[Illness related costs for spouses of patients suffering from a mental illness: results of a study with repeated measurements]. / Erkrankungsbedingte Kosten für Partner psychisch Kranker: Ergebnisse einer Mehrfacherhebung.

OBJECTIVE: Aim of this study is the documentation of illness-associated costs for spouses, whose relative is suffering from a mental illness. METHOD: Over a period of 12 month, 117 spouses of patients who are suffering from schizophrenia, depression or anxiety disorders repeatedly filled in a standardized questionnaire about illness related expenses and financial losses. RESULTS: 90 % of the spouses reported direct cash expenditures on behalf of the patients' illness. On average, these costs amounted to yearly expenditures of euro 1146 (range: euro 0 - 11 910). Costs did not differ significantly across types of illness and income was not found to be a significant covariate. CONCLUSIONS: Spouses reported substantial direct cash expenditures on behalf of the patients' illness. Since these expenditures varied to a large extent over the three points of measurement, repeated measurement designs seem to be a prerequisite for a reliable assessment of illness-associated costs. Since living together with a mentally ill partner is associated with an increased risk of developing a burden-related psychiatric illness for spouses themselves which may lead to double costs and double decreases in income, these aspects should be taken into consideration when planning changes in health policy.

[Financial burden on caregivers of schizophrenic patients: a comparison between parents and spouses]. / Finanzielle Belastungen von Eltern und Partnern schizophrener Patienten im Vergleich - Teil II: Qualitative Aspekte -

OBJECTIVE: Part II of this study will explore more accurately, how caregivers of schizophrenic patients perceive the financial burdens of the disease. METHOD: 42 In-depth-interviews with parents and spouses of schizophrenic patients were analysed using a qualitative-interpretative technique. RESULTS: When talking about their living situation, caregivers tended to keep away from the topic of financial charges; often they played down objective financial disadvantages or didn't assess them as burdensome. Considerable financial burdens were reported by parents of young patients still living in the parents' household and by spouses in families with very low income. DISCUSSION: Financial burdens are usually superimposed by other problems of the caregivers, such as dealing with acute episodes and sorrow about the future. Thus, not only the material, but also the immaterial costs of caregivers should be taken into consideration when taking health policy decisions.

[Financial burden on caregivers of schizophrenic patients: a comparison between parents and spouses]. / Finanzielle Belastungen von Eltern und Partnern schizophrener Patienten im Vergleich - Teil I: Quantitative Aspekte.

OBJECTIVE: The aim of this study was to compare financial burden of parents and spouses, whose relative is suffering from schizophrenia. The first article (part I) draws attention to quantitative analysis. METHOD: 51 parents and 52 spouses filled in the questionnaire about illness related expenses and financial loss; additionally they were asked to estimate the experienced burden on a subjective dimension. RESULTS: Direct cash expenditures on behalf of the patients' illness were reported by 63 % spouses and 69 % parents. Above all, the patient's reduced ability to work was seen as main cause for long-term loss of family income. In general economic disadvantages were not considered as burdensome. DISCUSSION: Although most parents and spouses of schizophrenic patients experience illness related financial disadvantages, it seems that these costs were usually not defined as serious problem. For a better understanding of this finding further analysis of the subjective perspective on perceived financial burden is needed (see part II).

Depressive disorders in spouses of mentally ill patients.

BACKGROUND: According to the literature on stress and coping, the burden of caregiving to a mentally ill partner might have an impact on the mental health of the spouse. METHOD: As part of a study on the burden of caregiving to mentally ill family members, a structured psychiatric interview (DIA-X-M-CIDI) was conducted with spouses of patients suffering from depression, anxiety disorders, or schizophrenia (n = 151). RESULTS: Covarying with the partner's gender and the severity of the patient's illness a significantly increased prevalence of depressive disorders could be found. CONCLUSION: Psychiatric patients' partners are at a high risk of developing a depressive disorder. It appears necessary to develop special interventions for spouses reducing stress and the risk of getting depressed.