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It has been difficult to identify relevant correlates of inpatient psychiatric length of stay (LOS), but few have examined family burden as a potential factor. The present study investigated the association of several dimensions of family burden with LOS net of other factors. Dimensions of burden experienced by primary caregivers were evaluated in a sample of 602 psychiatric inpatients in a large hospital in Guangzhou, China within 1 week of admission. Factor analysis reduced the burden data to five factors. Bivariate association and multiple linear regression analyzes were used to investigate burden and other factors associated with LOS (average LOS=58.8 days, SD=44.3). Multiple regression analysis showed that in addition to having health insurance coverage, being diagnosed with schizophrenia, being unmarried, and not being employed; being perceived by family members as showing more violent behavior and causing higher levels of caregiver distress were independently associated with longer LOS. [ABSTRACT FROM AUTHOR]

Background: Challenging behavior and psychiatric symptoms may be a major problem in adults with intellectual disability. Aims: The current study assessed the rate of challenging behavior among adults with intellectual disability and investigated the associated family burden. Subjects and methods: Two hundred and fifty adults with intellectual disability were recruited. The Structured Clinical Interview for Diagnosis of psychiatric disorders, according to DSM-IV criteria, Checklist of Challenging Behavior, Psychiatric Assessment Schedule for Adults with Developmental Disabilities and Wechsler Adult Intelligence Scale. Zarit caregiver Burden Interview was performed to assess the associated family burden. Results: One hundred and eighteen subjects (47%) had challenging behavior. Challenging behavior was significantly positively correlated with males (p < 0.001) and negatively correlated with hearing impairment (p <0.001). Schizophrenia and urinary incontinence were significantly found in subjects with challenging behavior (p <0.01 and p < 0.05 respectively). Ten items of Psychiatric Assessment Schedule were significantly higher among subjects with challenging behavior. Family burden of patients with challenging behavior were significantly higher in fourteen items of Zarit Caregiver Burden Interview. Conclusion: Challenging behavior was common among adults with intellectual disability. Psychiatric symptoms and the degree of family burden increased especially when associated with challenging behavior. [ABSTRACT FROM AUTHOR]

A chronic illness like schizophrenia seriously disrupts family functioning in various ways that can be addressed through family psychoeducational interventions in routine clinical services, an approach that has not received proper research attention. We pre- and post-tested four sets of parents of individuals with schizophrenia who participated in a long-term group psychoeducational intervention (treatment group) and four sets of parents of individuals with schizophrenia who received standard outpatient services (clinical control group), using three self-reported questionnaires to measure family functioning (Family Assessment Device), family atmosphere (Family Rituals Scale), and family burden (Family Burden Scale). At pre-test, there were no systematic differences between the two groups in any of the parameters assessed. At post-test, within and across groups, comparisons revealed significant improvements (under cut-off scores) in the mean scores of the treatment group (p<0.05) in all three parameters under study. Our findings provide pilot evidence that intensive group parent psychoeducation is an efficient and efficacious treatment intervention for improvement of systemic properties of families, such as family functioning, family atmosphere, and family burden. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: This study explores burden and social and professional support in families of young patients with muscular dystrophies (MDs) in Italy. Methods: The study was carried out on 502 key relatives of 4- to 25-year-old patients suffering from Duchenne, Becker, or Limb-Girdle MD who were living with at least 1 adult relative. Results: A total of 77.1% of relatives reported feelings of loss, 74.0% had feelings of sadness, and 59.1% had constraints in leisure activities. Burden was higher among relatives of patients with higher disability and who spent more daily hours in caregiving. Practical difficulties were higher among relatives who perceived lower help in patient emergencies and less practical support by their social network. Psychological burden was higher in those relatives who were unemployed, those with poorer support in emergencies, and those with lower social contacts. Conclusions: Caring for patients with MDs may be demanding for relatives even in the early stages of these disorders, especially when social support is poor and the patient's disability increases. Muscle Nerve 52: 13-21, 2015 [ABSTRACT FROM AUTHOR]

Background: Studies on determinants affecting family functioning of patients with psychosis are still limited in Greece. Aim: The aim of this study was to describe the socio-demographic and clinical characteristics associated with family functioning in patients with schizophrenia and bipolar disorder in Crete, Greece. Methods: A total of 100 patients and their caregivers agreed to participate in the study. Family functioning was assessed in terms of cohesion, adaptability, communication and satisfaction dimensions (Family Adaptability and Cohesion Evaluation Scale IV Package), expressed emotion (Family Questionnaire), family burden (Family Burden Scale) and caregivers' psychological distress (General Health Questionnaire-28). Multivariate linear regression models were implemented to examine the associations between each one of the family measures and different social and clinical characteristics. Results: With regard to the caregivers' characteristics, gender, employment status, origin, residence, financial status, relation to the patient, contact with the patient and family structure were among the most significant determinants of family functioning. Also, patients' socio-demographic characteristics, including age, education, origin, residence and employment status, as well as illness-related factors, such as onset of mental illness, number of hospitalisations, last hospitalisation, longer hospitalisation and clinical diagnosis impacted intrafamilial relationships. Conclusion: The results of this study suggest that a number of social and clinical factors contributed to the family environment of patients with psychosis. Identifying the determinants of family functioning in psychosis is instrumental in developing understandings regarding the factors which may contribute to the rehabilitation or relapse of the patient and the support required to strengthen positive family interactions. [ABSTRACT FROM AUTHOR]

