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Clinical correlates of the caregiving experience for Chinese caregivers of patients with schizophrenia

  • Victoria Wing Kay TangEmail author
  • Siu Kau Leung
  • Linda Chiu-Wa Lam
ORIGINAL PAPER

Abstract

Objective

To assess the correlation between clinical characteristics and the caregiving experience of caregivers of patients with schizophrenia.

Patients and methods

Two hundred and one patients with schizophrenia and their caregivers were recruited from a psychiatric clinic. The involvement evaluation questionnaire (IEQ) and the general health questionnaire (GHQ) were administered to the caregivers. The patients were assessed by the Structured Clinical Interview, the positive and negative syndrome scale (PANSS) and the global assessment of functioning scale (GAF). Correlation analysis and regression analysis was performed to identify the best predictors of caregiver stress.

Results

The most important clinical predictor of caregiver stress as assessed using IEQ was the GAF, followed by PANSS-Pos and Neg scores and admission. Positive symptoms contributed more to overall caregiver stress than negative symptoms.

Discussion

Both symptom severity and patient function were important factors in the caregiver experience. Treatment should aim not only to reduce symptoms but also maximize function. Service planning should include psychosocial intervention involving caregivers.

Key words

caregivers clinical correlation Chinese schizophrenia predictors 

Notes

Acknowledgments

The authors would like to thank Professor A. Schene and Professor H. Chiu for permission to use the IEQ and the Chinese version of the SCID. We would also like to thank all the patients and caregivers who kindly consented to participate in this study. This research is a part of the dissertation for the Hong Kong College of Psychiatrists Fellowship Examination.

Conflict of interest There is no financial support or conflict of interest.

