Gender and other factors influencing the burden of care in relatives of people diagnosed with schizophrenia and schizophrenia spectrum disorders

ABSTRACT

Burden of care is a complex construct. A gender approach could help to a further understanding of the process. However, previous publications give us inconclusive data. The aim of this study is to evaluate the impact of gender and other factors in the burden experienced by relatives of people diagnosed with schizophrenia spectrum disorders. A sample of 93 Mediterranean Caucasian caregivers (70% women) of 61 patients (87% men) responded to a structured interview and to the Spanish version of Zarit Burden Interview (ZBI). The ZBI showed a 0.872 Cronbach α-coefficient. The best factorial solution included five main components explaining 62% of the variance. Of caregivers, 89% showed high levels of burden. Burden ZBI scores (from highest to lowest) accounted for: worries about patient’s future, strain, interference with privacy, lack of resources and feelings of rejection towards the patient. Global burden was not associated with carer’s gender but it was significant with patients’ gender (p = 0.025). There were significant differences in caregiver’s gender in items ‘Health’ (p = 0.020) and ‘Loss of life control’ (p = 0.027). Burden suffered by female patients’ caregivers was 13 points higher (95%CI: 2–24%). In conclusion, in our sample, few relatives escaped from emotional distress and patient’s gender influenced the results.

KEYWORDS:

• burden of care
• gender
• caregivers
• schizophrenia
• Zarit burden interview

Acknowledgements

The authors wish to express their gratitude to Salvador Quintana for his great help in analysing data. They also want to thank Patricia Vigués for her help in the English translation of the manuscript. Last but not least, special thanks to Steven H. Zarit, Ph.D., for his useful help and support to this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Roser Cirici Amell, MS, PhD, is a clinical psychologist who works as a therapist at the Adult Mental Health Centre of Sant Cugat del Vallès, Mútua Terrassa University Hospital, located in Catalonia (Spain). She completed her PhD in Clinical Psychology in 2001 at University of Barcelona in Social Skills Training for Schizophrenic Patients. She is also Associate Professor at the University of Barcelona. Her main fields of research include Social Skills Training for Severe Mental Health Patients, Family Coping with Mental Health Relatives, Cognitive Therapy for Psychosis, Intimate Partner Violence and Mental Health Consequences of Traumatic Events and Resilient Strategies.

Nuria Giménez received her MD and PhD in Medicine from the University of Barcelona and completed a Master of Research methodology in the Autonomous University of Barcelona (UAB). She is a specialist in Clinical Biochemistry. At present, she is a Research Consultant and coordinates the clinical research training program in the Research Foundation Mutua Terrassa. She is also Associate Professor at the UAB. Her main fields of research include public health, bioethics, cancer and toxicology. She has presented over 200 papers in congresses and published over 85 scientific articles in peer-reviewed journals.

Jesus Cobo, MD, PhD, obtained his Bachelor’s Degree in Medicine at the Universidad de Cantabria in 1991 and completed a Psychiatry residency at the Hospital Universitari de Bellvitge in Barcelona in 2000. He earned a master’s degree in History of Science in 2004 and a master’s degree in Affective Neurosciences in 2009. He also obtained his doctoral degree in History of Science in 2006. He currently works as a Senior Psychiatrist at the Corporació Sanitària i Universitària Parc Taulí (Sabadell, Barcelona). Dr Cobo has participated in various research studies and authored or co-authored several scientific papers, primarily on women’s mental health, but also on bipolar disorders, psychopathology and psychopharmacology. He is an Associate Lecturer of Psychiatry at the Universitat Autònoma de Barcelona, where he has supervised numerous doctoral dissertations and academic papers. He is an active member of the Catalan Research Workgroup on Women's Mental Health in the Catalan Society of Psychiatry and Mental Health and co-organises several congresses, symposia and meetings in the field.

Maria Martí Castanyer, MS, PhD. Master of Science (MS) at the Psychology University of Barcelona. She is visiting schoolar and Family Therapy Training Program at Roberto Clemente Center in 2010 (New York). She realized the Clinical Psychology Residency Training Program (2012–2015) in Hospital Universitary Mutua de Terrassa (Terrassa, Barcelona). She obtained Doctor of Philosophy (Ph.D.) at the Universitat Autònoma de Barcelona with the Thesis title: Parenting in Latino head start families: A mixed method study (Columbia University). She also obtained an Alicia Koplowitz Research Fellow at New York Presbiterian Hospital-Columbia University (Division of Child and Adolescent Psychiatry) and worked as Psychotherapist at the Metropolitan Center for Mental Health (Columbia University). After her Degree, she worked at the New York Presbiterian Hospital-Columbia University as Research Staff Associate and Research Analyst. Since 2015, she is Postdoctoral Research Scientist at the Mailman School of Public Health (Columbia University), New York. She had realized different publications and research works.

ORCID

Jesus Cobo http://orcid.org/0000-0002-2032-9343