Caregiver's burden, coping and psycho-education in Indian households with single- and multiple-affected members with schizophrenia

Abstract

There is considerable evidence that family psycho-education combined with pharmacological intervention for patients with schizophrenia increases family understanding of the illness, reduces familial burden of care and improves patient outcomes. However, no studies have determined whether the burden of care is greater for those families with more than one ill member (multiplex), than for families with a single-affected individual (simplex), and whether psycho-educational programmes should be adapted to meet the specific needs of multiplex families. The study was conducted at a tertiary care postgraduate teaching hospital in New Delhi, India. Caregivers in simplex (N = 50) and multiplex families (N = 30) were compared with regard to levels of burden, coping and the impact of psycho-education on family functioning. All the caregiver participants attended eight bimonthly psycho-educational intervention sessions. They were assessed on the Burden Assessment Schedule (BAS) and the Coping Check List (CCL) before and after psycho-education. Caregivers from the multiplex families reported significantly more burden on two domains of the BAS, but there were no significant differences between the groups with regard to coping on the CCL. Following psycho-education, significant improvement occurred in the majority of domains of the BAS and the CCL; the effect sizes varied by domain and family type. Multiplex families face a greater burden of care compared with simplex families. Currently available psycho-education programmes are moderately effective for such families.

Keywords::

• Schizophrenia
• psycho-education
• caregiver's burden
• coping
• multiplex families

Acknowledgements

This work was funded in part by Neurobehavioral Family Study of Schizophrenia grant (MH63480 to VLN) and by the grant Training Program for Psychiatric Genetics in India (D43 TW006167) from the National Institutes of Health (NIH), USA. Salary of Dr Triptish Bhatia is supported by NIH-funded project and The impact of Yoga supplementation on cognitive function among Indian outpatients with schizophrenia; TW008289 to TB. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or other funding agencies.