Skip to main content
Erschienen in: Social Psychiatry and Psychiatric Epidemiology 4/2016

02.01.2016 | Original Paper

Family caregivers and outcome of people with schizophrenia in rural China: 14-year follow-up study

verfasst von: Mao-Sheng Ran, Cheryl H. K. Chui, Irene Yin-Ling Wong, Wen-Jun Mao, Fu-Rong Lin, Bo Liu, Cecilia Lai-Wan Chan

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 4/2016

Einloggen, um Zugang zu erhalten

Abstract

Objective

This study examined the differences in 14-year outcomes of persons with schizophrenia with and without family caregiver(s) in a rural community in China.

Methods

All participants with schizophrenia (n = 510) aged 15 years and older were identified in a 1994 epidemiological investigation of 123,572 people and followed up in 2004 and 2008 in Xinjin County, Chengdu, China.

Results

Individuals without family caregiver in 1994 had significantly higher rate of homelessness (23.8 %) and lower rate of survival (47.5 %) in 2008 than those with family caregivers (5.1 and 70.9 %). Compared with individuals with family caregivers, those without family caregivers were more likely to be male, live alone, have fewer family members, lower family economic status, lower rates of marriage and complete remission, higher mean scores on PANSS and lower mean score on GAF in 2008. The predictors of participants without family caregiver in 2008 included having a small number of family members at baseline and being male.

