University Lyon 1, Villeurbanne, France.
Service Universitaire d'Addictologie de Lyon, Le Vinatier Hospital, Bron, France.
Eur Arch Psychiatry Clin Neurosci. 2023 Jun;273(4):887-900. doi: 10.1007/s00406-022-01451-3. Epub 2022 Jun 30.
Caring for a relative with a severe mental disorder puts family caregivers to a great risk of depression. While overall caregiving burden is a strong predictor of depression, the contribution of the various dimensions of burden to caregivers' depression as well as their relationships with depressive symptoms has received little attention. 384 family caregivers completed a cross-sectional online survey including the Center for Epidemiological Studies Depression (CES-D) scale, the Zarit Burden Interview (ZBI), and the Brief Experience of Caregiving Inventory (BECI), measuring caregiving burden and experience. We estimated the structure of the relationships between caregiving experiences (i.e., ZBI and BECI subscales) and CES-D symptoms using a network approach. Negative Emotion/Consequences, (lack of) Positive Personal Experience, and Stigma/Effects on Family were the most connected caregiving dimensions to depression. To untangle the role of the Negative Emotion/Consequences component (by far the most central node in estimated networks), a secondary analysis incorporating its composing items was estimated. Losing control over life, feeling strained around the relative and impaired self-perceived health emerged as central nodes. Interestingly, these caregiving-related dimensions or experiences were differentially connected to depressive symptoms. We discuss how these findings might help future research and inform tailored psychoeducational interventions for family caregivers of people with a severe mental disorder.
照顾患有严重精神障碍的亲属会使家庭照顾者面临极大的抑郁风险。虽然总体照顾负担是抑郁的一个强有力的预测因素,但照顾负担的各个维度对照顾者抑郁的贡献以及它们与抑郁症状的关系却很少受到关注。384 名家庭照顾者完成了一项横断面在线调查,包括流行病学研究抑郁量表(CES-D)、Zarit 负担访谈(ZBI)和简要照顾体验量表(BECI),用于测量照顾负担和体验。我们使用网络方法估计了照顾体验(即 ZBI 和 BECI 分量表)与 CES-D 症状之间关系的结构。负面情绪/后果、(缺乏)积极的个人体验和耻辱感/对家庭的影响是与抑郁最相关的照顾维度。为了理清负面情绪/后果成分的作用(迄今为止是估计网络中最中心的节点),我们进行了一项纳入其组成项目的二次分析。对生活失去控制、对亲属感到紧张以及自我感知健康受损成为中心节点。有趣的是,这些与照顾相关的维度或体验与抑郁症状的关联程度不同。我们讨论了这些发现如何帮助未来的研究,并为严重精神障碍患者的家庭照顾者提供有针对性的心理教育干预。