Factors Affecting Quality of Life and Family Burden among the Families of Patients with Schizophrenia

Family are often the first diagnosticians and first decision makers of individuals with schizophrenia, and as providers of emotional and financial support, they play important roles in treatment and rehabilitation. However, if prejudices and stigma surrounding mental illness are strong, family members and patients alike face considerable social and physical threat. In particular, emotional responses including anxiety and depression not only exacerbate family pain and burden, but also negatively influence patient prognosis. With the dehospitalization trend, beginning in the late 1960s, patients suffering from schizophrenia returned to society, and recent atypical antipsychotic medications decreased frequency of relapse and hospital admissions. However, as communities lack basic support services, responsibility for patients’ support has been relegated to families, and this is related to family burden. Family burden refers to various psychological, social, and financial burdens borne while caring for patients. Hoenig and Hamilton5 conceptualized this on subjective and objective levels. Objective burden refers to concrete sacrifices and losses suffered by the family because of mental disorders, and subjective burden refers to the level of pain subjectively experienced as a result of the burdensome situation. The definition introduced by Dillehay and Sandys6 is often used, defining family burden as “the psychological status resultant from the combination of factors such as physical labor and emotional or social pressure.” Families caring for patients with schizophrenia face many burdens, but it is unclear which factors give rise to such burdens. There seems to be a degree of overlap regarding the connection to the patient’s symptoms, with significant correlation between family burden and symptom severity. However, each symptom showed conflicting results or did not show a significant difference. In much of the literature, the term family burden has a negative meaning, implying family burden directly or indirectly Received: August 8, 2016 / Revised: October 8, 2016 Accepted: October 12, 2016 Address for correspondence: Chul-Eung Kim, Department of Psychiatry, Inha University School of Medicine, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea Tel: 032-890-3475, Fax: 032-890-3580 E-mail: kce320@inha.ac.kr Factors Affecting Quality of Life and Family Burden among the Families of Patients with Schizophrenia