Conclusions

The absence of a family caregiver is a predictive factor of poorer long-term outcome of persons with schizophrenia in the rural community. The critical role of family caregiving should be incorporated in the planning and delivering of mental health policies and community-based mental health services.
Literatur
1.
Zurück zum Zitat Parabiaghi A, Lasalvia A, Bonetto C, Cristofalo D, Marrella G, Tansella M, Ruggeri M (2007) Predictors of changes in caregiving burden in people with schizophrenia: a 3-year follow-up study in a community mental health service. Acta Psychiatr Scand 116:66–76CrossRef Parabiaghi A, Lasalvia A, Bonetto C, Cristofalo D, Marrella G, Tansella M, Ruggeri M (2007) Predictors of changes in caregiving burden in people with schizophrenia: a 3-year follow-up study in a community mental health service. Acta Psychiatr Scand 116:66–76CrossRef
2.
Zurück zum Zitat García JIR, Chang CL, Young JS, López SR, Jenkins JH (2006) Family support predicts psychiatric medication usage among Mexican American individuals with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 41:624–631CrossRef García JIR, Chang CL, Young JS, López SR, Jenkins JH (2006) Family support predicts psychiatric medication usage among Mexican American individuals with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 41:624–631CrossRef
3.
Zurück zum Zitat Pilling S, Bebbington P, Kuipers E, Garety P, Geddes J, Orbach G, Morgan C (2002) Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy. Psychol Med 32:763–782PubMed Pilling S, Bebbington P, Kuipers E, Garety P, Geddes J, Orbach G, Morgan C (2002) Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy. Psychol Med 32:763–782PubMed
4.
Zurück zum Zitat Ran MS, Chan CL, Ng SM, Guo LT, Xiang MZ (2015) The effectiveness of psychoeducational family intervention for patients with schizophrenia in a 14-year follow-up study in a Chinese rural area. Psychol Med. doi:10.1017/S0033291715000197 PubMed Ran MS, Chan CL, Ng SM, Guo LT, Xiang MZ (2015) The effectiveness of psychoeducational family intervention for patients with schizophrenia in a 14-year follow-up study in a Chinese rural area. Psychol Med. doi:10.​1017/​S003329171500019​7 PubMed
5.
Zurück zum Zitat Bebbington P, Kuipers L (1994) The predictive utility of expressed emotion in schizophrenia: an aggregate analysis. Psychol Med 24:707–718CrossRefPubMed Bebbington P, Kuipers L (1994) The predictive utility of expressed emotion in schizophrenia: an aggregate analysis. Psychol Med 24:707–718CrossRefPubMed
6.
Zurück zum Zitat Butzlaff RL, Hooley JM (1998) Expressed emotion and psychiatric relapse: a meta-analysis. JAMA Psychiatry 55:547–552 Butzlaff RL, Hooley JM (1998) Expressed emotion and psychiatric relapse: a meta-analysis. JAMA Psychiatry 55:547–552
7.
Zurück zum Zitat Mihanović M, Restek-Petrović B, Bogović A, Ivezić E, Bodor D, Požgain I (2015) Quality of life of patients with schizophrenia treated in foster home care and in outpatient treatment. Neuropsychiatr Dis Treat 11:585–595PubMedPubMedCentral Mihanović M, Restek-Petrović B, Bogović A, Ivezić E, Bodor D, Požgain I (2015) Quality of life of patients with schizophrenia treated in foster home care and in outpatient treatment. Neuropsychiatr Dis Treat 11:585–595PubMedPubMedCentral
8.
Zurück zum Zitat Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A (1992) Schizophrenia: manifestations, incidence and course in different cultures: A World Health Organization ten-country study. Psychol Med Monogr Suppl 20:1–97CrossRefPubMed Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A (1992) Schizophrenia: manifestations, incidence and course in different cultures: A World Health Organization ten-country study. Psychol Med Monogr Suppl 20:1–97CrossRefPubMed
9.
Zurück zum Zitat Saha S, Chant D, Welham J, McGrath J (2005) A systematic review of the prevalence of schizophrenia. PLoS Med 2:e14CrossRef Saha S, Chant D, Welham J, McGrath J (2005) A systematic review of the prevalence of schizophrenia. PLoS Med 2:e14CrossRef
10.
