Spousal Burden and Coping across Patient Groups of Three Serious Mental Illnesses- A Comparative Study

ABSTRACT

Serious psychiatric conditions like schizophrenia, bipolar disorder, alcohol dependence syndrome lead to a great burden in care givers who adopt a variety of styles to cope with their family member’s illness. Burden perceived and coping styles used by spouses is quite different from other care givers given their close relationship with the patient. Little research is focused on spouses as an exclusive group for their assessment of burden & coping. The aim was to compare the burden and coping in spouses across three patient groups with schizophrenia, bipolar disorder and alcohol dependence syndrome.METHODSThis was conducted at Institute of Mental Health, Hyderabad with 180 spouses (30 male & 30 female) from patients of above three illnesses. After IEC approval and a written informed consent, the patient and spouse were interviewed with the semi-structured intake pro-forma to capture socio-demographic details of spouse, illness, marital, family & treatment history. After initial assessment of patient’s functional status using GAF scale; BAS, CCL, GHQ-12 instruments were administered on spouses to assess the burden of illness, coping styles and general health status. Data was analysed with SPSS 17.RESULTSAlcohol use and mental illness is high in families of patients with alcohol dependence reaching statistical significance. Nuclear families are high in schizophrenia group and in alcohol dependence group, substance use in spouses is high at 25 (52.1%) along with abuse of spouses at 19 (67.9%) which is statistically significant. On ANOVA & post hoc analysis, means of GHQ-12 in alcohol dependence group is higher than other groups while means of BAS is higher in alcohol dependence group showing high scores on BAS factor analysis.CONCLUSIONSBurden perceived by spouses of these three patient groups is significant. The coping styles used by spouses to handle the distress due to patient’s illness are many. A high global functioning score of the patient corresponds to good general health in the spouse. Proper psychosocial interventions when employed can help spouses deal better with burden and enhance coping styles.