Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Soc Psychiatry Psychiatr Epidemiol. 2020 Dec;55(12):1571-1580. doi: 10.1007/s00127-020-01864-2. Epub 2020 Mar 21.
Household poverty associated with schizophrenia has been long described. However, the mechanisms by which schizophrenia may have influenced the economic status of a household in rural communities are still unclear. This study aimed to test an integrated model of schizophrenia, social support and caregiving burden on household poverty in a rural community in China.
A mental health survey using identical methods and ICD-10 was conducted in six townships of Xinjin County (population ≥ 15 years old, n = 152,776), Chengdu, China in 2015. Identified persons with schizophrenia (n = 661) and their caregivers completed a joint questionnaire of sociodemographic information, illness conditions, social support and caregiving burden. Descriptive analysis was applied first to give an overview of the dataset. Then, multivariable regression analyses were conducted to examine the associative factors of social support, caregiving burden and household income. Then, structural equation modeling (SEM) was used to estimate the integrated model of schizophrenia, social support, caregiving burden and household income.
Households with patient being female, married, able to work and having better social function were better off. Larger household size, higher social support and lower caregiving burden also had salient association with higher household income. The relationship between schizophrenia and household poverty appeared to be mediated by the impacts of schizophrenia on social support and caregiving burden.
There was a strong association between schizophrenia and household poverty, in which social support and caregiving burden may had played significant roles on mediating it. More precise poverty alleviation policies and interventions should focus on supporting recovery for persons with schizophrenia, as well as on increasing social support and on reducing family caregiving burden.
家庭贫困与精神分裂症有关，这一现象长期以来一直存在。然而，精神分裂症如何影响农村家庭的经济状况的机制仍不清楚。本研究旨在检验中国农村社区中精神分裂症、社会支持和照顾负担对家庭贫困的综合模型。
2015 年，在中国成都市新津县的六个乡镇（≥15 岁的人口，n=152776）使用相同的方法和 ICD-10 进行了一项心理健康调查。确定患有精神分裂症的人（n=661）及其照顾者完成了一份关于社会人口统计学信息、疾病状况、社会支持和照顾负担的联合问卷。首先进行描述性分析，以概述数据集。然后，进行多变量回归分析，以检验社会支持、照顾负担和家庭收入的关联因素。然后，结构方程模型（SEM）用于估计精神分裂症、社会支持、照顾负担和家庭收入的综合模型。
患者为女性、已婚、能够工作和具有更好的社会功能的家庭状况较好。家庭规模较大、社会支持较高、照顾负担较低与家庭收入较高也有显著关联。精神分裂症与家庭贫困之间的关系似乎受到精神分裂症对社会支持和照顾负担的影响的调节。
精神分裂症与家庭贫困之间存在很强的关联，其中社会支持和照顾负担可能在其中起到了重要的中介作用。更精确的扶贫政策和干预措施应侧重于支持精神分裂症患者的康复，以及增加社会支持和减轻家庭照顾负担。