Zurück zum Zitat Bresnahan M, Menezes P, Varma V, Susser E (2003) Geographical variation in incidence, course and outcome of schizophrenia: A comparison of developing and developed countries. In: Murry R, Jones P, Susser E, van Os J, Cannon M (eds) The epidemiology of schizophrenia. Cambridge University Press, UK, pp 18–33 Bresnahan M, Menezes P, Varma V, Susser E (2003) Geographical variation in incidence, course and outcome of schizophrenia: A comparison of developing and developed countries. In: Murry R, Jones P, Susser E, van Os J, Cannon M (eds) The epidemiology of schizophrenia. Cambridge University Press, UK, pp 18–33
11.
Zurück zum Zitat Ran MS, Xiang MZ, Li SX, Shan YH, Huang MS, Li SG, Liu ZR, Chen EYH, Chan CLW (2003) Prevalence and course of schizophrenia in a Chinese rural area. Aust NZ J Psychiatr 37:452–457CrossRef Ran MS, Xiang MZ, Li SX, Shan YH, Huang MS, Li SG, Liu ZR, Chen EYH, Chan CLW (2003) Prevalence and course of schizophrenia in a Chinese rural area. Aust NZ J Psychiatr 37:452–457CrossRef
12.
Zurück zum Zitat Jenkins JH, Karno M (1992) The meaning of expressed emotion: theoretical issues raised by cross-cultural research. Am J Psychiatr 149:9–21CrossRefPubMed Jenkins JH, Karno M (1992) The meaning of expressed emotion: theoretical issues raised by cross-cultural research. Am J Psychiatr 149:9–21CrossRefPubMed
13.
Zurück zum Zitat Lefley HP (1990) Culture and chronic mental illness. Psychiatr Serv 41:277–286CrossRef Lefley HP (1990) Culture and chronic mental illness. Psychiatr Serv 41:277–286CrossRef
14.
Zurück zum Zitat Hansson L, Middelboe T, Merinder L, Bjarnason O, Bengtsson-Tops A, Nilsson L, Sandlund M, Sourander A, SØrgaard KW, Vinding H (1999) Predictors of subjective quality of life in schizophrenic patients living in the community: a Nordic multicentre study. Int J Soc Psychiatry 45:247–258CrossRefPubMed Hansson L, Middelboe T, Merinder L, Bjarnason O, Bengtsson-Tops A, Nilsson L, Sandlund M, Sourander A, SØrgaard KW, Vinding H (1999) Predictors of subjective quality of life in schizophrenic patients living in the community: a Nordic multicentre study. Int J Soc Psychiatry 45:247–258CrossRefPubMed
15.
Zurück zum Zitat Bond M (1996) Chinese values. In: Bond M (ed) The handbook of Chinese pscyhology. Oxford University Press, Oxford, pp 208–226 Bond M (1996) Chinese values. In: Bond M (ed) The handbook of Chinese pscyhology. Oxford University Press, Oxford, pp 208–226
16.
Zurück zum Zitat Chan GWL, Ungvari GS, Shek DTL, Leung JJP (2003) Hospital and community-based care for patients with chronic schizophrenia in Hong Kong: quality of life and its correlates. Soc Psychiatry Psychiatr Epidemiol 38:196–203CrossRefPubMed Chan GWL, Ungvari GS, Shek DTL, Leung JJP (2003) Hospital and community-based care for patients with chronic schizophrenia in Hong Kong: quality of life and its correlates. Soc Psychiatry Psychiatr Epidemiol 38:196–203CrossRefPubMed
17.
Zurück zum Zitat Leung J, Xu Y (2015) China’s social welfare. Polity Press, London Leung J, Xu Y (2015) China’s social welfare. Polity Press, London
18.
Zurück zum Zitat Ran MS, Chan CLW, Chen EYH, Mao WJ, Hu SH, Tang CP, Lin FR, Conwell Y (2009) Differences in mortality and suicidal behaviour between treated and never-treated people with schizophrenia in rural China. Br J Psychiatry 195:126–131CrossRefPubMedPubMedCentral Ran MS, Chan CLW, Chen EYH, Mao WJ, Hu SH, Tang CP, Lin FR, Conwell Y (2009) Differences in mortality and suicidal behaviour between treated and never-treated people with schizophrenia in rural China. Br J Psychiatry 195:126–131CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Ran MS, Chen S, Chen E, Ran BY, Tang CP, Lin FR, Li L, Li SG, Mao WJ, Hu SH (2011) Risk factors for poor work functioning of persons with schizophrenia in rural China. Soc Psychiatry Psychiatr Epidemiol 46:1087–1093CrossRefPubMed Ran MS, Chen S, Chen E, Ran BY, Tang CP, Lin FR, Li L, Li SG, Mao WJ, Hu SH (2011) Risk factors for poor work functioning of persons with schizophrenia in rural China. Soc Psychiatry Psychiatr Epidemiol 46:1087–1093CrossRefPubMed
20.
