Reinares M, Vieta E, Colom F, Martínez-Arán A, Torrent C, Comes M, Goikolea J M, Benabarre A, Daban C, Sánchez-Moreno J
Bipolar Disorders Program, Institute of Clinical Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, Villarroel 170, 08036 Barcelona, Spain.
J Affect Disord. 2006 Aug;94(1-3):157-63. doi: 10.1016/j.jad.2006.04.022. Epub 2006 Jun 5.
Identifying and modifying burdensome aspects might reduce the level of burden and their negative effects both on caregivers and patients' outcome. Most studies evaluate acutely ill patients, whereas the most relevant problems may be related to subthreshold symptoms and long-term outcome. The aims of the present study were to assess caregiver's subjective burden, to analyse which were the most burdensome aspects for caregivers and to study which variables could explain the caregiver's subjective burden.
Caregivers of 86 euthymic bipolar patients completed the subjective burden subscale from an adapted version of the Social Behaviour Assessment Schedule.
Caregivers showed a moderate level of subjective burden. The highest levels of distress were reported regarding the patient's behaviour; the most distressing behaviours were hyperactivity, irritability, sadness and withdrawal. Regarding the patient's role performance, the most worrying aspects were those associated with the patient's work or study and social relationships. Regarding adverse effects on others, caregivers were especially distressed by the way the illness had affected their emotional health and their life in general. Poorer social and occupational functioning, an episode in the last 2 years, history of rapid cycling and the caregiver being responsible for medication intake explained a quarter of the variance of the caregiver's subjective burden.
This was a cross-sectional study focused only on primary caregivers, there was no control group of non-bipolar patients.
This study provides relevant data concerning the burden of caregivers of stable bipolar patients, pointing at potential targets for psychosocial interventions.
识别并改善造成负担的方面可能会减轻负担程度及其对照顾者和患者预后的负面影响。大多数研究评估的是急性病患者，而最相关的问题可能与阈下症状和长期预后有关。本研究的目的是评估照顾者的主观负担，分析对照顾者来说最具负担的方面，并研究哪些变量可以解释照顾者的主观负担。
86名病情平稳的双相情感障碍患者的照顾者完成了一份改编自社会行为评估量表的主观负担分量表。
照顾者表现出中度主观负担水平。关于患者行为的痛苦程度最高；最令人苦恼的行为是多动、易怒、悲伤和退缩。关于患者的角色表现，最令人担忧的方面是与患者工作或学习以及社会关系相关的方面。关于对他人的不利影响，照顾者尤其因疾病对他们的情绪健康和总体生活的影响而苦恼。较差的社会和职业功能、过去2年内有发作、快速循环病史以及照顾者负责药物服用解释了照顾者主观负担差异的四分之一。
这是一项仅关注主要照顾者的横断面研究，没有非双相情感障碍患者的对照组。
本研究提供了有关病情稳定的双相情感障碍患者照顾者负担的相关数据，指出了心理社会干预的潜在目标。
