title: Caregiver distress in first-episode psychosis: the role of subjective appraisal, over-involvement and symptomatology.
abstract: BACKGROUND
  Caregivers of persons with first-episode psychosis (FEP) often report high levels of distress. Preventing long-term or chronic distress within the whole family is an important focus of early intervention for psychosis. However, a more comprehensive understanding of the psychological factors involved is needed.
  
  
  OBJECTIVE
  To examine the impact of subjective appraisals and expressed emotion on caregiver distress in FEP.
  
  
  METHODS
  Within a cross-sectional design, 154 caregivers of 99 persons with FEP in a clinical epidemiological sample completed a series of questionnaires to examine potential predictors of caregiver distress.
  
  
  RESULTS
  Thirty-seven percent of caregivers were suffering from clinically significant distress. A linear mixed model analysis found that, after controlling for caregiver socio-demographic factors, service-user symptoms and global functioning, emotional over-involvement and subjective appraisal of caregiving were significant predictors of caregiver distress.
  
  
  CONCLUSIONS
  Caregiver distress is significant in the early phase of illness, and this seems to be more related to their subjective appraisal and over-involvement, than to variations in symptoms and global functioning of the person diagnosed with FEP. This lends further support to the stress-appraisal coping model and the cognitive model of caregiving in FEP, and highlights supportive interventions aimed at handling unhelpful cognitions and behaviors.
authors: Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Smedegade 10, 4000, Roskilde, Denmark, jens.einar@gmail.com.
authors: Jens Einar
authors: JE
authors: Jansen
authors: Ulrik Helt
authors: UH
authors: Haahr
authors: Susanne
authors: S
authors: Harder
authors: Anne Marie
authors: AM
authors: Trauelsen
authors: Hanne-Grethe
authors: HG
authors: Lyse
authors: Marlene
authors: M
authors: Buch Pedersen
authors: Erik
authors: E
authors: Simonsen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D004644:Emotions; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult