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Caregiver distress in first-episode psychosis: the role of subjective appraisal, over-involvement and symptomatology

Social Psychiatry and Psychiatric Epidemiology volume 50, pages 371–378 (2015)Cite this article

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.

Aims

To examine the impact of subjective appraisals and expressed emotion on caregiver distress in FEP.

Method

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.

Conclusion

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.

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Acknowledgments

We are grateful to all of the patients and their caregivers who consented to participate, and to the clinicians in Opus Region Zealand, who provided access to their clients. The Region Zealand Health Scientific Research Foundation provided funding for this research, but had no involvement in the production of this paper.

Conflict of interest

None.

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Authors and Affiliations

  1. Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Smedegade 10, 4000, Roskilde, Denmark

    Jens Einar Jansen, Ulrik Helt Haahr, Hanne-Grethe Lyse & Marlene Buch Pedersen

  2. Department of Psychology, University of Copenhagen, Copenhagen, Denmark

    Jens Einar Jansen & Susanne Harder

  3. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Ulrik Helt Haahr, Anne Marie Trauelsen & Erik Simonsen

  4. Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Copenhagen, Denmark

    Anne Marie Trauelsen & Erik Simonsen

  5. Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    Erik Simonsen

Authors
  1. Jens Einar Jansen
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Correspondence to Jens Einar Jansen.

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Jansen, J.E., Haahr, U.H., Harder, S. et al. Caregiver distress in first-episode psychosis: the role of subjective appraisal, over-involvement and symptomatology. Soc Psychiatry Psychiatr Epidemiol 50, 371–378 (2015). https://doi.org/10.1007/s00127-014-0935-8

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  • DOI: https://doi.org/10.1007/s00127-014-0935-8

Keywords

  • Caregivers
  • Distress
  • Emotional over-involvement
  • First-episode psychosis