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Psych Congress  

Burden of disease: family caregiving of patients with predominant positive compared with predominant negative symptoms

Kathleen F. Villa MS
Betsy Pohlman PhD
Meryl Brod PhD

Background: Little is known about how family caregiver burden for schizophrenia may differ by patients’ symptom predominance. The study qualitatively compared caregivers of patients with predominant positive symptoms (PPS-C) with caregivers of patients with predominant negative symptoms (PNS-C). 

Methods: 8 semistructured focus groups with family caregivers of people with schizophrenia (4 groups each, PPS-C and PNS-C) were held to elicit the impacts on caregiving. Patient scores on the PANSS, BPRS, or SANS/SAPS were used to identify symptom predominance.

Results: 41 caregivers participated (20 PPS-C, 21 PNS-C), 29 females (71%) and 12 males (29%). Mean age was 48.3 (range, 18-76) years. 76% resided with the patient. 66% were parents and 22% were siblings of the patient.
The core experience of caring for someone with schizophrenia was similar across caregiver groups, but the reporting frequency for some themes differed by the symptom groups. 
• Emotional: PNS-Cs reported worry more often; PPS-Cs reported helplessness, anger, and frustration more often. 
• Family: PPS-Cs reported marriage/partnership disruption more often than the PNS-C group did. 
• Work and school: PNS-Cs reported work-related impacts and lost work opportunities more often. 
• Social: PPS-Cs reported more frequent reduction and concern about social stigma. 
• Health: Both groups experienced negative impacts on their emotional and physical health, including lost sleep, fatigue, and depression or anxiety.

Conclusion: Symptom predominance impacts caregivers differentially. The strongest impacts for all caregivers are in the family and work domains. The greatest differences are for PPS-Cs who experience marriage/partnership disruption more frequently and for PNS-Cs who have greater work impacts. 

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