Objective The role of behavioral inhibition ( BI) and parenting for an unfavorable emotional trauma response ( DSM- IV criterion A2) and post-traumatic stress disorder ( PTSD) development is unclear. Method A community sample of adolescents and young adults (aged 14-24) was followed up over 10 years ( N = 2378). Traumatic events, criterion A2, and PTSD (according to DSM- IV- TR) were assessed using the M- CIDI. BI and parenting were assessed using the Retrospective Self-Report of Inhibition and the Questionnaire of Recalled Parenting Rearing Behavior. Multiple logistic regressions adjusted for sex, age, and number of traumata were used to examine associations of BI as well as maternal and paternal overprotection, rejection, and reduced emotional warmth with (i) criterion A2 in those with trauma ( N = 1794) and (ii) subsequent PTSD in those with criterion A2 ( N = 1160). Results Behavioral inhibition ( BI; odds ratio, OR = 1.32) and paternal overprotection (OR = 1.27) predicted criterion A2 in those with trauma, while only BI ( OR = 1.53) predicted subsequent PTSD. BI and paternal emotional warmth interacted on subsequent PTSD ( OR = 1.32), that is, BI only predicted PTSD in those with low paternal emotional warmth. Conclusion Our findings suggest that BI and adverse parenting increase the risk of an unfavorable emotional trauma response and subsequent PTSD. Paternal emotional warmth buffers the association between BI and PTSD development. [ABSTRACT FROM AUTHOR]

Aims The objective of this study was to compare the family burden and environment of patients with panic disorder ( PD) with those of a control group composed of relatives of patients with clinical diseases. Methods A cross-sectional study was performed with 67 relatives of patients with PD, and 66 family members of patients with clinical diseases. All patients were administered a set of instruments to assess family burden and environment. Results Multivariate analyses revealed significant between-group differences on measurements of objective and subjective burden, both of which can be influenced by kinship, since higher levels of family burden tend to be reported by the children of the affected individual. Levels of family burden also tend to be associated with the severity of PD symptoms. Conclusions The assessment of family burden may be useful in developing family-focused therapeutic strategies and may contribute to the improvement of patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Caregiver burden is an important issue that needs to be addressed when developing management programs for persons with chronic mental illnesses, but there is, as yet, no reliable way for assessing this in China. Aim: Assess the validity and reliability of a brief adapted Chinese version of the Family Experience Interview Schedule (FEIS) among caregivers of inpatients with mental disorders in China. Methods: We first translated and back-translated the original 114-item FEIS and administered it to 606 primary caregivers of psychiatric inpatients. After excluding 9 items about sociodemographic variables and 9 items that over 15% of respondents were unable to answer, we conducted an exploratory factor analysis using a random half of the sample on the remaining 96 items and, based on the results of the factor analysis, selected the items to be included in the final shortened scale. Correlation analysis, confirmatory factor analysis, and internal consistency measures were used to assess the reliability and validity of the final scale using data from the second half of the sample. Results: The final scale included 28 items that loaded on five dimensions: (a) patients' violent behavior; (b) patients' suicidal tendency; (c) caregivers' depression and anxiety; (d) disruption of caregivers' daily routines; and (e) caregivers' satisfaction with health services. These five dimensions explained 50.5% of the total variance. Confirmatory factor analysis found reasonable fit of this 5-factor model (Χ2/df=2.94, p<0.001, goodness-of-fit index [GFI]=0.85, comparative fit index [CFI]=0.85, root-mean-square error of approximation [RMSEA]=0.08). The correlation coefficients between each item and the corresponding factor were all above 0.5. The Cronbach a coefficient of the entire scale was 0.76 and that for the five dimensions varied between 0.71 and 0.84. Conclusions: The five dimensions of family burden assessed by the 28-item brief Chinese version of FEIS have good internal consistency and, thus, appear to assess valid dimensions of family burden in Chinese caregivers of persons with serious mental illnesses. Further work is needed to assess the test-retest reliability of this scale and its sensitivity to change over time. [ABSTRACT FROM AUTHOR]

