Spectrum and Bipolar Disorders

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