Predictors of caregiver distress in first-episode psychosis: subjective appraisal and expressed emotion

Presentation First Author: 
Jens Einar Jansen

Background: Caregivers of persons with first-episode psychosis (FEP) often report high levels of distress. Preventing long-term or chronic distress within the whole family is an important focus of early intervention for psychosis. However, little is known about the psychological factors involved. Aims: To examine the impact of subjective appraisals and expressed emotion on caregiver distress in FEP. Method: Within a cross-sectional design, 154 caregivers of 99 persons with first-episode psychosis from a specialist FEP treatment service completed the following questionnaires between April 2011 and April 2013: Family Questionnaire (FQ), Experience of Caregiving Inventory (ECI), General Health Questionnaire (GHQ-30). Symptomatology was assessed with Positive and Negative Syndrome Scale for Schizophrenia (PANSS) and global functioning with Global assessment of Functioning scale (GAF). Results: Thirty seven per cent of caregivers were suffering from clinical significant distress. A linear mixed model analysis found that, after controlling for caregiver demographic factors, service user symptoms and overall functioning, emotional over-involvement and subjective appraisal of caregiving were significant predictors of caregiver distress. Conclusion: Caregiver distress is significant in the early phase of illness, and this seem to be more related to their subjective appraisal and over-involvement, than to variations in symptoms and overall functioning. This lends further support to the stress-appraisal coping model and the cognitive model of caregiver distress in FEP, and highlight supportive interventions aimed at reducing unhelpful cognitions and behaviours.

Conference Name: 
Presentation Date: 
January, 2015
Additional Authors: 
Ulrik Helt Haahr - Susanne Harder - Anne Marie Trauelsen - Hanne-Grethe Lyse - Marlene Buch Pedersen - Erik Simonsen
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