References

  1. 1.
    American Psychiatric Association (1994) The diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, WashingtonGoogle Scholar
  2. 2.
    Barrowclough C, Tarrier N, Johnston M (1996) Distress, expressed emotion, and attributions in relatives of schizophrenia patients. Schizophr Bull 22:691–702PubMedGoogle Scholar
  3. 3.
    Biegel DE, Milligan SE, Putnam PL, et al. (1994). Predictors of burden among lower socioeconomic status caregivers of persons with chronic mental illness. Community Ment Health J 30:473–494PubMedCrossRefGoogle Scholar
  4. 4.
    Birchwood M, Cochrane R (1990) Family’s coping with schizophrenia: coping styles, their origins and correlates. Psychol Med 20:857–865PubMedGoogle Scholar
  5. 5.
    Bulger MW, Wandersman A, Goldman C (1993) Burdens and gratifications of caregiving: appraisal of parental care of adults with schizophrenia. Am J of Orthopsychiatry 83:255–265CrossRefGoogle Scholar
  6. 6.
    Census, Statistics Department (2001) 2001 population census. Government of the Hong Kong Special Administrative Region: Printing Department, Hong Kong Special Administrative RegionGoogle Scholar
  7. 7.
    Chan DW (1985) The Chinese version of the general health questionnaire: Does language make a difference? Psychol Med 15:147–155PubMedGoogle Scholar
  8. 8.
    Chien WT, Chan SWC, Thompson DR (2006) Effects of a mutual support group for families of Chinese people with schizophrenia: 18-month follow-up. Br J Psychiatry 189:41–49PubMedCrossRefGoogle Scholar
  9. 9.
    Fadden G, Bebbington P, Kuipers L (1987) The burden of care: the impact of functional psychiatric illness on the patient’s family. Br J Psychiatry 150:285–292PubMedCrossRefGoogle Scholar
  10. 10.
    Falloon IRH, Graham-hole V, Woodroffe R (1993) Stress and health of informal carers of people with chronic mental disorders. J Ment Health 2:165–173CrossRefGoogle Scholar
  11. 11.
    Gibbons JS, Horn SH, Powell JM, et al. (1984) Schizophrenic patients and their families: a survey in a psychiatric service based on a DGH unit. Br J Psychiatry 144:70–77PubMedCrossRefGoogle Scholar
  12. 12.
    Goldberg D, Williams PA (1988) User’s guide to the general health questionnaire. NFER/Nelson, WindsorGoogle Scholar
  13. 13.
    Gopinath PS, Chaturvedi SK (1992) Distressing behaviour of schizophrenics at home. Acta Psychiatr Scand 86:185–188PubMedCrossRefGoogle Scholar
  14. 14.
    Grad J, Sainsbury P (1963) Mental illness and the family. Lancet 1:544–547PubMedCrossRefGoogle Scholar
  15. 15.
    Gubman GD, Tessler TC, Willis G (1987) Living with the mentally ill: factors affecting household complaints. Schizophr Bull 13: 727–736PubMedGoogle Scholar
  16. 16.
    Hoenig J, Hamilton MW (1966) The schizophrenic patient in the community and his effect on the household. Int J Soc Psychiatry 12:165–176PubMedCrossRefGoogle Scholar
  17. 17.
    Kay SR, Fiszbein A, Opler LA (1987) The positive and negative syndrome scale ( PANSS) for schizophrenia. Schizophr Bull 13:261–276PubMedGoogle Scholar
  18. 18.
    Kung WW (2005) Cultural adaptations of family intervention for patients with schizophrenia in China. Int Soc Work 48:409–418CrossRefGoogle Scholar
  19. 19.
    Laidlaw TM, Coverdale JH, Falloon IRH, et al (2002) Caregiver’s stresses when living together or apart from patients with chronic schizophrenia. Community Ment Health J 38:303–310PubMedCrossRefGoogle Scholar
  20. 20.
    Li Z, Arthur D (2005) Family education for people with schizophrenia in Beijing, China. Br J Psychol 187:339–345CrossRefGoogle Scholar
  21. 21.
    Li J, Lambert CE, Lambert VA (2007) Predictors of family caregivers’ burden and quality of life when providing care for a family member with schizohprenia in the People’s Republic of China. Nurs Health Sci 9:192–198PubMedCrossRefGoogle Scholar
  22. 22.
    Liu M, Lambert CE, Lambert VA (2007) Caregiver burden and coping patterns of Chinese parents of a child with a mental illness. Int J Ment Health Nurs 16:86–95PubMedCrossRefGoogle Scholar
  23. 23.
    Magliano L, Fadden G, Madianos M, et al (1998) Burden on the families of patients with schizophrenia: results of the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol 33:405–412PubMedCrossRefGoogle Scholar
  24. 24.
    Magliano L, Veltro F, Guarneri M, et al (1995) Clinical and socio-demographic correlates of coping strategies in relatives of schizophrenic patients. Eur Psychiatry 10:155–158CrossRefPubMedGoogle Scholar
  25. 25.
    Martens L, Addington J (2001) The psychological well being of family members of individuals with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 36:128–133PubMedCrossRefGoogle Scholar
  26. 26.
