A Comparative Study on the Burden of Disease of Schizophrenia, Bipolar Disorder Type I, and Autism Spectrum Disorder on the Family Caregivers in Iran

Abstract

Objective: Patients with severe psychiatric diseases, due to the debilitating and chronic nature of these diseases, requires prolonged care by family and other rated people. In addition to the patient, these diseases affect the caregiver and create high psychological, social, and individual pressure to take care of themselves. This study aims to compare the burden of schizophrenia, Bipolar Disorder (BD) type 1, and Autism Spectrum Disorder (ASD) on the family caregivers in Iran. Materials & Methods: In this descriptive-analytical study, using the non-probability sampling method, 450 family caregivers of patients with schizophrenia, BD type 1, and ASD were selected based on the inclusion criteria. Data collection tools comprised a demographic checklist, short-form Zarit Burden Interview (ZBI-12), and the Depression, Anxiety, and Stress Scale (DASS). The questionnaires were distributed to the patients selected from the Psychiatric Institute of Tehran, Iran Psychiatric Hospital, and Ali Asghar Hospital. The collected data were analyzed using descriptive statistics, ANOVA for evaluating the relationship of demographic factors with the amount and severity of disease burden, and interclass correlation coefficient in SPSS v. 22. Results: The disease burden was higher on caregivers of ASD patients, followed by that of BD type 1 and schizophrenia patients. The highest and lowest hours of care were related to the ASD and schizophrenia groups, respectively. Women made up the majority of family caregivers. The educational level of family caregivers was higher in the BD type 1 group and was lower in the schizophrenia group. Most caregivers in the BD type 1 group were employed, while most of them in the schizophrenia group were housewives. The lowest and highest income levels were related to the family caregivers of ASD and schizophrenia groups, respectively. The highest and lowest hospitalization frequencies were seen in the BD type 1 and ASD groups, respectively. Conclusion: The burden of three diseases on the family caregivers is high. It is recommended that state-run consulting and screening centers be more active in this field. Because of the low-income level of some family caregivers, it is better to plan for more employment of family caregivers with the assistance of governmental and non-governmental organizations. It is better to hold strategic classes for the family caregivers to reduce their disease burden. Different methods to reduce the burden of diseases in caregivers, such as lowering care hours and using respite care and respite recess and dividing tasks between caregivers, using social or daycare services, can reduce their symptoms of depression and anxiety. Their depression and anxiety should be monitored, and pharmacological and non-pharmacological measures should be used for their treatment.