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Rafiyah I, Suryani S, Rahayuwati L, Suttharangsee W. Culturally Adapted Psychoeducation among Family Caregivers of Schizophrenic Clients: A Scoping Review. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: As psychoeducation was originally developed from Western, this intervention should be integrated with a culture to obtain effective outcomes. However, how culturally adapted psychoeducation on family caregivers of schizophrenic client developed in previous studies has not been systematically documented. The purpose of this review was to map culturally adapted psychoeducation in previous studies.
Methods: This scoping review followed Arksey & O'Malley approach. Inclusion criteria including family caregiver, culture, psychoeducation, schizophrenia. Non-primary and non-experiment studies, non-English language and non-free articles were excluded. Advanced search technique used keywords family caregiver, culture, psychoeducation, schizophrenia on CINAHL, PubMed, and PsycInfo databases. Screening was done by checking duplication, title, and abstract. Full text of relevant articles was read in detail to select eligible articles. Selection results were described in the PRISMA flow chart. Data were analyzed after these were extracted and resumed on the table.
Result: A total of 8 studies were included in this review. More than half of articles used randomized control trial (RCT) but these studies did not conduct follow up. Most of studies were in Asia (6) and it conducted in the outpatient department (6). Almost all studies modified multifamily group psychoeducation with culture theories. The longest duration of intervention was 12 months. Multidiscipline health professional delivered the intervention and most of the were psychiatrist. Coping was the most family caregiver outcomes in reviewed studies.
Conclusion: In conclusion, limited studies were obtained in various ethnics and ways. Further studies need to measure effectiveness of the intervention in long term effect.
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Hinojosa-Marqués L, Domínguez-Martínez T, Barrantes-Vidal N. Family environmental factors in at-risk mental states for psychosis. Clin Psychol Psychother 2021; 29:424-454. [PMID: 34260123 DOI: 10.1002/cpp.2651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 11/07/2022]
Abstract
The family environment represents an important psychosocial factor that impacts psychosis prognosis, but little is known about its effect on the at-risk stages of psychosis. This study presents a comprehensive review and summarizes the state of the art of study on the wide range of family factors related to family functioning in the At-Risk Mental State (ARMS) for psychosis, as well as family interventions in ARMS individuals. Publications were retrieved by an extensive search on MEDLINE, PsycINFO and SCOPUS (1990-2020). Expressed Emotion is the most studied variable in ARMS literature, but there is scarce evidence of the role of other significant family factors at the ARMS stage. Overall, high Expressed Emotion did not appear to be reactive to ARMS patients' poor clinical status. However, initial evidence has suggested that relatives' beliefs about the disorder may play a significant role, either as mediators of these relationships or as predictors of Expressed Emotion. Available literature yet to yield a consistent pattern of findings on the association between Expressed Emotion or other family functioning indicators and negative outcomes, but some longitudinal studies highlight the greater potential for the protective effects of positive family environments at the ARMS stage. Family-based interventions have demonstrated benefits for both ARMS individuals and family dynamics. An increased focus on the impact of the at-risk stage of illness on relatives' mental well-being is required to provide family support based on their needs and to clarify the mechanisms leading to dysfunctional family dynamics during the critical ARMS period.
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Affiliation(s)
- Lídia Hinojosa-Marqués
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tecelli Domínguez-Martínez
- Global Mental Health Research Center, Directorate of Epidemiological and Psychosocial Research, 'Ramón de la Fuente Muñiz' National Institute of Psychiatry, Ministry of Health, Mexico City, Mexico
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.,Departament de Salut Mental, Sant Pere Claver - Fundació Sanitària, Barcelona, Spain.,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Onwumere J, Wilson S, Billings J, Brown L, Floyd C, Widuch K, Lyons N, Man LC, James G, Afsharzadegan R, Khan S, Padayatchi M, Souray J, Raune D. First episode psychosis: A comparison of caregiving appraisals in parents caring for the same child. Early Interv Psychiatry 2021; 15:525-535. [PMID: 32524757 DOI: 10.1111/eip.12975] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 03/18/2020] [Accepted: 04/28/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND The first onset of psychosis can be a traumatic event for diagnosed individuals but can also impact negatively on their families. Little is known about how parents of the same child make sense of the illness. In mothers and fathers caring for the same child with early psychosis, the current study assessed their similarities and differences in key areas of their caregiving role. METHODS Using a cross-sectional design, parental pairs caring for the same child treated within an early intervention in psychosis service, completed self-report measures on their caregiving experiences, illness beliefs, coping styles and affect. RESULTS Data from 44 mothers and fathers were analysed. Analyses confirmed that parents reported similar levels of emotional dysfunction and conceptualized the illness in broadly similar ways with regard to what they understood the illness to be, their emotional reactions to the illness, perceived illness consequences and beliefs about treatment. Significant differences were identified in their beliefs about the timeline of the illness and reported approaches to coping. CONCLUSIONS With exception of beliefs about illness timeline and an expressed preference for use of emotion-based coping, parent caregivers of the same child in early psychosis services are likely to report similar illness beliefs and caregiving reactions. Efforts to ensure staff awareness of the potential areas of divergence in parental caregiving appraisals and exploring the implications of the divergence for the caregiving relationship and patient outcomes are indicated.
