Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2015-0082
Trends in Psychiatry and Psychotherapy
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Family burden in schizophrenia: the influence of age of onset and negative symptoms

Sobrecarga familiar na esquizofrenia: a influência da idade de início e dos sintomas negativos

Lucas M. Mantovani; Rodrigo Ferretjans; Iara M. Marçal; Amanda M. Oliveira; Fernanda C. Guimarães; João Vinícius Salgado

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Abstract

Abstract Objectives: To investigate the determinants of family burden in a sample of patients with schizophrenia and their caregivers. Methods: Thirty-one stable patients with schizophrenia and their main caregivers were recruited. Sociodemographic variables were assessed in a semi-structured interview, and positive and negative symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). Cognitive performance was assessed with the Schizophrenia Cognition Rating Scale (SCoRS). Levels of burden on caregivers were assessed with the Family Burden Interview Schedule (FBIS). Interactions among variables were analyzed using Pearson correlations and linear regression analysis. Results: Objective and subjective FBIS scores were 1.9 (standard deviation [SD] = 0.5) and 2.4 (SD = 0.6) respectively. Objective burden correlated positively with positive and negative symptoms, and cognitive impairment. Subjective burden correlated positively with positive symptoms and negatively with mean age of disease onset. Positive, negative and cognitive symptoms accounted for 47.6% of the variance of objective burden, with negative symptoms accounting independently for 30.3%. Age of onset, parents as caregivers and positive symptoms accounted for 28% of the variance of subjective burden, with age of onset independently explaining 20.3%. Conclusion: Patients' clinical and sociodemographic variables are important determinants of family burden in schizophrenia. Objective burden is predicted by symptoms, particularly negative ones. Subjective burden is predicted by symptoms and sociodemographic variables, particularly age of disease onset.

Keywords

Schizophrenia, family burden, burden of illness, negative symptoms, age of onset, cognition

Resumo

Resumo Objetivo: Investigar os determinantes de sobrecarga familiar numa amostra de pacientes com esquizofrenia e seus cuidadores. Métodos: Trinta e um pacientes com esquizofrenia e seus principais cuidadores participaram do estudo. Variáveis sociodemográficas foram analisadas por meio de uma entrevista semiestruturada, e sintomas positivos e negativos foram quantificados através da Positive and Negative Syndrome Scale (PANSS). O desempenho cognitivo foi mensurado pela Schizophrenia Cognition Rating Scale (SCoRS). A Escala de Avaliação da Sobrecarga dos Familiares (FBIS) avaliou os níveis de sobrecarga entre os cuidadores. As interações entre as variáveis foram verificadas por meio do coeficiente de correlação de Pearson e de análise de regressão linear. Resultados: Os escores objetivos e subjetivos da FBIS foram 1,9 [desvio padrão (DP) 0,5] e 2,4 (DP 0,6), respectivamente. Sobrecarga objetiva se correlacionou positivamente com sintomas positivos e negativos, e com prejuízos cognitivos. A sobrecarga subjetiva se correlacionou positivamente com sintomas positivos, e negativamente com a idade de início da doença. Os sintomas positivos e negativos e os prejuízos cognitivos contribuíram com 47,6% da variância da sobrecarga objetiva, sendo que sintomas negativos foram responsáveis independentemente por 30,3%. A idade de início da doença, os pais na posição de cuidadores e os sintomas positivos contribuíram com 28% da variância da sobrecarga subjetiva, sendo que a idade de início da doença contribuiu independentemente com 20,3%. Conclusões: Variáveis sociodemográficas e clínicas dos pacientes são importantes determinantes de sobrecarga familiar na esquizofrenia. A sobrecarga objetiva pode ser predita por sintomas, especialmente os negativos. A sobrecarga subjetiva pode ser predita por sintomas e características sociodemográficas, particularmente a idade de início da doença.

Palavras-chave

Esquizofrenia, sobrecarga familiar, sobrecarga do adoecimento, sintomas negativos, idade de início, cognição

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