Zurück zum Zitat Yin Y, Zhang W, Hu Z, Jia F, Li Y, Xu H, Zhao S, Guo J, Tian D, Qu Z (2014) Experiences of stigma and discrimination among caregivers of persons with schizophrenia in China: a Field Survey. PLoS One 9:1–11 Yin Y, Zhang W, Hu Z, Jia F, Li Y, Xu H, Zhao S, Guo J, Tian D, Qu Z (2014) Experiences of stigma and discrimination among caregivers of persons with schizophrenia in China: a Field Survey. PLoS One 9:1–11
21.
Zurück zum Zitat Xiang YT, Wang CY, Chiu HFK, Weng YZ, Bo QJ, Chan SS, Lee EH, Ungvari GS (2011) Socio-Demographic and clinical profiles of paranoid and nonparanoid schizophrenia: a prospective, multicenter study in China. Perspect Psychiatr Care 47:126–130CrossRefPubMed Xiang YT, Wang CY, Chiu HFK, Weng YZ, Bo QJ, Chan SS, Lee EH, Ungvari GS (2011) Socio-Demographic and clinical profiles of paranoid and nonparanoid schizophrenia: a prospective, multicenter study in China. Perspect Psychiatr Care 47:126–130CrossRefPubMed
22.
Zurück zum Zitat Tang WK, Lau CG, Mok V, Ungvari GS, Wong KS (2011) Burden of Chinese stroke family caregivers: the Hong Kong experience. Arch Phys Med Rehabil 92:1462–1467CrossRefPubMed Tang WK, Lau CG, Mok V, Ungvari GS, Wong KS (2011) Burden of Chinese stroke family caregivers: the Hong Kong experience. Arch Phys Med Rehabil 92:1462–1467CrossRefPubMed
23.
Zurück zum Zitat Yan F, Xiang YT, Hou YZ, Ungvari G, Dixon L, Chan SS, Lee EH, Li WY, Li WX, Zhu YL, Chiu HE (2013) Suicide attempt and suicidal ideation and their associations with demographic and clinical correlates and quality of life in Chinese schizophrenia patients. Soc Psychiatry Psychiatr Epidemiol 48:447–454CrossRefPubMed Yan F, Xiang YT, Hou YZ, Ungvari G, Dixon L, Chan SS, Lee EH, Li WY, Li WX, Zhu YL, Chiu HE (2013) Suicide attempt and suicidal ideation and their associations with demographic and clinical correlates and quality of life in Chinese schizophrenia patients. Soc Psychiatry Psychiatr Epidemiol 48:447–454CrossRefPubMed
24.
Zurück zum Zitat Ran MS, Mao WJ, Chan CLW, Chen EYH, Conwell Y (2015) Gender differences in outcomes in people with schizophrenia in rural China: 14-year follow-up study. Br J Psychiatry 206:283–288CrossRefPubMedPubMedCentral Ran MS, Mao WJ, Chan CLW, Chen EYH, Conwell Y (2015) Gender differences in outcomes in people with schizophrenia in rural China: 14-year follow-up study. Br J Psychiatry 206:283–288CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Ran MS, Xiang MZ, Huang M, Shan Y (2001) Natural course of schizophrenia: 2-year follow-up study in a rural Chinese community. Br J Psychiatry 178:154–158CrossRefPubMed Ran MS, Xiang MZ, Huang M, Shan Y (2001) Natural course of schizophrenia: 2-year follow-up study in a rural Chinese community. Br J Psychiatry 178:154–158CrossRefPubMed
26.
Zurück zum Zitat Pearson V (1993) Families in China: an undervalued resource for mental health? J Fam Ther 15:163–185CrossRef Pearson V (1993) Families in China: an undervalued resource for mental health? J Fam Ther 15:163–185CrossRef
27.
Zurück zum Zitat Lin KM, Kleinman AM (1988) Psychopathology and clinical course of schizophrenia: a cross-cultural perspective. Schizophr Bull 14:555–567CrossRefPubMed Lin KM, Kleinman AM (1988) Psychopathology and clinical course of schizophrenia: a cross-cultural perspective. Schizophr Bull 14:555–567CrossRefPubMed
28.
Zurück zum Zitat Borge L, Martinsen EW, Ruud T, Watne Ø, Friis S (1999) Quality of life, loneliness, and social contact among long-term psychiatric patients. Psychiatr Serv 50:81–84CrossRefPubMed Borge L, Martinsen EW, Ruud T, Watne Ø, Friis S (1999) Quality of life, loneliness, and social contact among long-term psychiatric patients. Psychiatr Serv 50:81–84CrossRefPubMed
29.
Zurück zum Zitat Yang K (1995) Chinese social orientation: an integrative analysis. In: Lin T, Tseng W, Yeh E (eds) Chinese societies and mental health. Oxford University Press, Oxford, pp 19–39 Yang K (1995) Chinese social orientation: an integrative analysis. In: Lin T, Tseng W, Yeh E (eds) Chinese societies and mental health. Oxford University Press, Oxford, pp 19–39
30.