Background: This study assessed the efficacy of the Falloon model of psychoeducational family intervention (PFI), originally developed for schizophrenia management and adapted to bipolar I disorder. The efficacy of the intervention was evaluated in terms of improvement of patients׳ social functioning and reduction of family burden.Methods: This was a multicentre, real-world, controlled, outpatient trial carried out in 11 randomly recruited Italian mental health centres. Enroled patients and key-relatives were consecutively allocated either to receive PFI and Treatment As Usual (TAU) or to a waiting list receiving TAU alone. The efficacy of the intervention was evaluated in terms of improvement in patients׳ social functioning (primary outcome) and reduction of family burden (secondary outcome).Results: Of the 137 recruited families, 70 were allocated to the experimental group and 67 to the control group. At the end of the intervention, significant improvements in patients׳ social functioning and in relatives׳ burden were found in the treated group compared to TAU. This effect of the intervention remained also after controlling for several confounding patient׳s socio-demographic and clinical factors. The experimental intervention had an impact also on other outcome measures, such as patients׳ clinical status and personal burden.Limitations: Lack of an active control group.Conclusions: The results of this study clearly show that the psychoeducational family intervention according to the Falloon model is effective in improving the social outcome of patients with bipolar I disorder. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of atopic dermatitis on families of pediatric patients.Study Design: This cross-sectional, web-based survey of children/adolescents (6 months to <18 years old) with atopic dermatitis and their parents and caregivers was conducted in 18 countries encompassing North America, Latin America, Europe, Middle East/Eurasia, and East Asia. Children and adolescents with atopic dermatitis and their parents and caregivers were identified by the International Study of Asthma and Allergies in Childhood criteria and ever being told by a physician that they had "eczema". Atopic dermatitis severity was assessed using the Patient-Oriented Eczema Measure and the Patient Global Assessment. Atopic dermatitis impact on families' lives was evaluated using the Dermatitis Family Impact questionnaire and stand-alone questions on hours of atopic dermatitis-related care (past week) and missed work days (past 4 weeks) owing to their child's atopic dermatitis.Results: A total of 7465 pairs of pediatric participants with atopic dermatitis and their parents or caregivers were surveyed. Across age groups, the Dermatitis Family Impact questionnaire total score for all regions ranged from 7.1 to 8.6, 13.2 to 14.9, and 17.0 to 17.2 for Patient-Oriented Eczema Measure mild, moderate, and severe atopic dermatitis, respectively. Subscale scores showed that greater atopic dermatitis severity had a greater impact on all family life domains, including sleep and tiredness. No specific patterns or trends were observed across age groups. Time spent on childcare and missed work days increased with atopic dermatitis severity.Conclusions: Across pediatric age groups and geographic regions, greater atopic dermatitis severity was associated with a greater negative impact on physical, emotional, social, and economic components of family life. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate possible differences in family environment among patients experiencing their First Episode of Psychosis (FEP), chronic patients and controls. Family cohesion and flexibility (FACES-IV) and psychological distress (GHQ-28) were evaluated in families of 50 FEP and 50 chronic patients, as well as 50 controls, whereas expressed emotion (FQ) and family burden (FBS) were assessed in families of FEP and chronic patients. Multivariable linear regression analysis, adjusted for confounders, indicated impaired cohesion and flexibility for families of FEP patients compared to controls, and lower scores for families of chronic patients compared to those of FEP patients. Caregivers of chronic patients scored significantly higher in criticism, and reported higher burden and psychological distress than those of FEP patients. Our findings suggest that unbalanced levels of cohesion and flexibility, high criticism and burden appeared to be the outcome of psychosis and not risk factors triggering the onset of the illness. Furthermore, emotional over-involvement both in terms of positive (i.e. concern) and negative behaviors (i.e. overprotection) is prevalent in Greek families. Psychoeducational interventions from the early stages of the illness should be considered to promote caregivers' awareness regarding the patients' illness, which in turn, may ameliorate dysfunctional family interactions. [ABSTRACT FROM AUTHOR]

Family members of mental health service users who take everyday care are often subjected to objective and subjective burden. Practical strategies to deal with the task of care and solidarity actions between family members can help improve the quality of life of caregivers and users. This study describes and analyzes strategy developed with Psychosocial Care Centers (CAPS), in collaboration with the family, in order to better know the experience of overload and support self-help initiatives, health education and promotion of autonomy. The collection and analysis of data used qualitative methodology, such as observation and focus groups. Preliminary results identify high levels of overload, good response of family participation in self-help groups and health education activities, and the need to improve and intensify actions developed by CAPS for support and guidance of the family. [ABSTRACT FROM AUTHOR]

PURPOSE: To explore the impact moderate to severe traumatic brain injury (TBI) in a child has on family functioning. METHODS: The search was conducted using 9 bibliographic databases for articles published between 1980 and 2013. Two reviewers independently screened for inclusion and assessed study quality. Two reviewers extracted study data and a third checked for completeness and accuracy. Findings are presented by three domains: injury-related burden and stress, family adaptability, and family cohesion.RESULTS: Nine observational studies were included. Across the studies, differences between study groups for family functioning varied, but there was a trend for more dysfunction in families whose child had a severe TBI as compared to families whose child had a moderate TBI or orthopedic injury. In three studies, injury-associated burden was persistent post-injury and was highest in families whose child had a severe TBI followed by families with a child who had a moderate TBI. One study found fathers reported more family dysfunction caused by their child's injury compared to mothers. Two studies found that mothers' adaptability depended on social support and stress levels while fathers' adaptability was independent of these factors and injury severity. CONCLUSION: Moderate to severe TBI has a significant, long-standing impact on family functioning. Factors associated with family adaptability vary by parental role. [ABSTRACT FROM AUTHOR]

Families of children with Duchenne muscular dystrophy (DMD) go through significant challenges in dealing with the condition. Few studies have looked into the situation, especially in the sociocultural scenario that is unique to India. The authors' aim was to identify the psychosocial challenges for caregivers of children with DMD. A cross-sectional descriptive study was performed among the caregivers of 60 children with DMD who were attending the neuromuscular disorders clinic ofa national tertiary referral center for neurological disorders. The knowledge and attitude, psychosocial needs, burden, and coping patterns were assessed in an interview. The findings showed that parents of children with DMD tended to have inadequate understanding of the disease but had a positive attitude, had a moderate family burden, and tended to rely more on religion, focus on and venting of emotions, and instrumental and emotional social support for coping. Caregivers of children with DMD would benefit from psychosocial intervention to address their understanding of and attitude toward the disease, as well as burden of dealing with it, and to help them develop their coping skills and meet their children's and their own needs. [ABSTRACT FROM AUTHOR]