    Oldridge ML, Hughes IC (1992). Psychological well-being in families with a member suffering from schizophrenia: an investigation into long-standing problems. Br J Psychiatry 161:249–251PubMedGoogle Scholar
  27. 27.
    Östman M, Hansson L, Andersson K (2000) Family burden, participation in care and mental health—an 11-year comparison of the situation of relatives to compulsorily and voluntarily admitted patients 46:191–200Google Scholar
  28. 28.
    Platt S (1985) Measuring the burden of psychiatric illness on the family: an evaluation of some rating scales. Psychol Med 15:383–393PubMedCrossRefGoogle Scholar
  29. 29.
    Schene AH, van Wijngaarden B (2000) Caregiving in schizophrenia: development, internal consistency and reliability of the involvement evaluation questionnaire—European version EPSILON study 4. Br J Psychiatry 177:s21-s27CrossRefGoogle Scholar
  30. 30.
    Schene AH (1990). Objective and subjective dimensions of family burden: towards an integrative framework for research. Soc Psychiatry Psychiatr Epidemiol 25:289–297PubMedCrossRefGoogle Scholar
  31. 31.
    Schene AH, Tessler RC, Gamache GM (1994) Instruments measuring family or caregiver burden in severe mental illness. Soc Psychiatry Psychiatr Epidemiol 29:228–240PubMedCrossRefGoogle Scholar
  32. 32.
    Schulze B, Rossler W (2005) Caregiver burden in mental illness: review of measurement, findings and interventions in 2004–2005. Curr Opin Psychiatry 18:684–691PubMedCrossRefGoogle Scholar
  33. 33.
    So E, Kam I, Leung CM, et al (2003) The Chinese-bilingual SCID-I/P project: stage 1—reliability for mood disorders and schizophrenia. Hong Kong J Psychiatry 13:7–18Google Scholar
  34. 34.
    Song LY, Biegel DE, Milligan SE (1997) Predictors of depressive symptomatology among lower class caregivers of persons with chronic mental illness. Community Ment Health J 33:269–286PubMedCrossRefGoogle Scholar
  35. 35.
    Spaniol L, Zipple AM, Lockwood D (1992) The role of family in psychiatric rehabilitation. Schizophr Bull 18:341–348PubMedGoogle Scholar
  36. 36.
    Szmuckler GI, Burgess P, Heman H, et al (1996) Caring for relatives with serious mental illness: the development of the experience of caregiving inventory. Soc Psychiatry Psychiatr Epidemiol 31:137–148CrossRefGoogle Scholar
  37. 37.
    Tang VWK, Leung SK, Lam LCW (2008) Validation of the Chinese version of the involvement evaluation questionnaire. Hong Kong J Psychiatry 18:6–14Google Scholar
  38. 38.
    Tarricone I, Leese M, Szmukler GI, et al (2006) The experience of carers of patients with severe mental illness: a comparison between London and Bologna. Eur Psychiatr 21:93–101CrossRefGoogle Scholar
  39. 39.
    Thompson EH, Doll W (1982) The burden of families coping with the mentally ill: an invisible crisis. Fam Relat 31:379–388CrossRefGoogle Scholar
  40. 40.
    Veltro F, Magliano L, Lobrace S, et al (1994) Burden on key relatives of patients with schizophrenia vs. neurotic disorders: a pilot study. Soc Psychiatry Psychiatr Epidemiol 29:66–70PubMedGoogle Scholar
  41. 41.
    van Wijngaarden B, Schene AH, Koeter M, et al (2000) Caregiving in schizophrenia: development, internal consistency and reliability of the involvement evaluation questionnaire-European Version. EPSILON study 4. European psychiatric services: inputs linked to outcome domains and needs. Br J Psychiatry Suppl 39:s21–27PubMedCrossRefGoogle Scholar
  42. 42.
    van Wijngaarden B, Schene AH, Koeter M, et al (2003) People with schizophrenia in five countries: conceptual similarities and intercultural differences in family caregiving. Schizophr Bull 29:573–586PubMedGoogle Scholar
  43. 43.
    Williams JB, Gibbon M, First MB, et al. (1992) The structured clinical interview for DSM-III-R (SCID). II: multisite test–retest reliability. Arch Gen Psychiatry 49:630–636PubMedGoogle Scholar
  44. 44.
    Winefield HR, Harvey EJ (1993) Determinants of psychological distress in relatives of people with chronic schizophrenia. Schizophr Bull 19:619–625PubMedGoogle Scholar
  45. 45.
    Wong DF, Tsui HK, Pearson V, et al. (2004) Family burdens, Chinese health beliefs and the mental health of Chinese caregivers in Hong Kong. Transcult Psychiatry 41:497–513PubMedCrossRefGoogle Scholar
  46. 46.
    World Health Organization (1993) The ICD 10 classification of mental and behavioural disorders: diagnostic criteria for research. World Health Organization, GenevaGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Victoria Wing Kay Tang
    • 1
    Email author
  • Siu Kau Leung
    • 1
  • Linda Chiu-Wa Lam
    • 2
  1. 1.Dept. of PsychiatryCastle Peak HospitalTuen MunChina
  2. 2.Dept. of PsychiatryThe Chinese University of Hong KongNew TerritoriesChina

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