title: Burden and Expressed Emotion of Caregivers in Cases of Adult Substance Use Disorder with and Without Attention Deficit/Hyperactivity Disorder or Autism Spectrum Disorder.
abstract: OBJECTIVE
  To identify and compare caregiver burden and expressed emotion (EE) in adult substance use disorder (SUD) patients with and without co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). To examine possible differences in correlations between caregiver burden and EE across patient groups.
  
  
  METHODS
  Cross-sectional study with measures of perceived burden (Involvement Evaluation Questionnaire: IEQ), subjective stress (General Health Questionnaire: GHQ) and perceptions of expressed emotion (Level of Expressed Emotion: LEE) in informal caregivers for patients with SUD, SUD+ADHD or SUD+ASD.
  
  
  RESULTS
  No differences in caregiver burden or expressed emotion when caregivers for patients with SUD were compared to caregivers for patients with SUD+ADHD. A moderate but non-significant difference for caregivers of patients with SUD versus SUD+ASD, which disappeared when the number of contact hours between patient and caregiver for the SUD only group was controlled for. The IEQ sum scores also substantially correlated with the LEE sum scores.
  
  
  CONCLUSIONS
  Informal caregivers for patients with only SUD show higher levels of burden and EE than informal caregivers for patients with SUD and a co-occurring ASD. This difference was largely explained by the higher number of contact hours between patient and caregiver in the SUD only group.
authors.affiliation: Department of Residency Training MANP Mental Health, Dimence, Deventer, The Netherlands ; Expertise Centre Developmental Disorders, Dimence, Deventer, The Netherlands ; Dimence, P.O. Box 5003, 7400 GC Deventer, The Netherlands.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Kronenberg
authors.affiliation: GGZVS, Institute for the Education of Clinical Nurse Specialists in Mental Health, Utrecht, The Netherlands ; SCBS, Dimence, Deventer, The Netherlands ; Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands ; Department of Public Health, University Centre for Nursing and Midwifery, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Peter J J
authors.initials: PJ
authors.lastname: Goossens
authors.affiliation: University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
authors.forename: Jooske T
authors.initials: JT
authors.lastname: van Busschbach
authors.affiliation: Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands ; Centre for Health Services and Nursing Research, KU Leuven, Leuven, Belgium ; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Theo
authors.initials: T
authors.lastname: van Achterberg
authors.affiliation: Amsterdam Institute for Addiction Research, Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
keywords: Attention deficit/hyperactivity disorder; Autism spectrum disorder; Burden; Expressed emotions; Substance use disorder