Zurück zum Zitat Xiong W, Phillips M, Hu X, Wang R, Dai Q, Kleinman J, Kleinman A (1994) Family based intervention for schizophrenic patients in China: a randomised controlled trial. Br J Psychiatry 165:239–247CrossRefPubMed Xiong W, Phillips M, Hu X, Wang R, Dai Q, Kleinman J, Kleinman A (1994) Family based intervention for schizophrenic patients in China: a randomised controlled trial. Br J Psychiatry 165:239–247CrossRefPubMed
31.
Zurück zum Zitat Davidson RJ, Kabat-Zinn J, Shchumacher J, Rosenkranz M, Muller D, Santorelli SF, Urbanowski F, Harrington A, Bonus K, Sheridan JF (2003) Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med 65:564–570CrossRefPubMed Davidson RJ, Kabat-Zinn J, Shchumacher J, Rosenkranz M, Muller D, Santorelli SF, Urbanowski F, Harrington A, Bonus K, Sheridan JF (2003) Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med 65:564–570CrossRefPubMed
32.
Zurück zum Zitat Mattsson M, Topor A, Cullberg J, Forsell Y (2008) Association between financial strain, social network and five-year recovery from first episode psychosis. Soc Psychiatry Psychiatr Epidemiol 43:947–952CrossRefPubMed Mattsson M, Topor A, Cullberg J, Forsell Y (2008) Association between financial strain, social network and five-year recovery from first episode psychosis. Soc Psychiatry Psychiatr Epidemiol 43:947–952CrossRefPubMed
33.
Zurück zum Zitat Chien WT, Chan SW, Morrissey J (2007) The perceived burden among Chinese family caregivers of people with schizophrenia. J Clin Nurs 16:1151–1161CrossRefPubMed Chien WT, Chan SW, Morrissey J (2007) The perceived burden among Chinese family caregivers of people with schizophrenia. J Clin Nurs 16:1151–1161CrossRefPubMed
34.
Zurück zum Zitat Gumley AI, Taylor HEF, Schwannauer M, MacBeth A (2014) A systematic review of attachment and psychosis: measurement, construct validity and outcomes. Acta Psychiatr Scand 129:257–274CrossRefPubMed Gumley AI, Taylor HEF, Schwannauer M, MacBeth A (2014) A systematic review of attachment and psychosis: measurement, construct validity and outcomes. Acta Psychiatr Scand 129:257–274CrossRefPubMed
35.
Zurück zum Zitat Berry K, Wearden A, Barrowclough C (2007) Adult attachment styles and psychosis: an investigation of associations between general attachment styles and attachment relationships with specific others. Soc Psychiatr Psychiatr Epidemiol 42:972–976CrossRef Berry K, Wearden A, Barrowclough C (2007) Adult attachment styles and psychosis: an investigation of associations between general attachment styles and attachment relationships with specific others. Soc Psychiatr Psychiatr Epidemiol 42:972–976CrossRef
36.
Zurück zum Zitat Ran MS, Leff J, Hou ZJ, Xiang MZ, Chan CLW (2003) The characteristics of expressed emotion among relatives of patients with schizophrenia in Chengdu, China. Cult Med Psychiatry 27:95–106CrossRefPubMed Ran MS, Leff J, Hou ZJ, Xiang MZ, Chan CLW (2003) The characteristics of expressed emotion among relatives of patients with schizophrenia in Chengdu, China. Cult Med Psychiatry 27:95–106CrossRefPubMed
37.
Zurück zum Zitat Miralles C, Alonso Y, Verge B, Setó S, Gaviria AM, Moreno L, Cortés MJ, Gutiérrez-Zotes A, Vilella E, Martorell L (2014) Personality dimensions of schizophrenia patients compared to control subjects by gender and the relationship with illness severity. BMC Psychiatry 14:242–262CrossRef Miralles C, Alonso Y, Verge B, Setó S, Gaviria AM, Moreno L, Cortés MJ, Gutiérrez-Zotes A, Vilella E, Martorell L (2014) Personality dimensions of schizophrenia patients compared to control subjects by gender and the relationship with illness severity. BMC Psychiatry 14:242–262CrossRef
Metadaten
Titel
Family caregivers and outcome of people with schizophrenia in rural China: 14-year follow-up study
verfasst von
Mao-Sheng Ran
Cheryl H. K. Chui
Irene Yin-Ling Wong
Wen-Jun Mao
Fu-Rong Lin
Bo Liu
Cecilia Lai-Wan Chan
Publikationsdatum
02.01.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Social Psychiatry and Psychiatric Epidemiology / Ausgabe 4/2016
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-015-1169-0

Weitere Artikel der Ausgabe 4/2016

Social Psychiatry and Psychiatric Epidemiology 4/2016 Zur Ausgabe

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.