The aims of the study were twofold. First, the study examined the extent to which there are gender differences in the experience of caring in a sample of relatives of patients with serious mental illness. Secondly, the study examined the association of self-reports of health and functioning with the experience of burden among relatives of patients with serious mental illness. A total of 50 relatives of 32 patients receiving psychiatric treatment for their bipolar or psychotic condition completed the Experience of Caregiving Inventory (ECI) and COOP-WONCA (a self-report measure of general state of health and functioning). The study revealed that female relatives had a higher score on eight of 10 ECI subscores, and in both ECI negative and ECI positive. Additionally, the study revealed significant correlations between a higher score on the COOP-WONCA feeling subscore and the following ECI subscores: stigma (r = 0.304, p < 0.05), problem with services (r = 0.348, p < 0.05), need to back up (r = 0.335, p < 0.05), loss (r = 0.293, p < 0.05) and the total ECI negative subscore (r = 0.343, p < 0.05). We also found a significant correlation between a higher score on the overall health subscore (COOP-WONCA) and a higher score on problems with services (r = 0.290, p < 0.05). Gender was the strongest predictor of the ECI negative subscore. Neither the COOP-WONCA subscore physical health, daily activities or social activities correlated significantly with any of the ECI subscores. Our results showed strong associations between poor mental well-being and caregiver burden. We also found a higher association with gender and the feelings subscore (COOP-WONCA) on ECI negative than we had expected.

We conclude that the SMAST-13 and DAST-20 in combination with the AUS and DUS, which are easy and quick to perform, are helpful in establishing a common understanding of the patient's alcohol and drug problems in an early intervention clinic.

The main objective of this study was to compare symptom load and lifetime treatment experiences between psychotic patients with substance abuse problems and psychotic patients without substance abuse problems. This is a cross-sectional study of 48 patients (26 inpatients and 22 outpatients) in a clinic for early intervention in psychosis. Patients' were grouped into two categories based on whether they had a substance abuse problem or not. Twenty-one (43.8%) had a substance abuse problem and 27 (56.2%) had not. We used the Positive and Negative Symptom Scale (PANSS) scale to measure symptoms and several scales to measure substance abuse. Parametric tests (independent t-tests) were used to compare continuous variables, and chi-square tests were used to compare frequencies. Positive symptoms, negative symptoms, general psychopathology symptoms and the total score of psychotic symptoms did not differ significantly between the groups with psychosis alone and psychosis with substance abuse. The delusion subscore was significantly higher in the group with psychosis alone (t = -2.3, df = 41, P < 0.05), and the anxiety subscore was significantly higher in the group with psychosis with substance abuse (t = -2.3, df = 41, P < 0.05). There were no significant differences in the subscores for negative symptoms. The absence of differences in psychotic symptoms between the two groups with psychosis does not imply a strong relationship between psychotic symptoms and substance abuse. These results do not support the self-medication hypothesis. The higher rates of institutionalization among substance abusers may be explained by mechanisms other than exacerbations of psychotic symptoms, as there are few differences in symptoms among abusers and non-abusers.

The main objective of this study was to compare life skills between psychotic patients with substance abuse problems and psychotic patients without substance abuse problems. This is a cross-sectional study of 48 patients (26 inpatients and 22 outpatients) in a clinic for early intervention in psychosis. Patients were grouped into two categories based on if they had a substance abuse problem or not. Twenty-one (43.8%) had a substance abuse problem and 27 (56.2%) had not. We used several scales to measure substance abuse and the Life Skills Profile to measure aspects of functioning. A parametric test (t-test) was used to compare continuous variables. A non-parametric chi-square test was used to compare frequencies. The self-care subscore and the non-turbulence subscore were higher in the group with psychosis alone. These results were not significant controlling for age. The social contact subscore, the communication subscore, the responsibility subscore and the Life Skills Profile total score did not differ significantly between the groups. The abusers did not differ from the non-abusers in functioning in any area measured.