Wang Dan, Li Yilu, Qiu Dan, Wu Qiuyan, Tang Zixuan, Zhang Chengcheng, Ni Anyan, Xiao Shuiyuan
Center for Behavioral Health & School of Government, Beijing Normal University, Beijing, People's Republic of China.
Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
Schizophrenia (Heidelb). 2025 May 23;11(1):79. doi: 10.1038/s41537-025-00623-z.
This study aimed to assess the household income, consumption, catastrophic health expenditure, and financial distress of people living with schizophrenia (PLS) households and examine the association between economic well-being and family caregiving experiences. A multi-site, cross-sectional survey was conducted in four cities across China with measures of household economic status and caregiving experiences. Linear regression analyses were used to determine the association between economic well-being and family caregiving experiences. A total of 493 PLS households were included in the analysis. In China, PLS Household income has been extremely low, as well as household consumption. Half of the PLS households has per capita incomes below half the national average in China. Overall, 23.3% of PLS household report catastrophic health expenditure and 58.6% of households perceived the financial situation is poor/very poor. In facing with financial difficulty, 38.7% of PLS household adopt at least one of cost-minimization and cost-management coping strategies. Household income was positively associated with caregiver rewarding feeling and negatively associated with caregiving burden. Household with catastrophic health expenditure, using financial coping strategies and subjective poor financial situation reported higher level of caregiving burden and affiliate stigma. The support for PLS families need to break through the traditional "medical-centered" intervention model, with economic empowerment as the core, integrating financial security, employment support, psychological services, and social welfare networks, and building a three-level system of "prevention alleviation development". This can not only improve patient prognosis but also break the vicious cycle of "mental illness poverty" and help families achieve long-term well-being.
本研究旨在评估精神分裂症患者（PLS）家庭的家庭收入、消费、灾难性医疗支出和经济困境，并考察经济状况与家庭照料经历之间的关联。在中国四个城市开展了一项多地点横断面调查，对家庭经济状况和照料经历进行了测量。采用线性回归分析来确定经济状况与家庭照料经历之间的关联。共有493个PLS家庭纳入分析。在中国，PLS家庭收入极低，家庭消费也很低。一半的PLS家庭人均收入低于中国全国平均水平的一半。总体而言，23.3%的PLS家庭报告有灾难性医疗支出，58.6%的家庭认为财务状况差/非常差。在面临经济困难时，38.7%的PLS家庭至少采取了一种成本最小化和成本管理应对策略。家庭收入与照料者的奖励感呈正相关，与照料负担呈负相关。有灾难性医疗支出、使用财务应对策略和主观财务状况差的家庭报告的照料负担和相关耻辱感水平更高。对PLS家庭的支持需要突破传统的“以医疗为中心”的干预模式，以经济赋权为核心，整合金融安全、就业支持、心理服务和社会福利网络，构建“预防-缓解-发展”三级体系。这不仅可以改善患者预后，还可以打破“精神疾病-贫困”的恶性循环，帮助家庭实现长期福祉。