Purpose: The influential role of family in the outcome of chronic schizophrenia is well documented. However, there has been relatively little research on the intrafamilial relationships of people experiencing their first episode of psychosis (FEP), a point in time when most of the changes in family dynamics are observed. The aim of this article is to present a review of the literature focusing on the family environment of FEP patients. Methods: We carried out a computerized literature search on MEDLINE and PsycINFO (1990-2013), and a manual search of references of pertinent articles. In total, 27 studies investigating expressed emotion (EE) and family burden (FB) in FEP were identified and fulfilled the inclusion criteria. Results: Similar to chronic patients, a high prevalence of high-EE in carers of FEP patients was reported. High-EE status appears to be independent of the patient's illness-related characteristics, but dependent of relatives' attributions. In contrast to chronic patients, low levels of FB and psychological distress among family members of FEP patients were observed indicating that in the early stages of the illness family involvement is not yet associated with significant disruption in their lives. Studies assessing FB in chronic patients have found a well-established link of FB with patient's illness-related factors, but in FEP patients the families' appraisal of FB is more closely associated with their coping mechanisms. Conclusions: Further studies evaluating family functioning in terms of cohesion and adaptability will shed light on the intrafamilial relationships in FEP patients which may be associated with the long-term outcome of this chronic illness. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to focus on the subjective experience of mothers of daughters with ongoing anorexia nervosa. Specifically, we explored the stressors faced by these mothers while coping with their daughters’ illnesses; we also looked at how they experienced their maternal selves and roles, and their perceived competence in coping with their daughters’ illnesses. Two related aspects were found to be central in the participants’ experiences. One aspect was their network of relationships and how these relationships were challenged or compromised as a result of their daughters’ illnesses. This aspect included the mothers’ relationships with their daughters, the mothers’ relationships with other family members and with their spouses/partners, the mothers’ relationships with the professionals treating their daughters, and the mothers’ relationships with themselves.The second related aspect was the challenge presented to the participants’ self-perception as ‘good mothers’ by their daughters’ illnesses. The findings showed that coping with a daughter’s eating disorder (ED) posed a significant obstacle to the mother’s ability to maintain a satisfying relationship with her daughter and her environment, as well as to maintain a positive maternal self-perception. The implications of these findings for professionals working with caregivers are discussed, and a more nuanced, gender-specific attitude is suggested in working with mothers caring for daughters with EDs. [ABSTRACT FROM PUBLISHER]

Accessible summary This randomized-controlled trial investigated the effect of group psychoeducation therapy on family burden in caregivers of Iranian patients with schizophrenia., Results of this study on 71 caregivers of patients with schizophrenia showed that a 4-week group psychoeducational programme was significantly effective in reducing family burden by more than one third., Findings showed that group psychoeducational programme for caregiver and family of patients with schizophrenia is beneficial for reducing family burden., Abstract This study was aimed at assessing the impact of group psychoeducation therapy on family burden in caregivers of Iranian patients with schizophrenia during the acute phase of the disease. Using a randomized-controlled trial design, 71 caregivers of patients with schizophrenia were randomly assigned to either a 4-week group psychoeducational programme ( n = 36) or the control group ( n = 35). Family burden was assessed by Family Burden Index Schedule ( FBIS) at the beginning, and after a month of psychoeducation therapy as a follow-up. FBIS assesses family burden in six different dimensions with score ranging from 0 to 48, higher scores indicating higher burdens. At baseline mean, FBIS score was not significantly different between the cases and the controls. After the intervention, the mean total FBIS score was significantly lower in the case group compared with the control group ( P < 0.001). In the intervention group, FBIS score change was significant through the study in all dimensions as well as the total score ( P < 0.001). A significant reduction in family burden has been achieved by implementing group psychoeducational programmes for inpatients with acute phase schizophrenia in Iranian population. [ABSTRACT FROM AUTHOR]

The diagnosis of cancer is a family experience that changes the lives of all its members, bringing an immense amount of stress and many challenging situations. The daily routine, common activities and distribution of duties all have to change. Family members follow the phases of the disease, very often suffering comparable or greater distress than the patient. They use various coping methods which aim at helping both the sick relative and themselves. These methods, together with emotional responses, change over time according to the phase of the disease. Cancer puts the family at risk since it imposes an alternation in the relations among family members. It affects the couple's relationship, their sex life, and it can also be a cause of major trauma among their children and adolescents. The diagnosis of cancer brings also individual risks for the family members in terms of psychological and physical health impairment. Family caregivers often feel overloaded with the additional obligations and roles they have to pick up. They find it increasingly burdening to care full-time for the household and provide emotional support for the patient. The family's problems and the way family members regard the disease may be also a result of the family system they are in. This article describes the nature of caregiving to a patient with cancer and the biggest concerns for the family. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to determine the effects of family-to-family support programs provided for the families of schizophrenic patients on the need for information about the illness, family burden and self-efficacy Method: The study was carried out with 34 relatives who have key roles in the lives of 34 outpatients who were diagnosed with schizophrenia under DSM-IV-TR. A volunteering family member was given training about the purpose, contents and planning of the program. The family member who had been trained then extended this training to other family members with the assistance of the psychiatric nurse. The training was done once a week, for a total of 12 sessions. The data were collected using a Disease Information Form (DIF), the Perceived Family Burden Scale (PFBS) and the Self-Efficacy Scale (SES). Results: There was a significant decrease in the PFBS objective scores (from 11.76±3.89 to 9.82±4.03, p=0.000), subjective scores (from 37.85±14.57 to 32.74±4.39, p=0.030) and total scores (from 49.62±18.25 to 42.56±7.56, p=0.005) and a significant increase in the SESS scores (from 82.65±12.01 to 97.79±7.17, p=0.000). Before training, 58.8% of family members correctly answered that schizophrenia is a brain disease, while 94.1% correctly stated that, it must be treated with medication; however, 55.9% of caregivers incorrectly believed in magical attributions relating to the disease. After training, all caregivers were able to answer correctly. Conclusion: A family-to-family support program was found to be effective in reducing caregivers' need for information, reducing their burden, and increasing their self-efficacy in our country. [ABSTRACT FROM AUTHOR]

