title: Psychological impact on caregivers traumatized by the violent behavior of a family member with schizophrenia.
abstract: BACKGROUND
  A combination of factors such as substance abuse problems, medication noncompliance, and insufficient insight are generally known to increase the risk of violent behavior. However, little is known regarding the psychological impact on caregivers who are traumatized by the violent behavior of a family member with schizophrenia. Therefore, we carried out an investigation to measure this impact.
  
  
  METHODS
  A questionnaire was given to 116 caregivers of individuals with schizophrenia in family support groups in Seoul and Daegu, Korea. Their responses were then evaluated using the 22-item version of the Impact of Event Scale-Revised (IES-R), the 8-item short version of the Zarit Caregiver Burden Interview (ZBI-8), and the 15-item version of the Mental Illness and Disorder Understanding Scale (MIDUS).
  
  
  RESULTS
  The mean (SD) IES-R score was 26.69 (17.83) (range, 1-84). Multiple regression analysis showed that the psychological impact of traumatic experiences was significantly associated with the following factors: medical non-adherence (P<0.01), living without the patient (P<0.01), and caregiver burden (P<0.05).
  
  
  CONCLUSIONS
  Our results from the present study suggest that even when family caregivers live apart from the patient, they still experience the harmful psychological impact of trauma from the patient's violent behavior. The psychological impact continued as a result of the huge caregiver burden and the medication non-adherence of the family member with schizophrenia in spite of receiving long-term treatment and multiple hospitalizations. The present findings suggest the need for improved community-based service for preventive long-term care, including medication adherence, for outpatients with schizophrenia instead of multiple hospitalizations.
authors: School of Nursing, Jichi Medical University, Tochigi, Japan. hanzawa@jichi.ac.jp
authors: Setsuko
authors: S
authors: Hanzawa
authors: Jeong-Kyu
authors: JK
authors: Bae
authors: Yong Jun
authors: YJ
authors: Bae
authors: Moon-Hyeon
authors: MH
authors: Chae
authors: Hideki
authors: H
authors: Tanaka
authors: Hideyuki
authors: H
authors: Nakane
authors: Yasuyuki
authors: Y
authors: Ohta
authors: Xianghua
authors: X
authors: Zhao
authors: Hideki
authors: H
authors: Iizuka
authors: Yoshibumi
authors: Y
authors: Nakane
mesh_terms: D000328:Adult; D017028:Caregivers / Q000523:psychology*; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012111:Residence Characteristics; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications / Q000451:nursing*; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D014754:Violence / Q000523:psychology*