Psychological Distress Among Latino Family Caregivers of Adults With Schizophrenia: The Roles of Burden and Stigma

Abstract

Objective-Little research has focused on the mental health of Latino caregivers with a relative with schizophrenia, despite data showing that up to three-quarters of Latino persons with schizophrenia live with their families. This study examined the relation between caregivers' mental health and perceived burden and stigma and characteristics of the patient and caregiver.Methods-Interviews were conducted in the language of preference (Spanish or English) in Wisconsin, California, and Texas with 85 Latinos caring for an adult with schizophrenia. Measures included the Center for Epidemiologic Studies-Depression Scale, the Zarit Burden Scale, and the Greenley Stigma Scale.Results-General population studies of Mexican Americans have found that between 12% and 18% meet the cutoff for being at risk of depression; however, 40% of the sample met this criterion. Younger caregiver age, lower levels of caregivers' education, and higher levels of the patients' mental illness symptoms were predictive of higher levels of caregivers' depressive symptoms. Caregivers' perceived burden mediated the relation between patients' psychiatric symptoms and caregivers' depression. Caregivers' perceived stigma was significantly related to caregivers' depressive symptoms, even when the analyses statistically adjusted for psychiatric symptoms and demographic variables.Conclusions-The high rates of depressive symptoms among Latino families caring for a relative with schizophrenia suggest that interventions should include attention to the mental health and recovery of family caregivers in addition to the patient's recovery. Younger Latino caregivers and those with lower levels of education are particularly at risk of depression.Research on Latino families who have a relative with mental illness (that is, the patient) has largely focused on how the family relates to the patient and how family attitudes and interactions may impact the patient (1-5). Data suggest that Latino family caregivers are more likely to live with the patient, be more accepting and more hopeful for a cure (6-9), and exhibit fewer critical comments toward the patient, compared with European-American families (1-3). These key cross-ethnic differences in caregiver involvement and affect may also reflect differences in the way that caregiving is linked with the course of schizophrenia. For example, low levels of caregiver warmth were a significant predictor of relapse among Latino patients but not among European-American patients (5). Researchers continue to investigate how family caregiving among Latinos may affect patients' outcomes; however, it is equally important to attend to the well-being of family caregivers. A substantial body of research on families and mental illness has examined how caregiving processes are linked to the emotional health of family caregivers (10-13). A consistent pattern of findings underscores that more psychiatric symptoms of the patient, more behavior problems of the patient, and more caregiving demands are associated with higher levels...

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