A Comparative Study of Family Caregiver Burden of Schizophrenia and Bipolar Affective Disorder

The concept of family caregiving came into the limelight following the deinstitutionalization movement. The caregiver provides physical, emotional, and economic support, and in the process, they undergo considerable stress, like sleep deprivation, physical pain, emotional turmoil, financial issues, and social strains. Major chronic mental illnesses like Schizophrenia and bipolar disorder differ significantly in the symptomatology, course, outcome, response to medications, and degree of dependency, and thus impact the caregivers differently.

This study aimed to compare the caregiver burden among schizophrenia and bipolar affective disorder (BPAD) and identify factors associated with higher caregiver strain.

It was a hospital-based cross-sectional study, with a total sample of 110 participants, with 55 each with schizophrenia and BPAD. The severity of symptoms and level of functioning were assessed in patients with schizophrenia and Bipolar affective disorder (BPAD). The caregiver burden was measured using the Caregiver Strain Index (CSI). A multivariate regression model was constructed to determine predictors of caregiver burden.

The baseline demographic data was comparable between the groups. The caregivers of schizophrenia and BPAD groups expressed similar burden. The patient factors contributed to about 64.5% of the burden, and the key factors were duration of illness and level of functioning. The caregiver factors accounted for 20.4%, and the key factors were the caregiver's relationship with the patient and the duration of caregiving. The caregiver burden had a strong association with the severity of psychopathology with schizophrenia and the manic subgroup of BPAD.

The study brings out the major levels of burden experienced by the carers of chronic mental illness. This proves the necessity to provide adequate and routine screening for difficulties faced by caregivers to pick up early signs of burnout. Psychotherapy targeting the coping strategies and effective functioning of the caregivers is essential, along with patient management.