A systematic review comparing caregiver burden and psychological functioning in caregivers of individuals with schizophrenia spectrum disorders and bipolar disorders

Abstract

Background Informal primary caregivers provide crucial supports to loved ones experiencing serious mental illnesses with profound outcomes for the caregivers themselves. A comprehensive understanding of how different serious mental illnesses change the caregiving experience may provide important insight into the ways in which caregivers can be better supported in their role. The aim of this review was to synthesize the comparative literature examining caregiver burden and psychological functioning (anxiety, depression, distress, and psychological wellbeing) between caregivers of people with schizophrenia spectrum disorders and bipolar disorder. Methods Studies were included if they compared caregivers across both diagnostic groups and used measures assessing either caregiver burden or psychological functioning of caregivers. Databases searched up until 11th of January 2022 included: Medline COMPLETE, Embase, PsycINFO and CINAHL. Reference list scans and grey literature searches across government, organisational and dissertation databases were also conducted. Results Twenty-eight studies comprising 6166 caregivers were included. Fourteen studies suggested that caregiving burden was comparable across both groups. The effects of caring on caregiver mental health and stress were comparable across both groups. However, methodological limitations were noted, including a reliance on cross-sectional studies, multiple and sometimes competing definitions of caregiving burden, variable sample sizes, and variation in measures used. Conclusion and implications The experience of providing care is multidimensional and complex. Symptoms and functional difficulties experienced by people being cared for may affect caregivers more so than diagnosis. Caregivers play a vital role in helping people with serious mental illness. Supporting caregivers by reducing their burden and improving their psychological functioning may help them to continue to provide support, and cope with, the challenges of providing care.

Need of support for significant others to persons with borderline personality disorder–A Swedish focus group study

“…It is important to include a validating encounter, nourishing relationships and possibilities to a flexible and individualised support, regardless the type of support. This accords to several studies where researchers have emphasised the need for future development of support to SOs with focus on including decreased stigmatisation and increased empowerment [4,8,[33][34][35].…”

“…Mental illness are often devastating for both the persons experiencing symptoms and for their significant others (SOs) [1][2][3][4][5] For instance, SOs to persons with schizophrenia and bipolar disorder have reported significantly higher levels of stress, anxiety, depression and family burden than the general population [4] Further SOs to persons with mental illness experienced higher levels of alienation from professional care than SOs to persons in elderly and palliative care [6]. Similar aspects were reported for SOs to persons with borderline personality disorder (BPD) as well as a high incidence of substance use disorders, post-traumatic stress disorder and fear [5,7].…”

Factors of Parental Preparation of Children with Mental Illnesses for Their Independent Living after Their Own Death

“…Caregivers of people with mental illnesses experience self-stigma [ 40 ], guilt, and shame [ 41 ]. Additionally, they feel burdens and distress and require peer support [ 42 ]. Gaining social support is crucial for improving the resilience of their families, responding to difficulties in providing daily care, and enhancing the recovery of their children [ 43 ].…”

State of the art in psychological therapies for psychosis: Family interventions for psychosis

“…Guidelines do not usually differentiate particular psychosis presentations: all families where there is psychosis are considered eligible for FIp (NICE, 2014), and psychoeducation accordingly covers diagnostic uncertainty and complexity (Health Education England, 2020; Roth & Pilling, 2013). Evaluation is lacking regarding adaptations to the intervention to best address affective, interpersonal, neurodevelopmental and substance use comorbidity: each of these may impact the task of adjustment for caregivers, particularly comorbidity with organic disorders in older adults (Bayes et al, 2019; Cham et al, 2022; Dobri et al, 2022; Karambelas et al, 2022; Reynolds et al, 2022). It is also unclear whether the same approach ought to be recommended for psychosis symptoms occurring secondarily to a mood condition, or complex emotional and interpersonal difficulties (NICE, 2009, 2022).…”