Burden and Expressed Emotion in Caregivers of Schizophrenia and Bipolar Affective Disorder Patients: A Comparative Study

Abstract

Background: Caregiver burden and expressed emotion have been studied in patients with schizophrenia but literature is less regarding these in bipolar affective disorder (BPAD). No study could be found which compared the caregiver burden and expressed emotion in these two patient groups. Hence, the study is conducted to investigate and compare the caregiver burden and expressed emotion in caregivers of patients with schizophrenia and BPAD. Materials and Methods: Data were collected from outpatient department of psychiatry, Institute of Mental Health and Hospital, Agra regarding sociodemographic characteristics (e.g., age, gender, domicile), followed by burden assessment schedule, family emotional involvement and criticism scale, positive and negative syndrome scale, Young mania rating scale, and hamilton depression rating scale (HDRS) from patients of schizophrenia and BPAD and their caregivers. Descriptive statistics such as mean and standard deviation (SD) and unpaired t test were applied for continuous data and chi square for categorical data. Spearman correlation was used to find correlation. Results: No statistically significant difference between the sociodemographic variable of either patient of schizophrenia and bipolar disorder or their caregivers was observed. Significantly higher total burden (P = 0.01) with mean value of 82.8 (SD = 8.8) in caregivers of patients with schizophrenia compared to BPAD with mean value of 76.7 (SD = 12.3) was noted. Emotional over-involvement was significantly more in patients with BPAD compared to patients with schizophrenia (P = 0.0007). Spearman correlation shows positive correlation among age of caregivers, education, and burden of care in both the groups (P < 0.05 in both groups). Conclusion: The presence of significant amount of burden of care and expressed emotion point out to the need for psychosocial support to the family members for mitigation of the burden and reduction in the expressed emotion, which in turn could reduce the relapse rates and facilitate the caregivers to effectively cope and manage the ill family member.

Keywords

• Bipolar affective disorder
• caregiver burden
• expressed emotion
• schizophrenia