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Impact of psychosis on Portuguese caregivers: a cross-cultural exploration of burden, distress, positive aspects and clinical-functional correlates

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Abstract

Purpose

Further cross-cultural comparisons are needed on caregiving consequences of chronic psychotic disorders. The EPSILON study (European Psychiatric Services: Inputs Linked to Outcome Domains and Needs) involved five European countries, but not Portugal. We aimed to analyse the impact of severe mental illness in a Portuguese sample and to provide support to comparisons with some of the EPSILON results, focusing on the north-European Dutch centre.

Methods

We studied 108 caregiver-patient dyads by a consecutive sampling of people with schizophrenia-spectrum disorders in psychiatric outpatient services. Relatives’ assessments included the Involvement Evaluation Questionnaire, European version (IEQ), the 12-item General Health Questionnaire (GHQ-12); the loss, stigma and positive aspects’ subscales of the Experience of Caregiving Inventory, and the Social Network and Family Coping Questionnaires. Patients were assessed regarding symptoms, disability and global functioning.

Results

Caregiving rewards and negative consequences co-existed. On the IEQ, 49.1 % reported negative consequences and rank order of domain scores was worrying > urging > tension > supervision. More than one-third of caregivers were psychologically distressed according to GHQ screenings. Involvement Evaluation Questionnaire scores were correlated with caregivers’ distress, stigma, loss, patient’s involvement and other ways of coping, and patients’ variables. Some of these failed to be included in a regression model.

Conclusions

Many of these Portuguese caregivers were at risk regarding burden and psychological distress. In comparison with other European samples, caregiving arrangements and assessments were typical of Mediterranean countries, as Italy or Spain. All IEQ scores were significantly higher than those in the Netherlands. On account of small numbers, caution is needed in the interpretation of associations.

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Acknowledgments

We thank all patients and caregivers for participating in our study. The Portuguese translation of the ECI was developed in 2005 by the first author. Prof. George Szmukler kindly checked the ECI back-translation by R.Rogers and provided scoring instructions. Members of the FAPS Workgroup contributing to data collection: A. L. Alves, A. Cardoso, A. Martinho, A. Ramires, C. Conceição, C. Janeiro, I. Landeiro, J. A. Silva, J. Grácio, M. Gomes, M. Pereira, N. Ventura, S. Andrade, T. Ribeiro. The FAPS study was supported by a clinical research grant from the Portuguese AstraZeneca Foundation, Fundação AstraZeneca Portugal (2005).

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Authors and Affiliations

  1. CEDOC, Departamento de Saúde Mental, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisbon, Portugal

    Manuel Gonçalves-Pereira, Miguel Xavier & José Miguel Caldas-de-Almeida

  2. Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands

    Bob van Wijngaarden

  3. Department of Biostatistics and Informatics, Faculdade de Ciências Médicas, Universidade Nova de Lisboa and CEAUL, Lisbon, Portugal

    Ana L. Papoila

  4. Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Aart H. Schene

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  1. Manuel Gonçalves-Pereira
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  2. Miguel Xavier
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  4. Ana L. Papoila
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  6. José Miguel Caldas-de-Almeida
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Corresponding author

Correspondence to Manuel Gonçalves-Pereira.

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Gonçalves-Pereira, M., Xavier, M., van Wijngaarden, B. et al. Impact of psychosis on Portuguese caregivers: a cross-cultural exploration of burden, distress, positive aspects and clinical-functional correlates. Soc Psychiatry Psychiatr Epidemiol 48, 325–335 (2013). https://doi.org/10.1007/s00127-012-0516-7

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  • DOI: https://doi.org/10.1007/s00127-012-0516-7

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