title: Assessing health status in informal schizophrenia caregivers compared with health status in non-caregivers and caregivers of other conditions.
abstract: BACKGROUND
  Research indicates schizophrenia is a cause of burden for patients and caregivers. This study examined health-related quality of life (HRQoL) and comorbidities experienced by informal schizophrenia caregivers compared with non-caregivers and caregivers of adults with other conditions (e.g., Alzheimer's disease, cancer, and stroke).
  
  
  METHODS
  Data were obtained from the 5EU (France, Germany, Italy, Spain, UK) National Health and Wellness Survey, an online questionnaire that is representative of the total 5EU adult (18+ years) population. Respondents provided information on HRQoL (SF-36v2: mental and physical component summary (MCS, PCS) and SF-6D (health utility) scores), items from the Caregiver Reaction Assessment (strongly disagree to strongly agree) and comorbidities (sleep difficulties, insomnia, pain, headaches, heartburn, anxiety, depression) experienced in the past 12 months. Schizophrenia caregivers (n = 398) were matched to non-caregivers (n = 158,989) and caregivers of other conditions (n = 14,341) on baseline characteristics via propensity scores. Chi-square tests and ANOVAs were used to determine significant differences across groups.
  
  
  RESULTS
  The average age of schizophrenia caregivers was 45.3 years (SD = 15.8), and 59.6% were female. After matching, schizophrenia caregivers reported lower MCS (40.3 vs. 45.9), PCS (46.8 vs. 49.0), and health utilities (0.64 vs. 0.71) compared with non-caregivers (all p < 0.001). Schizophrenia caregivers were more likely to experience sleep difficulties (42.7% vs. 28.5%), insomnia (32.4% vs. 18.5%), pain (39.7% vs. 30.4%), headaches (48.0% vs. 42.0%), heartburn (31.7% vs. 22.9%), anxiety (37.9% vs. 23.6%), and depression (29.4% vs. 19.4%) than non-caregivers. Comparing schizophrenia caregivers and other caregivers, schizophrenia caregivers reported lower MCS (40.3 vs. 42.7, p < 0.001), and health utilities (0.64 vs. 0.67, p < 0.001). Schizophrenia caregivers were more likely to experience sleep difficulties, insomnia, pain, and anxiety than other caregivers. Almost 60% of schizophrenia caregivers agree/strongly agree that caring for the patient is important to them, but only 31.9% agree/strongly agree that they have the financial resources to provide adequate care.
  
  
  CONCLUSIONS
  Schizophrenia caregivers reported worse HRQoL than non-caregivers and caregivers of other conditions. Providing care for an adult relative with schizophrenia is important to caregivers, but caregivers need more resources to provide adequate care. Providing informal schizophrenia caregivers with support services to help better manage patients may improve their health status.
authors.affiliation: Health Outcomes Practice, Kantar Health, 1 Independence Way, Suite 220, Princeton, NJ, 08540, USA. shaloo.gupta@kantarhealth.com.
authors.forename: Shaloo
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Kantar Health, Epsom, Surrey, UK. gina.isherwood@kantarhealth.com.
authors.forename: Gina
authors.initials: G
authors.lastname: Isherwood
authors.affiliation: European Federation of Associations of Families of People with Mental Illness, Diestsevest 100, B-3000, Leuven, Belgium. secr.general.office@eufami.org.
authors.forename: Kevin
authors.initials: K
authors.lastname: Jones
authors.affiliation: Janssen-Cilag GmbH, Neuss, Germany. kvimpe1@its.jnj.com.
authors.forename: Kristel
authors.initials: K
authors.lastname: Van Impe
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000706:statistics & numerical data*; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology; D011788:Quality of Life; D012559:Schizophrenia / Q000453:epidemiology*; D013030:Spain / Q000453:epidemiology