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Affiliation(s)
- Juliana Onwumere
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,The National Psychosis Unit & PiCuP Services, South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Sophie Wilson
- Harrow & Hillingdon Early Intervention in Psychosis Service, The Pembroke Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Jo Billings
- Department of Clinical, Educational and Health Psychology, University College, London, UK
| | - Lucy Brown
- Harrow & Hillingdon Early Intervention in Psychosis Service, The Pembroke Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Caroline Floyd
- Harrow & Hillingdon Early Intervention in Psychosis Service, The Pembroke Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Kaja Widuch
- Harrow & Hillingdon Early Intervention in Psychosis Service, The Pembroke Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Natasha Lyons
- Harrow & Hillingdon Early Intervention in Psychosis Service, The Pembroke Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Lai Chu Man
- Harrow & Hillingdon Early Intervention in Psychosis Service, The Pembroke Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Gareth James
- Harrow & Hillingdon Early Intervention in Psychosis Service, The Pembroke Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Roya Afsharzadegan
- Harrow & Hillingdon Early Intervention in Psychosis Service, The Pembroke Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Sanna Khan
- Harrow & Hillingdon Early Intervention in Psychosis Service, The Pembroke Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Mellisha Padayatchi
- Harrow & Hillingdon Early Intervention in Psychosis Service, The Pembroke Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Jonathan Souray
- Harrow & Hillingdon Early Intervention in Psychosis Service, The Pembroke Centre, Central and North West London NHS Foundation Trust, London, UK
| | - David Raune
- Harrow & Hillingdon Early Intervention in Psychosis Service, The Pembroke Centre, Central and North West London NHS Foundation Trust, London, UK
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4
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Izon E, Berry K, Wearden A, Carter L, Law H, French P. Investigating expressed emotion in individuals at‐risk of developing psychosis and their families over 12 months. Clin Psychol Psychother 2021; 28:1285-1296. [DOI: 10.1002/cpp.2576] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 12/27/2022]
Affiliation(s)
- Emma Izon
- Division of Psychology and Mental Health, Manchester Academic Health Science Centre The University of Manchester Manchester UK
- The Psychosis Research Unit Greater Manchester Mental Health NHS Foundation Trust Manchester UK
| | - Katherine Berry
- Division of Psychology and Mental Health, Manchester Academic Health Science Centre The University of Manchester Manchester UK
- Complex Trauma Research Unit Greater Manchester Mental Health NHS Foundation Trust Manchester UK
| | - Alison Wearden
- Division of Psychology and Mental Health, Manchester Academic Health Science Centre The University of Manchester Manchester UK
| | - Lesley‐Anne Carter
- Division of Psychology and Mental Health, Manchester Academic Health Science Centre The University of Manchester Manchester UK
| | - Heather Law
- Division of Psychology and Mental Health, Manchester Academic Health Science Centre The University of Manchester Manchester UK
- The Psychosis Research Unit Greater Manchester Mental Health NHS Foundation Trust Manchester UK
- Youth Mental Health Research Unit Greater Manchester Mental Health NHS Foundation Trust Manchester UK
| | - Paul French
- Department of Psychology Manchester Metropolitan University Manchester UK
- Department of Research and Innovation Pennine Care NHS Foundation Trust Lancashire UK
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Charles S, Kirkbride JB, Onwumere J, Lyons N, Man LC, Floyd C, Widuch K, Brown L, James G, Afsharzadegan R, Souray J, Raune D. Carer subjective burden after first-episode psychosis: Types and predictors. A multilevel statistical approach. Int J Soc Psychiatry 2021; 67:73-83. [PMID: 32522056 PMCID: PMC8191154 DOI: 10.1177/0020764020930041] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Carer burden at first-episode psychosis is common and adds to the multiple other psychiatric and psychological problems that beset new carers; yet, knowledge of the factors that predict carer burden is limited. AIM This study sought to investigate the types and predictors of carer burden at first-episode psychosis in the largest, most ethnically diverse and comprehensively characterised sample to date. METHOD This study involved a cross-sectional survey of carers of people with first-episode psychosis presenting to Harrow and Hillingdon Early Intervention in Psychosis service between 2011 and 2017. Carers completed self-report measures assessing their illness beliefs, coping styles and caregiving experiences (i.e. burden). Thirty carer and patient sociodemographic and clinical factors were also collected. Mixed effects linear regression modelling was conducted to account for clustering of carers by patient, with carer burden (and its 8 subtypes) investigated as dependent variables. RESULTS The sample included data on 254 carers (aged 18-74 years) and 198 patients (aged 14-36 years). Regression modelling identified 35 significant predictors of carer burden and its subtypes at first-episode psychosis. Higher total burden was independently predicted by perceiving greater negative consequences of the illness for the patient (B = .014, p < .001, 95% CI: [.010-.018]) and the carer (B = .008, p = .002, 95% CI: [.003-.013]), and engaging in avoidant-focussed coping (B = .010, p = .006, 95% CI: [.003-.016]). Lower burden was independently predicted by patients being in a relationship (B = -.075, p = .047, 95% CI: [-.149 to -.001]). Predictors of the eight burden subtypes (difficult behaviours, negative symptoms, stigma, problems with services, effects on family, dependency, loss and need to backup) are also included in the article. CONCLUSION Findings can be used to inform the identification of carers 'at-risk' of experiencing burden and highlight potential targets for theraputic intervention to lower carer buden.
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Affiliation(s)
- Shereen Charles
- Division of Psychiatry, University College London, London, UK
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | | | - Juliana Onwumere
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Beckenham, UK
| | - Natasha Lyons
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Lai Chu Man
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Caroline Floyd
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Kaja Widuch
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Lucy Brown
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Gareth James
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Roya Afsharzadegan
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - Jonathan Souray
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
| | - David Raune
- Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
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6
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Barbeito S, Sánchez-Gutiérrez T, Becerra-García JA, González Pinto A, Caletti E, Calvo A. A systematic review of online interventions for families of patients with severe mental disorders. J Affect Disord 2020; 263:147-154. [PMID: 31818771 DOI: 10.1016/j.jad.2019.11.106] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/29/2019] [Accepted: 11/21/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Several studies show the effectiveness of face-to-face interventions with families in improving the prognosis of patients with severe psychiatric disorders and their relatives; however, the effectiveness of online interventions is poorly understood. The current study aims to provide an overview of evidence for the effectiveness of online treatments (web/app) for patients with severe psychiatric disorders and their families. METHOD We performed a systematic review of online treatments for informal family caregivers of patients with a severe psychiatric disorder. The study psychological interventions had to have been administered in an exclusively online format (app, internet) and aimed at families of patients with severe mental disorder (at least one of first episode psychosis, schizophrenia, schizoaffective, bipolar disorder, and psychotic disorder). RESULTS Of a total of 1331 articles, we identified 9 viable studies; 4 randomized clinical trials, and 5 nonrandomized clinical studies. The present study is the first systematic review in this area. Online interventions were well accepted, with good adherence and satisfaction among the caregivers and patients and improved the symptoms of both caregivers and patients. LIMITATIONS Clinical and methodological diversity of the studies. CONCLUSIONS Burden improved, and perceived stress decreased in families. Moreover, the severity of positive symptoms decreased and fewer hospitalizations were recorded in patients than in the control group. Therefore, online interventions are a promising therapeutic approach for patients with severe mental disorder and their families. However, more studies-particularly randomized clinical trials-are needed in this area.
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Affiliation(s)
- Sara Barbeito
- Faculty of Health Sciences, Universidad Internacional de la Rioja (UNIR), Spain.
| | | | | | - Ana González Pinto
- University of the Basque Country, Biomedical Research Center in Mental HealthNet (CIBERSAM), Department of Neurosciences, University of the Basque Country, Vitoria, Spain.
| | - Elisabetta Caletti
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
| | - Ana Calvo
- Faculty of Health Sciences, Universidad Internacional de la Rioja (UNIR), Spain.
