title: What really matters to bipolar patients' caregivers: sources of family burden.
abstract: BACKGROUND
  Identifying and modifying burdensome aspects might reduce the level of burden and their negative effects both on caregivers and patients' outcome. Most studies evaluate acutely ill patients, whereas the most relevant problems may be related to subthreshold symptoms and long-term outcome. The aims of the present study were to assess caregiver's subjective burden, to analyse which were the most burdensome aspects for caregivers and to study which variables could explain the caregiver's subjective burden.
  
  
  METHODS
  Caregivers of 86 euthymic bipolar patients completed the subjective burden subscale from an adapted version of the Social Behaviour Assessment Schedule.
  
  
  RESULTS
  Caregivers showed a moderate level of subjective burden. The highest levels of distress were reported regarding the patient's behaviour; the most distressing behaviours were hyperactivity, irritability, sadness and withdrawal. Regarding the patient's role performance, the most worrying aspects were those associated with the patient's work or study and social relationships. Regarding adverse effects on others, caregivers were especially distressed by the way the illness had affected their emotional health and their life in general. Poorer social and occupational functioning, an episode in the last 2 years, history of rapid cycling and the caregiver being responsible for medication intake explained a quarter of the variance of the caregiver's subjective burden.
  
  
  CONCLUSIONS
  This was a cross-sectional study focused only on primary caregivers, there was no control group of non-bipolar patients.
  
  
  CONCLUSIONS
  This study provides relevant data concerning the burden of caregivers of stable bipolar patients, pointing at potential targets for psychosocial interventions.
authors.affiliation: Bipolar Disorders Program, Institute of Clinical Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, Villarroel 170, 08036 Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Reinares
authors.forename: E
authors.initials: E
authors.lastname: Vieta
authors.forename: F
authors.initials: F
authors.lastname: Colom
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Arán
authors.forename: C
authors.initials: C
authors.lastname: Torrent
authors.forename: M
authors.initials: M
authors.lastname: Comes
authors.forename: J M
authors.initials: JM
authors.lastname: Goikolea
authors.forename: A
authors.initials: A
authors.lastname: Benabarre
authors.forename: C
authors.initials: C
authors.lastname: Daban
authors.forename: J
authors.initials: J
authors.lastname: Sánchez-Moreno
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D012648:Self Care / Q000523:psychology; D012917:Social Adjustment; D013030:Spain