A Comparison Study on the Psychological Stresses of Families of Patients with Either Depression or Schizophrenia

우울증 환자 가족들의 심리적 스트레스에 관한 연구 : 정신분열병 환자 가족과 비교

  • Kim, Jin-Hee (Department of Psychiatry, Keimyung University School of Medicine) ;
  • Lee, Eun-Jeong (Department of Psychiatry, Keimyung University School of Medicine) ;
  • Jung, Sung-Won (Department of Psychiatry, Keimyung University School of Medicine) ;
  • Sung, Hyung-Mo (Department of Psychiatry, Pochon Cha University) ;
  • SaKong, Jeong-Kyu (Department of Psychiatry, Gyeongju Hospital, College of Medicine, Dongguk University) ;
  • Kim, Jung-Bum (Department of Psychiatry, Keimyung University School of Medicine)
  • 김진희 (계명대학교 의과대학 정신과학교실) ;
  • 이은정 (계명대학교 의과대학 정신과학교실) ;
  • 정성원 (계명대학교 의과대학 정신과학교실) ;
  • 성형모 (포천중문의과대학 구미병원 정신과학교실) ;
  • 사공정규 (동국대학교 의과대학 경주병원 정신과학교실) ;
  • 김정범 (계명대학교 의과대학 정신과학교실)
  • Received : 2009.12.22
  • Accepted : 2010.04.11
  • Published : 2010.04.30

Abstract

Objective : This study compared the psychological stresses of depressed patients' families with those of schizophrenic patients' families. We investigated the influence of depressive patients' clinical features and their families' demographic characteristics on the families' depressive symptoms and stresses. Methods : Participants were 23 family members of depressed patients and 20 family members of schizophrenic patients. We measured the patients' clinical features (duration of illness, number of previous hospitalizations, and satisfaction with medication), and each family member's socioeconomic status and psychological characteristics (depressive mood, anxiety, family stress, and stress response), analyzing the data via independent t-test, chi-square test, and correlation and hierarchical multiple regression analyses. Results : The depressed patients' average clinical global impression (CGI) was significantly higher than that of the schizophrenic patients. The depressed patients' family members showed stress responses significantly higher than those of schizophrenic patients' family members. Furthermore, in depressed patients, frequency of hospitalization was positively correlated with family members' stat anxiety. For both patient types, family stress was positively correlated with the patient's severity of illness and the family's state anxiety, trait anxiety, and stress response ; socioeconomic status was positively correlated with the family's depressive symptoms ; the family's state anxiety positively correlated with the family's trait anxiety and stress response ; and the family's trait anxiety positively correlated with the family's stress response. Socioeconomic status predicted the family's depressive symptoms, and socioeconomic, illness severity and stress response predicted family stress. Conclusion : These findings suggest that both depressed patients' families and schizophrenic patients' families suffer from psychological stress. The study data also have important clinical implications, in that families of depressed patients need psychiatric intervention, as well as the patients themselves. In particular, family intervention should focus on psycho-education and stress coping strategies.

