Psychiatric Morbidity, Social Support, and Coping in Wives of Alcohol and Opioid Dependent Men

A prospective observational study of change in caregiver burden and psychological distress in caregivers of patients with alcohol dependence

Background

Alcohol use disorder has a substantial impact on patients' caregivers, leading to burden and adverse effects on their psychological health. Currently, there is limited literature which is available to suggest whether the burden and psychological distress of the family members change when patients with alcohol dependence undergo treatment. This study aimed to longitudinally examine the change in burden, depression, anxiety, and stress experienced by caregivers of patients with alcohol dependence undergoing treatment.

Subjects and Methods

This prospective observational study recruited treatment-seeking men with alcohol dependence and their caregivers as dyads. The burden, depression, anxiety, and stress of caregivers were assessed at baseline and at six weeks, using the Family Burden Interview Schedule and Depression Anxiety Stress Scale, respectively. Pre and post values were compared using paired t-test. Interaction effects of resumption of drinking were assessed using repeated measures test.

Results

Of the 101 dyads recruited in the study, 60 could be followed up at six weeks. Significant decrements were seen in burden, depression, anxiety, and stress of caregivers at six weeks compared to baseline (mean 62.3%, 54.2%, 65.9%, and 53.4%, respectively, all P < 0.001). The decrement in burden and depression was lower in those caregivers where the patients had resumed alcohol use within the span of six weeks.

Conclusions

Findings suggest that engagement in treatment by patients with alcohol dependence may reduce the burden and psychological distress among their caregivers, more so in situations where the patients had quit alcohol. However, the change in burden and psychological distress could be due to several other factors as well.

Sexual relationship, self-esteem, dysfunction, and sexual satisfaction in treatment naïve men with heroin dependence

Heroin use, a prevalent and disabling condition, affects sexual functioning and the sexual quality of life. While there is adequate literature on sexual dysfunction with heroin use, the literature is scarce on the emotional aspects of sex, like the perception of sexual relationship, self-esteem, and satisfaction amongst heroin users. The study assessed these parameters among treatment-naïve, sexually active, married, male patients with heroin dependence. We interviewed 63 treatment-naïve men seeking treatment for heroin dependence using Self-esteem and Relationship Questionnaire (SEAR), New Sexual Satisfaction Scale-Short form (NSSS-S), Sexual Quality of Life Questionnaire-Male (SQoL-M), Index of Premature Ejaculation (IPE), and International Index of Erectile Function (IIEF). Overall scores in SEAR, NSSS-S, SQoL-M, IIEF, and IPE were low, suggesting poor self-esteem and relationship, poor sexual quality of life and sexual satisfaction, higher premature ejaculation, and erectile dysfunction. Injecting drug use was associated with lower scores on confidence domain of SEAR, partner activity focused domain of NSSS-S, intercourse-satisfaction, and overall sexual quality of life. Sexual dysfunctions, poor sexual relationship, and sexual quality of life are common among men seeking treatment for heroin dependence. Treatment strategies must not lose focus on this dimension of health during the treatment process.

Social networks of patients with chronic depression: A systematic review

INTRODUCTION AND AIM

The social networks of patients are an important factor for the prognosis of mental disorders and can be potentially targeted through psycho-social interventions. We aimed to explore these networks in patients with chronic depression, by conducting a systematic review on the characteristics of social networks in this patient group.

METHODS

Six databases, three key journals and grey literature were searched. Two reviewers screened the articles, assessed the risk of bias and extracted the information needed. Findings were descriptively synthesised.

RESULTS

Nineteen articles met the inclusion criteria reporting the findings of a total of 873 patients with chronic depression. Four papers presented results without a comparison group (six in comparison to a healthy population, eight to patients with non-chronic major depression and three to patients with other mental disorders). Social networks of patients with chronic depression appeared to be smaller than those of healthy individuals, patients with non-chronic major depression and other disorders.

LIMITATIONS

Studies used different concepts of chronic depression and inconsistent methodologies for assessing social networks. Only three studies adopted objective measures.

CONCLUSIONS

Whilst the evidence on social networks of patients with chronic depression is limited, the networks appear smaller than in most comparison groups, including patients with non-chronic depression.