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Introduction: Post intensive care syndrome (PICS) affects an increasing number of critical illness survivors and their families, with serious physical and psychological sequelae. Since little is known about the burden of critical illness on ICU survivor families, we conducted a prospective observational study aiming to assess this, and investigate correlations of the patients' psychometric and health-related quality of life (HRQOL) scores with family burden., Materials and Methods: Twenty-nine patients were evaluated in the presence of a family member. Participants were assessed with the use of validated scales for anxiety, depression, post-traumatic stress disorder, cognitive decline, and the family burden scale (FBS)., Results: High burden was present in 27.6% of family members. Statistically significant correlations were observed between the FBS score and trait anxiety, depression, and the physical and psychological components of HRQOL., Conclusions: Our results suggest that family burden following critical illness is common, suggesting that its assessment should be incorporated in the evaluation of PICS-family in large observational studies., Competing Interests: Conflict of interest None to declare., (© 2022 Vassiliki Mantziou, Charikleia S. Vrettou, Alice G. Vassiliou, Stylianos E. Orfanos, Anastasia Kotanidou, Ioanna Dimopoulou, published by Sciendo.)

Background: The impact of melanoma on quality of life (QoL) is not limited to the patient but may also affect caregivers., Objectives: To investigate the impact of melanoma on caregivers' QoL., Materials & Methods: Caregivers of melanoma patients were recruited at the melanoma unit of our hospital. The impact on caregivers' QoL was measured using the Family Dermatology Life Quality Index (FDLQI)., Results: Data were collected for 120 caregivers, of whom 51.7% were men and the mean age was 56.9 years. Breslow thickness of melanoma was <0.8 mm in 70.8% of cases. Mean FDLQI score was 5.7 (SD: 2.4). Among the single items of the FDLQI, the highest mean score corresponded to emotional distress. The impact on QoL was greater when the caregiver was a son/daughter, and increased relative to the age of the patient and number of years since diagnosis., Conclusion: To our knowledge, this is the first study to quantitatively evaluate the impact of melanoma on caregivers. Such impact was not negligible and mostly concerned emotional aspects. Caregivers need to be supported by structured educational and psychological interventions.

Accelerated atherosclerosis and vascular calcification, with oxidative stress, endothelial dysfunction, and other factors causing the arterial stiffness, increases cardiovascular morbidity and mortality in patients on peritoneal dialysis. The aim of this paper is to assess changes in intima media thickness (IMT) at common carotid arteries (CCA) in patients with stable continuous ambulatory peritoneal dialysis (PD) and examine the relationship of these changes and other risk factors on the occurrence of atherosclerosis. The study was conducted on 35 stable PD patients (25 type 2 diabetic patients), aged 58,6 ± 10’6 years. CCA-IMT was assessed using ultrasound B-mode technique, bilaterally. Other risk factors for the occurrence of atherosclerosis were monitored through regular laboratory control. One atheromatous plaque was found in 19 patients (54,3%). Among 25 type 2 diabetic patients, vascular calcifications were found in 80% patients. In all PD patients, CCA-IMT is 0,77 ± 0,23, in PD patients with vascular calcifications CCA-IMT is 1,05 ± 0,2 mm, while in group without vascular calcifications the value of this parameter is 0,56 ± 0,09 (p

