Burden of care in caregivers of patients with alcohol use disorder and schizophrenia and its association with anxiety, depression and quality of life

Background Caregivers play a pivotal role in providing care for mentally ill patients.Increase in caregiver burden can make them vulnerable to mental illness themselves.Aims We assessed the severity of burden of care and its association with depression,anxiety and quality of life among caregivers of patients with alcohol use disorder(AUD)and schizophrenia.Methods This was an observational,cross-sectional,single-centred study of 50 consecutive caregivers of patients with AUD and schizophrenia.Participants were recruited from the psychiatry outpatient department of a tertiary care hospital between January and June 2017.The caregivers were further assessed by demographic details,Hospital Anxiety Depression Scale for assessment of depression and anxiety,Zarit Burden Interview for assessment of caregiver burden and WHO Quality Of Life-BREF for assessment of quality of life.Statistical data were analysed using GraphPad InStat V.3.06(California).Multiple linear regression analysis was applied to identify the predictors of caregiver burden.Results Burden of care experienced by caregivers of patients with AUD is as high as that of caregivers of patients with schizophrenia(U=1142.5,p=0.46).Caregivers experiencing high burden of care are likely to have symptoms of anxiety(U=22,p<0.001),depression(U=32,p<0.001)and poor quality of life(U=84.5,p<0.001).Female caregivers are likely to experience higher burden of care(U=819.5,p=0.006).For caregivers of patients with schizophrenia,anxiety,environmental health,socioeconomic status and patients,occupation can predict burden of care,while for caregivers of patients with AUD,depression and environmental health can predict burden of care.Conclusion Our study suggests that caregivers of patients with AUD experience burden of care as high as that of caregivers of patients with schizophrenia.Caregivers with high burden of care are more likely to have depression,anxiety and poor quality of life.Trial registration number CTRI/2017/03/008224.

Impact of clinical posting in psychiatry on the attitudes towards psychiatry and mental illness in undergraduate medical students

Background A major public health problem around the world today is mental illness. Although there are several studies on the topic, it is rarely conducted in the context like the current study. Aims This study aims to find out the attitudes of medical students towards psychiatry and mental illness as a clinical medicine major and evaluate the effects of clinical posting on their attitudes towards psychiatry and mental illness. Methods This is a longitudinal study of 6 months* duration conducted with students in their fifth semester of medical college in Western India during the academic year of 2016-2017. The participants were assessed by pro forma containing demographic details, and the questionnaires—Attitude Towards Psychiatry-30 items (ATP-30) scale and Mental Illness Clinician's Attitude (MICA) scale, which were presented to the students at the beginning and at the end of their psychiatry clinical posting. The statistical analysis was done with GraphPad, InStat V.3.06. A p value <0.05 was considered statistically significant. Results The students' attitudes towards psychiatry were neutral at the beginning of the psychiatry clinical posting, and improved significantly at the end of the posting on both scales: ATP-30 (p=0.002) and MICA (p=0.048). The students became more positive towards the subject and mental illness in general, negative attitudes also reduced but the change was not statistically significant (p=0.058). We found significant improvement in students' thinking towards being a psychiatrist in the future post-term (p=0.0002). The changes in attitude in terms of gender were equivocal, with an increase in positive attitude and reduction in negative attitude post-term in both sexes. Conclusion Psychiatry clinical posting aids in cultivating positive attitude towards psychiatry and mental illness and reduces the stigma associated with the students of this major and psychiatric patients.