Determinants of burden in caregivers of patients with exacerbating schizophrenia.
OBJECTIVE
Restriction in involuntary hospital admission and reduced lengths of inpatient stay increase burden on relatives of individuals with schizophrenia. This study aims at assessing the relationship between caregiver burden and behavioural disturbances of the affected, e.g. threats, nuisances, but also substance use and aggression. Two weeks before the last hospitalisation of the affected are considered as being the most burdensome period for relatives.


METHODS
Sixty-four relatives of schizophrenic patients were assessed by the semi-structured "Interview for Measuring the Burden on the Family". Subscales and total scales of burden were calculated. Predictors were identified by regression analyses.


RESULTS
The most important predictor of burden is burden in the relationship between caregiver and the affected representing the changes in the relationship occurring in acute illness. Threats, nuisances, time spent with the affected, and burden due to restricted social life and leisure activities were additional predictors, but not aggression or substance abuse. Eighty-five percent of the cases could be assigned correctly.


CONCLUSIONS
To better encounter burden, relatives should learn to cope with disturbing behaviour of and altered relationship to the affected, but also with their own needs. Finally, relatives must be included in the decision whether or not an affected person should be hospitalised.
Lauber
Christoph
C
Psychiatric University Hospital, Militärstrasse 8, P.O. Box 19030, 8021 Zurich, Switzerland. christoph.lauber@puk.zh.ch
Eichenberger
Adrian
A
Luginbühl
Peter
P
Keller
Christian
C
Rössler
Wulf
W
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000374:Aggression / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D005195:Family Relations; D005260:Female; D006760:Hospitalization; D006801:Humans; D007406:Interview, Psychological; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D012919:Social Behavior; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology; D013557:Switzerland