Balkan endemic nephropathy (BEN) is chronic tubulointersticial nephritis of unknown aetiology characterized by an insidious onset and gradual progression to end stage renal disease (ESRD). Endemic regions of Bosnia and Herzegovina are Posavina and Semberija, sited at basin of Sava River. In BEN, just like in other chronic renal diseases (CKD), glomerular filtration rate (GFR), is assumed a marker of overall renal function. The aim of this study was to compare GFR in examinees of endemic and non-endemic region for BEN, and between examinees with and without risk factors for BEN within endemic region Study included 603 inhabitants of Bosnian Posavina, out of whom 386 (65%) from endemic (Domaljevac) and 217 (36%) from non-endemic (Svilaj) village, and it was performed in two phases. The first phase encompassed obtaining anamnestic data (demographic, personal and family history), measurement of arterial blood pressure, and urine dipstick testing (specific gravity, pH, proteins, leukocytes, glucose, ketones, and mycroalbuminuria). In the second phase, besides repeated urine dipstick test, laboratory blood testing and abdominal ultrasound, with special attention to urinary tract, was also performed. We have compared GFR between examinees of endemic and non-endemic regions for BEN, and between examinees with and without family burden for BEN within endemic region, using MDRD formula for calculating GFR, with cut-off value (5 th percentile) based on result of studies performed in European Caucasians in screening for CKD and for establishing stages of CKD in BEN. Medical was used for statistical testing. Out of total number of examined inhabitants (603), 145 examinees were included in the second phase. After exclusion of 17 diabetic patients, 94 (73%) examinees from endemic and 34 (27%) examinees from non-endemic region remained. In the endemic region there were 46 (49%) examinees with and 48 (51%) without family burden for BEN. Overall GFR in examined groups was within physiologic range. There was not statistically significant difference in calculated GFR between examinees of endemic and non-endemic regions for BEN (Mann-Whitney test p=0.104; Fisher’s test p=1), neither between examinees with and without family burden for BEN within endemic region (Mann-Whitney test p=0’7393; Fisher’s test p=0,263). Overall GFR in examined groups was within physiologic range. There wasn’t statistically significant difference in calculated GFR between examinees of endemic and non-endemic regions for BEN, neither between examinees with and without family burden for BEN within endemic region. GFR, no matter how accurately calculated and estimated, does not represent significant biomarker for diagnosis, especially early diagnosis, of BEN, until maybe its overt advanced form.

Depression is the most frequent psychological complication of haemodialysis (HD) patients (pts) and has been associated with impaired Quality of Life (QoL). The aim of our study was to investigate the prevalence of depression in HD pts in relation to sociodemographic factors and the relationship between depression and QoL. 200 pts from Clinic for haemodialysis in Sarajevo, B&H were participating in the study. Mean age was S7,26±13,78 years and mean HD duration was 64’26±58,18 months. From the test material we applied BDI and SF-36. 51% of our pts have shown depression (BDI>11) in various degrees (30%-mild depression, 8,5%-moderate depression and 12,5%-severe depression). As we could expect, the most emphasized symptoms of depression were somatic symptoms. 55,5% of pts have shown QoL lower then average. Sociodemographic data such as gender, marital status and HD duration did not influence significantly on pt’s QoL and occurrence of depression (p>0,05). As the age of the pts increased, level of depression increased too and QoL significantly decreased (p

This study examined hope and family burden among Latino families of individuals with schizophrenia. The sample consisted of 54 family members, one family member per outpatient adult recruited from public mental health programs in a diverse urban community. Hierarchical linear regression analyses were used to test the hypothesis that the family member's increased hope for the patient's future would be associated with decreased family burden beyond effects explained by the patient's length of illness and severity of symptoms. Results supported the study hypothesis. Family hope for the patient's future was associated with four of five types of family burden. Findings point to the prominent role of hope as a source of resilience for Latino families dealing with severe mental illness of a loved one. [ABSTRACT FROM AUTHOR]

Objective: This randomized-controlled experimental study was conducted to determine the effects of psychoeducation in the inpatient clinic and regular telepsychiatric follow-up (via telephone) after discharge on emotional expression, depression and family burden of primary caregivers of the schizophrenic patients. Methods: This study was performed on 62 caregivers of the schizophrenic patients, assigned to experiment (n=32) and control (n=30) groups, from 1st July 2010 to 31st May 2011. The Scales for Expressed Emotion, the Beck Depression and the Zarit Family Burden were applied for the caregivers in experiment and control groups before education, after education and after 6-months telephone follow-up. Results: The mean scores of the caregivers in experiment group on family burden, emotional expression and depression were decreased after education and after telephone follow-up and difference was significant (p < 0.001). Conclusions: Psychoeducation and telepsychiatric follow-up via telephone induced decrease in family burden, emotional expression and depressive symptoms for their caregivers and was a support for the family in the patient care. [ABSTRACT FROM AUTHOR]

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Background. Current trends in population aging affect both recipients and providers of informal family caregiving, as the pool of family caregivers is shrinking while demand is increasing. Epidemiological research has not yet examined the implications of these trends for burdens experienced by aging family caregivers. Method. Cross-sectional community surveys in 20 countries asked 13 892 respondents aged 50+ years about the objective (time, financial) and subjective (distress, embarrassment) burdens they experience in providing care to first-degree relatives with 12 broadly defined serious physical and mental conditions. Differential burden was examined by country income category, kinship status and type of condition. Results. Among the 26.9-42.5% respondents in high-, upper-middle-, and low-/lower-middle-income countries reporting serious relative health conditions, 35.7-42.5% reported burden. Of those, 25.2-29.0% spent time and 13.5-19.4 % money, while 24.4-30.6 % felt distress and 6.4-21.7% embarrassment. Mean caregiving hours per week in those giving any time were 16.6-23.6 (169.9-205.8 h/week per 100 people aged 50+ years). Burden in low-/lower-middle- income countries was 2- to 3-fold higher than in higher-income countries, with any financial burden averaging 14.3% of median family income in high-, 17.7% in upper-middle-, and 39.8% in low-/lower-middle-income countries. Higher burden was reported by women than men and for conditions of spouses and children than parents or siblings. Conclusions. Uncompensated family caregiving is an important societal asset that offsets rising formal healthcare costs. However, the substantial burdens experienced by aging caregivers across multiple family health conditions and geographic regions threaten the continued integrity of their caregiving capacity. Initiatives supporting older family caregivers are consequently needed, especially in low-/lower-middle-income countries. [ABSTRACT FROM AUTHOR]