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Kim SW, Kim JJ, Lee BJ, Yu JC, Lee KY, Won SH, Lee SH, Kim SH, Kang SH, Kim E, Lee JY, Kim JM, Chung YC. Clinical and psychosocial factors associated with depression in patients with psychosis according to stage of illness. Early Interv Psychiatry 2020; 14:44-52. [PMID: 30919575 DOI: 10.1111/eip.12806] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 01/20/2019] [Accepted: 02/17/2019] [Indexed: 11/29/2022]
Abstract
AIM This study investigated the clinical characteristics and psychosocial factors associated with depression in patients with early psychosis according to stage of illness. METHODS The present study includes patients who fulfil the DSM-5 criteria for schizophrenia spectrum and other psychotic disorders. Patients were divided into two groups according to illness stage (the acute stage of first-episode psychosis and stabilization phase of recent-onset psychosis). Clinically meaningful depression was defined as moderate or severe on the depression dimension of the Clinician-Rated Dimensions of Psychosis Symptom Severity scale in the DSM-5. RESULTS In total, 340 (207 first-episode and 133 recent-onset) patients were recruited in this study. Patients with comorbid depression were characterized by frequent suicidal ideation, a past suicide attempt, and lower scores on the Subjective Well-being Under Neuroleptics and Brief Resilience Scale in both groups. Long duration of untreated psychosis and higher scores on the Early Trauma Inventory Self Report were associated with depression in the acute stage of first-episode psychosis. In the stabilization phase of recent-onset psychosis group, a monthly income and scores for sexual desire and on the Family Adaptability and Cohesion Evaluation Scale-III were significantly lower in patients with depression than in those without depression. CONCLUSION Comorbid depression was associated with high suicidality, lower quality of life and poor resilience in patients with first-episode and recent-onset psychosis. Depression was associated with factors that had been present before the initiation of treatment in patients with first-episode psychosis and with environmental factors in those in the stabilization phase.
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Affiliation(s)
- Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jung Jin Kim
- Department of Psychiatry, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Bong Ju Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Je-Chun Yu
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Daejeon, Korea
| | - Kyu Young Lee
- Department of Psychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea
| | - Seung-Hee Won
- Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University College of Medicine, Goyang, Korea
| | - Seung-Hyun Kim
- Department of Psychiatry, Korea University College of Medicine, Guro Hospital, Seoul, Korea
| | - Shi-Hyun Kang
- Department of Psychiatry, Seoul National Hospital, Seoul, Korea
| | - Euitae Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Young Chul Chung
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea
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Onwumere J, Parkyn G, Learmonth S, Kuipers E. The last taboo: The experience of violence in first-episode psychosis caregiving relationships. Psychol Psychother 2019; 92:1-19. [PMID: 29399952 DOI: 10.1111/papt.12173] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 10/26/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Informal caregiving relationships play an important role in facilitating recovery outcomes in psychosis. The relationship can serve as a source of positive experiences that co-exist alongside common challenges typically associated with mental health problems. People with psychosis, when compared to the general population, are more likely to perpetrate acts of violence, a relationship that is particularly evident during the first psychosis episode. Although victims of service user violence are typically people already known to them, such as informal carers, there remains a lack of understanding about their caring experiences and needs. This study sought to address gaps in the literature by exploring the subjective accounts of informal carers supporting a relative experiencing their first episode of psychosis who has also behaved violently towards them. DESIGN A cross-sectional design was employed. METHODS Individual semi-structured interviews, which were audio recorded and later transcribed for analyses, were undertaken with a convenience sample of eight carers drawn from a specialist early psychosis service. Interview questions focused on their experiences of patient violence, the subjective impact, and coping strategies. An interpretative phenomenological approach was used to analyse the data. RESULTS Participants were mostly living with their relative with psychosis and were typically female, parents, and from a black and minority ethnic background. Data analyses identified seven key themes from participant interviews including the lack of predictability over when the violence occurred, being scared and fearful, keeping quiet about what happens at home and in the caregiving relationship, and staying safe. CONCLUSIONS Reports by informal carers about experiencing violence and victimization from their relatives with psychosis are an important issue in some caregiving relationships during the first episode. Developing a more informed understanding of the specific needs of these carers and the caregiving relationship is indicated. The implications for service providers are discussed. PRACTITIONER POINTS Carers were exposed to a broad range of patient violence, which included being kicked and having weapons used against them. The violence typically occurred within carers' homes, when no other people were around. Patient violence impacted negatively on carer emotional and physical functioning, which included leaving carers living in fear of their own safety and what might become of their relative. The results highlight the importance of routinely asking first-episode carers about their experience of patient violence. The development of interventions (e.g., identification of early triggers, de-escalation) that are able to take account of the ongoing nature and complexity of the caregiving relationship but are purposefully aimed at supporting carers to remain safe in their relationship should be explored for their impact.
