Patient's determinants of subjective and objective burden in caregivers of people with first episode psychosis

Background

Understanding if there are differential determinants of objective and subjective burdening in caregivers of first episode psychosis (FEP) patients would be essential to optimize current early support programs. Our aim was to elucidate the clinical and sociodemographic characteristics of FEP patients that influence the objective and subjective burdening of their informal caregivers.

Materials and methods

75 participants with FEP were assessed in social functioning and psychotic symptoms. Their caregivers were assessed with an instrument of objective and subjective family burden. Objective burdening was assessed in terms of time spent. Subjective burden was assessed in terms of worry experienced.

Results

Regression analyses showed that impaired social functioning of the patient was the major determinant of family burdening, in assisting in daily activities and containing disrupted behavior. Excitative symptoms were more determinant than positive symptoms in explaining burdening when containing disrupted behavior. A younger age of the patient specifically determined higher subjective but not objective burdening. Economic incomes had little contribution to family burdening.

Conclusions

Our results suggest that there may not be differential determinants of objective and subjective burdening on domains of family burdening in FEP. Current multicomponent early interventions may consider social functioning and excitative symptoms the factors that may focus on to reduce both objective and subjective family burdening. Caregivers of youngest patients may need additional psychological support as they care of patients with higher dependency level and involving more subjective burdening.