Objective: This study examines 6-month follow-up data from participants in a randomized trial of a peer-driven 12-session family support and education program, called family-to-family (FTF) and offered by the US National Alliance on Mental Illness, to determine whether improvements in distress, family functioning, coping and empowerment were sustained. Method: Individuals randomized to the FTF condition were assessed after program completion and then 3 months later on measures of distress, family functioning, coping, and empowerment. We used a multilevel regression model ( sas proc mixed) to test for significant changes over time (baseline, 3 and 9 months). Results: All significant benefits that FTF participants gained between baseline and immediately post-FTF were sustained at 9 months including reduced anxiety, improved family problem-solving, increased positive coping, and increased knowledge. Greater class attendance was associated with larger increases in empowerment and reductions in depression and displeasure with ill relative. Conclusion: Evidence suggests that benefits of the FTF program were sustained for at least 6 months without any additional boosters or supports. Peer-based programs may produce sustained benefits for individuals seeking help in addressing challenges and stresses related to having a family member with a mental illness. [ABSTRACT FROM AUTHOR]

Background: The economic and moral implications of family burden are well recognised. What is less understood is whether or how family health and family burden relate to personal mental health. This study examines family health and perceived family burden as predictors of personal mental health, taking personal and sociodemographic factors into consideration. Methods: Data used was from the National Comorbidity Study Replication (NCS-R), namely the random 30% of participants (N = 3192) to whom the family burden interview was administered. Measures of family burden and mental health were considered for analysis. Results: Binary logistic regressions were used as means of analyses. Perception of family burden was associated with an increased vulnerability to personal mental health problems, as was the presence of mental health difficulties within the family health profile. Which member of the family (kinship) was ill bore no relation to prediction of personal mental health. Personal and socio-demographic factors of sex, age, marital status, education and household income were all predictive of increased vulnerability to mental health problems over the last 12 months. Conclusions: Certain elements of family health profile and its perceived burden on the individuals themselves appears related to risk of personal incidence of mental health problems within the individuals themselves. For moral and economic reasons, further research to understand the dynamics of these relationships is essential to aid developing initiatives to protect and support the mental health and wellbeing of relatives of ill individuals. [ABSTRACT FROM AUTHOR]

Background & objectives: A substance dependent person in the family affects almost all aspects of family life. This leads to problems, difficulties or adverse events which impact the lives of family members and causes enormous burden on family caregivers. The present study aimed to assess the pattern of burden borne by the family caregivers of men with alcohol and opioid dependence. Methods: A cross-sectional study was conducted with ICD-10 diagnosed substance dependence subjects and their family caregivers attending a de-addiction centre at a multispecialty teaching hospital in north India. Family Burden Interview Schedule was used to assess the pattern of burden borne by the family caregivers of 120 men with alcohol and/or opioid dependence. Results: Compared to opioid and alcohol+opioid dependence groups, more often the alcohol dependence group was older, married, currently working, having a higher income and with the wife as a caregiver. Family burden was moderate or severe in 95-100 per cent cases in all three groups and more for 'disruption of family routine', 'financial burden', 'disruption of family interactions' and 'disruption of family leisure'. Family burden was associated with low income and rural location. It was associated neither with age, education or duration of dependence of the patients, nor with family size, type of caregiver or caregiver's education and occupation. Interpretation & conclusions: Almost all (95-100%) caregivers reported a moderate or severe burden, which indicates the gravity of the situation and the need for further work in this area. [ABSTRACT FROM AUTHOR]

Copyright of Sante Mentale au Quebec is the property of Revue Sante Mentale au Quebec and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aimed to assess mental health, family burden, and quality of life (PQoL) in parents of children with persistent congenital hyperinsulinism (CHI). Forty-eight individual CHI parents (75% female) completed self-reported questionnaires and screening tools for anxiety (GAD-7), depression (PHQ-8), PQoL (ULQIE), and family burden (FaBeL). Additional data on sociodemographics, social support, and child- and disease-related data were recorded. 29.8% of parents showed major depressive symptoms and 38.3% had a probable general anxiety disorder, including 20.8% who had both. The family burden was moderate and assessment of PQoL yielded average scores. Neurological impairment in an affected child (p = .002 and p < .001, respectively) and lower working hours (p = .001 and p = .012, respectively) were the strongest predictors of worse GAD-7 and PHQ-8 scores. Furthermore, lower working hours (p = .012) and comorbidities in the affected child (p = .007) were significantly associated with lower PQoL. Mothers had worse GAD-7 scores (p = .006) and lower PQoL (p = .035) than fathers. Indication of sleep disturbance was associated with worse PHQ-8 scores (p = .003), higher family burden (p = .039), and reduced PQoL (p = .003). A higher number of caretakers besides parents was associated with decreased family burden (p = .019), improved PQoL (p < .001), and lower scores for anxiety (p = .016) and depressive (p = .021) symptoms.    Conclusion: Symptoms of depression and anxiety are alarmingly prevalent in parents of children with CHI. Psychological screening of parents should be initiated to ensure early identification of psychological strains and psychosocial support should be offered as needed. A good support network and regular work activities can improve parental mental health and well-being. What is Known: • Psychosocial strains and reduced quality of life are common in parents of chronically ill children. What is New: • In this first study evaluating mental health, family burden, and quality of life in parents of children with congenital hyperinsulinism (CHI), symptoms of depression and anxiety were alarmingly prevalent. • Parents of children with CHI should receive regular psychological screening and psychosocial support should be offered as needed. A good support network and regular work activities can improve parental mental health and well-being., (© 2022. The Author(s).)

