A comparison of the level of functioning in chronic schizophrenia with coping and burden in caregivers

Abstract

Background: A chronic mental illness such as schizophrenia is a challenging task for caregivers especially in the current era of de-institutionalization. In India, few studies have attempted to directly determine the relationship between coping mechanisms and burden; in the West, studies have found that improved coping in family members can decrease the perceived burden.

Aim: To evaluate the burden and coping of caregivers in relation to the level of functioning in patients with chronic schizophrenia.

Methods: The sample was 100 patients with their primary caregivers attending a Psychiatry OPD. Patients were assessed on the Global Assessment of Functioning (GAF) scale while caregivers were administered the Burden Assessment Schedule (BAS) and Mechanisms of Coping (MOC) scale.

Results: Fatalism and problem-solving were the two most preferred ways of coping. Problem-focused coping, i.e. problem-solving and expressive-action decreased the burden of caregivers, while emotion-focused coping, i.e. fatalism and passivity, increased it. As the level of functioning of the patient decreased, the significance with which the coping mechanisms influenced the burden, increased. The use of problem-solving coping by caregivers showed a significant correlation with higher level of functioning in patients.

Conclusion: Coping mechanisms such as problem-solving can decrease the burden of illness on caregivers and may even improve the level of functioning of patients.

Keywords: Chronic schizophrenia; burden of illness; caregivers; level of functioning; mechanisms of coping.

Fig 1

Patient distribution by the Global Assessment of Functioning (GAF) score