[Validating the efficacy of a group intervention program on the quality of life of depressed patient's spouses]. / Uberprüfung der Wirksamkeit eines neu entwickelten Gruppeninterventionsprogramms auf die Lebensqualität von Angehörigen depressiv Erkrankter.

A new group intervention program has been assessed, rating its ability to increase the quality of life in partners of patients suffering under depression. Over a period of six months 66 subjects participated in an intervention group for a total of twelve sessions. The control group consisted of 50 persons, and quality of life was assessed with the WHOQOL-BREF. The five WHOLQOL domains were used as independent variables in random-effects regression models measuring the time effect. Although the quality of life of the subjects was below that of the general population at the beginning of the intervention, the study resulted in no significant improvement in quality of life. In contrast, satisfaction of participants with the intervention was high.

[A group intervention for spouses of patients with depression - is it effective?]. / Gruppenintervention zur unterstützung von partnerndepressiv erkrankter - eine lohnende massnahme?

OBJECTIVE: Spouses of patients with depression have an elevated risk to develop an affective disorder themselves. We evaluate whether a group intervention program for spouses of patients with depression does improve participants' depressive and anxiety symptoms. METHODS: 66 spouses participated in a six months intervention with 12 group sessions. 50 nonparticipants were included as a control group. We measured depressive and anxiety symptoms with the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) at the beginning and the end as well as 3 and 9 months after the intervention. RESULTS: The intervention did not cause any improvement with regard to BDI and BAI scores. Scores in the BDI and BAI were normal in most participants before the intervention. Regardless, satisfaction with the program among participants was very high. CONCLUSION: The influence of the intervention concept on the wanting participation of more severely affected spouses is discussed and adaptations of the program are proposed.

Quality of life of spouses of mentally ill people.

BACKGROUND: Spouses of people with mental disorder experience various forms of objective and subjective burden. This should negatively affect their quality of life. However, until now no single study has addressed this question. AIMS: To investigate the quality of life of spouses of people with schizophrenia, depression or anxiety disorders. METHOD: Spouses of patients suffering from schizophrenia (n = 45), depression (n = 49) and anxiety disorders (n = 39) were consecutively recruited from outpatient services in the city of Leipzig. Quality of life was assessed by means of the WHOQOL-BREF, a self-administered questionnaire developed by the World Health Organisation. RESULTS: Compared with the general population, the quality of life of the spouses of mentally ill people was lower in the domains 'psychological well-being' and 'social relationships'. There was a significant association between the patient's functional level and the spouse's quality of life. CONCLUSIONS: Better treatment, professional support and participation in self-help and advocacy groups may help to improve the quality of life of spouses of mentally ill people.

[Everyday burden of mentally ill people's spouses -- client orientated approaches in relatives' support]. / Alltagsbelastungen von Partnern psychisch Kranker - Ansätze für eine nutzerorientierte Angehörigenarbeit.

OBJECTIVE: Regarding clinical practice groups for relatives of mentally ill people mostly are conceptualized depending on the type of disorder the patient is suffering from. However, results of research on burden of caregivers indicate aspects of burden which do not seem to be associated with the patients' disorder. METHOD: As part of a study on the burden of caregiving to mentally ill family members in-depth interviews as well as diary writing over a 12 weeks period were carried out with 6 spouses of patients suffering from schizophrenia or depression. RESULTS: Differences in the burden of caregiving do not seem to be related to the type of the patients' diagnosis. Aspects of partnership dominated the interviews and diary writing of the spouses. In all cases substantial parts of experienced burden are related to the spouses' efforts to share mastering of the illness with the patient. CONCLUSIONS: The hypothesis of specific aspects regarding the type of the patients' disorder related to spouses caregiver burden can not be supported by the results of this study. However, our results seem to encourage aspects of relationship within the development of support programs for relatives of mentally ill people.

The disregarded caregivers: subjective burden in spouses of schizophrenia patients.

Although the burdens of relatives of schizophrenia patients have been the subject of numerous studies, there are hardly any publications on the living situation of the patients' spouses. The findings of this qualitative interview study of 52 spouses of schizophrenia patients are, therefore, especially noteworthy. Spouses not only face illness-specific burdens but also burdens resulting from their partnership and family roles. From a biographical point of view, schizophrenia is often evaluated by the spouse as a decisive point in life that seriously affects the couple's relationship, the family, and the spouse's own life. The chronic burdens of everyday living can profoundly reduce the quality of life and the subject's satisfaction with the partnership. Though partnerships with schizophrenia patients are at risk of breakdown and separation in many respects, they are often maintained for years. Despite the illness-related burdens, many spouses take positive stock of living together. Stable partnerships seem to be achievable when the partner's impairment is perceived as moderate or moderately severe, and when the frequency at which psychotic episodes occur is assessed as still being tolerable. Spouses who suffer from mental illness or impairment themselves often experience the partnership as an appropriate and satisfactory way of life. In these cases, the mutual understanding rooted in the subject's own experiences with the illness is important.

Subjective burden over 12 months in parents of patients with schizophrenia.

This is a follow-up study aimed at investigating subjective burden in parents of patients with schizophrenia during a 12-month period. Using a narrative interview technique, parents were questioned regarding the subject of illness-related burden; follow-up interviews were conducted after 6 and 12 months, respectively. Forty-seven interview sets were examined with the aim of determining different types of burden development. The analysis yielded the following six developmental types: (1). constantly high level of burden; (2). increased burden; (3). reduced burden; (4). shifting burden; (5). preeminence of other burdens; and (6). constantly low level of burden. In general, changes in the parents' burden level are closely interconnected with the illness curve of the patients, with 40% of the study participants experiencing a constantly high level of burden during the course of the study. The results suggest that parents of continuously and severely affected patients are overloaded with their long-term caring tasks. Particularly for these extremely strained parents, practical and psychologic assistance should be provided.

[Caregivers' views of the treating psychiatrists: coping resource or additional burden?]. / Der behandelnde Arzt aus Sicht der Angehörigen: Bewältigungsressource oder zusätzliche Belastung?

OBJECTIVE: This study aimed at investigating how caregivers of schizophrenic patients perceive the contact with mental health professionals and which are the key factors for their satisfaction or dissatisfaction. METHOD: 42 in-depth interviews were analysed with a view to discover the caregivers' experiences with psychiatric treatment. RESULTS: The analysis of the interview data showed three fundamental areas in which caregivers perceive the contact with psychiatrists as supportive or troublesome: 1. the information about the disease and the treatment, 2. the long-term cooperation with the caregivers, and 3. the general way of behaving towards the caregivers and the patients. Caregivers' attitudes towards psychiatry are strongly influenced by positive and negative experiences they have had in these three fields. DISCUSSION: The widespread criticism of caregivers is caused by dissatisfaction with central areas of psychiatric practice. Optimal treatment and consulting conditions, from the caregivers' perspective, can only be approximately achieved. However, psychiatrists, patients, and caregivers should stay in close contact in order to meet the needs of the caregivers, such as being informed, being taken seriously and being involved in the treatment.

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.