Introduction: Caring for the disabled elderly puts heavy burdens on their families. This study aimed to explore family function (FF) as a mediator in the relationship between disability severity (DS) and family burden (FB) of the Uygur and Kazakh home-dwelling disabled elderly cared for by informal caregivers in China., Method: A cross-sectional design with multistage sampling was used to recruit 431 families with Uygur and Kazakh disabled elderly in Bortala, Xinjiang, China. Data were collected using the Activities of Daily Living Scale, Family Burden Interview Schedule, and Family Adaptation, Partnership, Growth, Affection, and Resolve Index Scale and then analyzed using hierarchical regression., Results: FF had a partial mediating effect on the relationship between DS and FB (β = 0.131; 95% confidence interval [CI] = [0.074, 0.197]; p < .01); the effective rate was 41.46%., Discussion: Multidisciplinary care teams should implement targeted interventions to improve FF of the disabled elderly to alleviate FB.

Aims: Assertive community treatment (ACT) is known to have a positive impact on the number and length of inpatient stays. However, recent studies have shown little or no effect of such programs in European settings. This paper aims to describe the impact of a newly implemented ACT program on patients and their families' burden. Predictive factors have also been examined. Method: Fifty-five patients characterized by heavy use of psychiatric care, numerous hospitalizations, or failure to link with outpatient psychiatric care and their relatives were followed. Data were gathered on patients before and after follow up as well as on relatives' burden and costs. The number and domains of clinician interventions have been detailed. Results: The ACT program had a positive effect on symptoms, psychosocial adaptation and quality of life. Age was the most significant predictor of changes. Older patients, most of them suffering from delusional disorders, showed no improvement or even some impairment. Finally, the program appeared to have a marked effect on easing families' burden in domains such as assistance in daily life activities and costs. Conclusions: ACT appears to be recommended for patients with poor outcome when treated in other settings. Early intervention seems to be justified as highlighted by younger age being the best predictor of positive changes. Families can be helped considerably, particularly those confronted with patients with persistent disturbing symptoms which do not, however, warrant hospitalization. Finally, the fact that patients with delusional disorder do not seem to improve warrants further research. [ABSTRACT FROM AUTHOR]

Few studies have been found that to assess the factors that explain higher levels of family burden in adults with intellectual disability (ID) and intellectual disability and mental disorders (ID–MD). The aims of this study were to assess family burden in people with ID and ID–MD and to determine which sociodemographic, clinical and functional disability variables account for family burden. The sample is composed of pairs of 203 participants with disability and their caregivers, of which 33.5% are caregivers of people with ID and 66.5% of ID–MD. Assessments were performed using scales of clinical and functional disability as the following instruments: Weschler Adult Intelligence Scale-III (WAIS-III), Inventory for Client and Agency Planning (ICAP), Psychiatric Assessment Schedule for Adults with Development Disability (PAS-ADD checklist), Disability Assessment Schedule of the World Health Organization (WHO-DAS-II) and family burden (Subjective and Objective Family Burden Inventory – SOFBI/ECFOS-II). People with ID–MD presented higher levels of functional disability than those with ID only. Higher levels of family burden were related to higher functional disability in all the areas (p <0.006–0.001), lower intelligence quotient (p <0.001), diagnosis of ID–MD (p <0.001) and presence of organic, affective, psychotic and behavioral disorders (p <0.001). Stepwise multiple regression showed that behavioral problems, affective and psychotic disorder, disability in participation in society, disability in personal care and presence of ID–MD explained more than 61% of the variance in family burden. An integrated approach using effective multidimensional interventions is essential for both people with ID and ID–MD and their caregivers in order to reduce family burden. [Copyright &y& Elsevier]

Purpose: In this study, the individuals with psychotic disorders' daily life function was investigated on six dimensions considering their relations to family burden. Functional ratings carried out by relatives and staff were also compared. Methods: Totally 88 relatives, to as many individuals diagnosed with a psychotic disorder, participated in this study. Relatives were to rate their own perceived burden and their ill relatives' physical functioning, personal care skills, interpersonal relationships, social acceptability, activities, and work skills. The outpatient staff, in all 24 case managers also rated the patients' functional level on the same assessment tool as did the relatives. Results: Most dimensions of patients' everyday functioning were highly correlated to relatives' burden. The two functional dimensions 'interpersonal relationships' and 'activities' were best at classifying burden when rated by relatives. Also, comparing independent functional ratings by relatives and staff showed that despite great agreements on most dimensions, they differed significantly on 'social acceptability' where relatives rated the function to be poorer and 'activities' where relatives rated the function to be better. Conclusions: Relatives, who perceive individuals with a psychotic disorder to be limited in their ability to interpersonal relationships and limited in their ability to activate in everyday life, are more likely to perceive a higher burden. Even though staff and relatives mainly agree on the patients' functional ability, they often differ in ratings regarding patients' social acceptability and ability to activate in everyday life. This should be worth considering in clinical practice as well as in future research. [ABSTRACT FROM AUTHOR]