Disability in persons with Schizophrenia correlated to family burden and family distress among their caregivers.

Background: Families are the main support system or primary care givers for persons with Schizophrenia in India. Family burden and distress is a concern one should get acquainted about the disability of the client in relation to the accompanying world. Aim: To correlate the disability in persons with schizophrenia and family burden and distress among their caregivers. Objectives: (1) To assess the disability of persons with schizophrenia. (2) To assess the family burden among the caregivers of persons with schizophrenia. (3) To assess the family distress among the caregivers of persons with schizophrenia. (4) To correlate the disability of persons with schizophrenia and the family burden and family distress among their caregivers. Method: One hundred individuals diagnosed to be suffering from schizophrenia as per DSM IV or ICD – 10 criteria and hundred primary care givers were taken up for the study with their consent to participate after the intake screening. The data collected were primarily by interviewing & administering validated Indian research instruments Indian Disability Evaluation Assessment Schedule (IDEAS), Schedule for Assessment of Family Burden (SAFB), Schedule for Assessment of Family Distress (SAFD) to the client and the significant key relative or caregiver. Results: Among the participants 83% of clients found with mild to moderate disability. Majority (96%) of the key relatives had moderate to severe burden with a mean score of 1.27 + 0.863, and 46 percent had minimal distress and 50 percent had moderate to marked distress with mean score of 5.22 + 3.265. Conclusion: Level of disability does not affect the intensity or the severity of the family burden or distress experienced among their care givers. Hence psychosocial interventions are mandatory for reducing burden and distress among the primary care givers while intervening to reduce the level of the disability.

Rehabilitation needs and disability in persons with Schizophrenia and the needs of the care givers.

Background: In India, Families are primary care givers of individuals with chronic mental illness such as Schizophrenia, However these caregivers needs to be assessed along with their ill relative to understand the care giving process. Aim: To get acquainted with the rehabilitation needs of persons diagnosed to have Schizophrenia and their care givers while correlating with disability quantified. Specific Objectives: (i) To assess the level of disability in the area of self care, interpersonal activities communication and understanding, work in persons with schizophrenia. (ii) To assess the rehabilitation needs of the persons with schizophrenia and their care givers. (iii) To evaluate the rehabilitation needs based on the level of disability of persons with schizophrenia. Method: Thirty individuals diagnosed to have schizophrenia as per DSMIV\ICD-10 criteria who fulfil inclusion and exclusion criteria were taken up for the study. The data was collected by administering the standardized research instruments such as IDEAS and RNAS. Results: 100 percent of the sample had a need in some area or the other. Majority of the sample (76.66%) had less than 40% disability. Among the need assessment, we found help for the family in terms of family education, group meetings, family burden and distress reduction interventions, interventions to deal with expressed emotion of the family member, were given priority by the majority (96.66%). Conclusion: Psycho social interventions to deal with family burden and distress should go hand in hand while reducing the disability of the patient. Impact on the family should be taken care for better care giving process and all the care givers require family interventions despite of variation in level of disability in their ill relative.

Disability in Schizophrenia and Bipolar Mood disorder at General Hospital Psychiatry Unit.

Aim: To compare the disability in the persons with Schizophrenia and persons with Bipolar Mood Disorder by using IDEAS from a GHPU Mental Health Treatment Users. Objectives: 1.To assess the level of disability in the area of self care, interpersonal activities, communication and understanding and in the area of work in persons with Schizophrenia and in persons with Bipolar Mood Disorder. 2. To evaluate & compare the extent of disability found in Schizophrenia and Bipolar Mood Disorder. Method: Thirty individuals with schizophrenia and thirty individuals with Bipolar Mood Disorder along with significant caregiver were assessed by administering IDEAS. The data was analyzed to prioritize the need for psychosocial interventions along with pharmacological interventions; to reduce disability during hospitalization. Individuals with co-morbid condition and illness duration less than two year were excluded. Result: Majority of persons with Schizophrenia had severe, moderate, profound disability in psychosocial role functioning where as most of the persons with Bipolar Mood Disorder had only mild to moderate disability. Conclusion: Disability was found to be more in persons with Schizophrenia compared to persons with Bipolar Mood Disorder.