Keywords

References

  1. Ha YS, Kim SJ, Kim KS, Pack HS. The effect of community-based mental health program on burdon of family cares of mentally ill patients. J korean Acad Psychiatr Ment Health Nurs 1998;6:170-178.
  2. Liakos A, Papocostas I, Stephanis CA. A repertory grid investigation of the concept of illness by parents of schizophrenic patients. Br J Med Hypn 1975;126:63-68.
  3. Rose LE. Families of psychiatric patients: a critical review and future research directions. Arch Psychiatr Nurs 1996;10:67-76. https://doi.org/10.1016/S0883-9417(96)80069-0
  4. Lauren MW, Gabor IK, Christine ER, David AS. Family functioning and mood disorders: a comparison between patients with major depressive disorder and bipolar I disorder. J Consult Clin Psychol 2006;74:1192-1202. https://doi.org/10.1037/0022-006X.74.6.1192
  5. Wijngaarden B, Schene AH, Koeter MWJ. Family caregiving in depression: impact on caregivers' daily life, distress and helf seeking. J Affect disord 2004;81:211-222. https://doi.org/10.1016/S0165-0327(03)00168-X
  6. Bob VW, Maarten K, Martin K, Michele T, Graham T, Aart S, et al. Caring for people with depression or with schizophrenia: are the consequences different. Psychiatry Res 2009;169:62-69. https://doi.org/10.1016/j.psychres.2008.06.013
  7. Chakrabarti S, Kulhara P, Verma SK. Extent and determinants of burden among families of patients with affective disorders. Acta Psychiatrica Scandinavica 1992;86:247-252. https://doi.org/10.1111/j.1600-0447.1992.tb03261.x
  8. Kim JY, Jung SH, Shu TS, Bhang SY, Lee HK, Chung IW. Implication of the global burden of disease caused by psychiatric disorders in the viewpoint of mental health professionals. J Korean Neuropsychiatr Assoc 2008;47:94-101.
  9. Fadden G, Bebbington P, Kuipers L. The impact of functional psychiatric illness on the patient's family. Br J Med Hypn 1987;150:285-292.
  10. Fadden G, Bebbington P, Kuipers L. Caring and its burdens: a study of the spouse of depressed patients. Br J Med Hypn 1987;151:660-667.
  11. Keitner GI, Ryan CE, Miller IW, Kohn R, Bishop DS, Epstein NB. Role of the family in recovery and major depression. Acad Psychiatry 1995;152:1002-1008.
  12. Swindle RW, Cronkite RC, Moos RH. Life stressors, social resources, coping, and the 4-year course of unipolar depression. J Abnorm Psychol 1989;98:468-477. https://doi.org/10.1037/0021-843X.98.4.468
  13. Alison MH, Christine ER, Heather M. Psychoeducation for caregivers of patients with chronic mood disorders. Bull Menninger Clin 2005;69:331-340. https://doi.org/10.1521/bumc.2005.69.4.331
  14. Lynn MM, Gregory AH, Jennifer QM, Charles FR, Ariel GG, Benoit HM, et al. The Mood Disorder Burden Index: a scale for assessing the burden of caregivers to adults with unipolar or bipolar disorder. Psychiatry Res 2009;168:67-77. https://doi.org/10.1016/j.psychres.2008.04.010
  15. Jose GM, Alejandra CU, David JK. Burden of care and general health in families of patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2005;40:899-904. https://doi.org/10.1007/s00127-005-0963-5
  16. Choi HK. The subjective burden of family caregivers with schizophrenics and its predictors. Korean J of Soc Welfare 2001;45:374-399.
  17. Guy W. Early clinical drug evaluation. Rockville: US department of health and human services publication;1976.
  18. Zung A. Self-rating depression scale. Arch Gen Psychiatry 1965;16: 543-547.
  19. Lee YH, Song JY. A study of the reliability and the validity of the BDI, SDS, and MMPI-D scales. Korean J of Clin Psychol 1991;15: 98-113.
  20. Kim MK. Study on the stress of mental patients' families and their coping methods: Centered on outpatients and inpatients' families. gwangju: Honam University;2000.
  21. Sun DS. A study on the family stress and social support of mentally disabled. Bull Yong-In Psychiatr Inst 1998;5:158-175.
  22. Go KB, Pack JG, Kim CH. Development of the Stress Response Inventory. J Korean Neuropsychiatr Assoc 2007;39:707-719.
  23. Spielberger, CD. Manual for the State-Trait Anxiety Inventory 1970; Palo Alto: Consulting Psychologist Press;1970.
  24. Kim JT. The relationship between trait anxiety and social tendency: On Spielberger's state-trait anxiety inventory. Seoul: Korea University; 1978.
  25. Sim MY, Yim SJ, Kim JH, Kwon OH, Cho SJ, Kim SJ, et al. Depressive symptoms and associated factors in caregivers of patients with chronic mental illness. J Korean Neuropsychiatr Assoc 2008; 47:341-346.
  26. Yun YH. Stress response of the psychiatric patients in community. seoul: Ewha Womens University;1999.
  27. Yang DS, Kook SH, Lee HY. The relations among sociodemographic, clinical and psychological characteristics, and quality of life in patients with psychotic disorders and their caregivers. J Korean Neuropsychiatr Assoc 2001;40:1044-1054.
  28. Heru AM, Ryan CE. Burden, reward and family functioning of caregivers for relatives with mood disorders: one-year follow-up. J Affect disord 2004;83:221-225. https://doi.org/10.1016/j.jad.2004.04.013
  29. Baker AF. How families cope. J Psychosoc Nurs Ment Health Serv 1989;27:31-36.