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Affiliation(s)
- Juliana Onwumere
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
| | - Grace Parkyn
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
| | - Stephanie Learmonth
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Elizabeth Kuipers
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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9
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Onwumere J, Amaral F, Valmaggia LR. Digital Technology for Caregivers of People With Psychosis: Systematic Review. JMIR Ment Health 2018; 5:e55. [PMID: 30185402 PMCID: PMC6231782 DOI: 10.2196/mental.9857] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/11/2018] [Accepted: 05/19/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Psychotic disorders are severe mental health conditions that adversely affect the quality of life and life expectancy. Schizophrenia, the most common and severe form of psychosis affects 21 million people globally. Informal caregivers (families) are known to play an important role in facilitating patient recovery outcomes, although their own health and well-being could be adversely affected by the illness. The application of novel digital interventions in mental health care for patient groups is rapidly expanding; interestingly, however, far less is known about their role with family caregivers. OBJECTIVE This study aimed to systematically identify the application of digital interventions that focus on informal caregivers of people with psychosis and describe their outcomes. METHODS We completed a search for relevant papers in four electronic databases (EMBASE, MEDLINE, PsycINFO, and Web of Science). The search also included the Cochrane database and manual search of reference lists of relevant papers. The search was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. RESULTS The search identified 9 studies derived from 8 unique datasets. Most studies were assessments of feasibility and were undertaken in the United States. Interventions were predominately Web-based, with a focus on improving the caregivers' knowledge and understanding about psychosis. CONCLUSIONS This study offers preliminary support for the feasibility and acceptability of digital interventions for psychosis in informal caregiver populations. However, the findings underpin a clear need for greater development in the range of caregiver-focused digital approaches on offer and robust evaluation of their outcomes. The use of digital approaches with caregiver populations seemingly lags someway behind the significant developments observed in patient groups.
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Affiliation(s)
- Juliana Onwumere
- Institute of Psychology, Psychiatry and Neuroscience, Department of Psychology, King's College, London, London, United Kingdom.,Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Filipa Amaral
- Institute of Psychology, Psychiatry and Neuroscience, Department of Psychology, King's College, London, London, United Kingdom
| | - Lucia R Valmaggia
- Institute of Psychology, Psychiatry and Neuroscience, Department of Psychology, King's College, London, London, United Kingdom
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10
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Sadath A, Muralidhar D, Varambally S, Gangadhar BN, Jose JP. Do stress and support matter for caring? The role of perceived stress and social support on expressed emotion of carers of persons with first episode psychosis. Asian J Psychiatr 2017; 25:163-168. [PMID: 28262142 DOI: 10.1016/j.ajp.2016.10.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 08/26/2016] [Accepted: 10/29/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Caring for a person with first episode psychosis (FEP) is a challenging and distressing task for the carers. The carers' stress in the early stage of psychosis can increase their expressed emotion (EE) while social support is hypothesized to decrease EE. However, the influence of stress and social support on carers' EE is not well understood in FEP. AIM To examine how the stress and social support shape expressed emotion in the carers of FEP. METHODS Seventy one carers of the patients with non-affective FEP were recruited from the inpatient psychiatry ward of a tertiary mental health care center in South India. The family questionnaire, perceived stress scale and multidimensional scale of perceived social support were used to measure their EE, stress and social support respectively. RESULTS Carers experienced high level of perceived stress, EE and poor social support. Perceived stress significantly increased EE (β=0.834; p<0.001) and social support did not significantly influence EE (β=-0.065; p>0.05). Perceived stress predicted 76 percent of the variance on EE (Adjusted R2=0.761). CONCLUSION The results emphasize high level of stress and EE in carers of patients with FEP that implies the need for appropriate psychosocial interventions to manage their stress.
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Affiliation(s)
- Anvar Sadath
- Institute of Mental Health and Neurosciences, Kozhikode, Kerala 673 008, India.
| | - D Muralidhar
- Department of Psychiatric Social Work, National Institute of Mental Health & Neuro-Sciences, Bangalore, 560 029, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health& Neuro-Sciences, Bangalore, 560 029, India
| | - B N Gangadhar
- Department of Psychiatry, National Institute of Mental Health& Neuro-Sciences, Bangalore, 560 029, India
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11
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Hamaie Y, Ohmuro N, Katsura M, Obara C, Kikuchi T, Ito F, Miyakoshi T, Matsuoka H, Matsumoto K. Correction: Criticism and Depression among the Caregivers of At-Risk Mental State and First-Episode Psychosis Patients. PLoS One 2016; 11:e0156590. [PMID: 27232502 PMCID: PMC4883782 DOI: 10.1371/journal.pone.0156590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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