The impact of caregivers' characteristics, patients' conditions and regional differences on family burden in schizophrenia: a longitudinal analysis.
OBJECTIVE
Impact of caregiver characteristics, patient variables, and regional differences on family burden.


METHODS
Two hundred and eighteen schizophrenia patients and key-relatives of an urban and a rural area were examined five times over 30 months. Patients' psychopathology, service utilization; relatives' burden, coping abilities and contact duration with the patients were recorded. Effects of interpersonal differences and intrapersonal changes over time were analyzed with regression models.


RESULTS
Interpersonal differences (patients' positive and negative symptoms, relatives' coping abilities, and patient contact) and intrapersonal changes (relatives' coping abilities, patients' negative symptoms and utilization of community care) predicted family burden.


CONCLUSIONS
Family education programs should help caregivers to improve their coping strategies. Therapy solutions must address negative symptoms just as much as positive symptoms, as these especially impact caregivers. Intensified community-based care can reduce burden, but provision alone is not sufficient. Psychiatrists and caregivers should motivate patients to take advantage of such offers.
Roick
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C
Department of Psychiatry, University of Leipzig, Leipzig, Germany. roich@medizin.uni-leipzig.de
Heider
D
D
Toumi
M
M
Angermeyer
M C
MC
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000339:Affect; D017028:Caregivers / Q000523:psychology*; D002391:Catchment Area, Health; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D017281:Cost of Illness; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012424:Rural Population / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data