IMPACT OF FAMILY BURDEN IN BIPOLAR DISORDER

双相情感障碍家庭负担的影响

• 批准号: 2250597
• 负责人: Deborah A. Perlick
• 金额: $ 22.66万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-09-01 至 1996-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2250597
• 关键词: bipolar depression; caregivers; community mental health services; computer data analysis; coping; family; health care service utilization; human subject; interview; longitudinal human study; mental health services; outpatient care; psychometrics; questionnaires; relapse /recurrence; social psychology; social support network

Bipolar affective disorder is a severe mental illness associated with low utilization of outpatient psychiatric services, and high rates of relapse and utilization of inpatient services; naturalistic studies indicate that about 50% of bipolar patients discharge from inpatient care are readmitted within 15-18 months. These data are particularly striking when viewed in the context of recent advances in the pharmacotherapy of bipolar disorder, demonstrating the urgent need for studies examining psychosocial influences on service use and outcome of bipolar patients, influences which have received scant attention to date. Family factors such as caregiver burden, social support and expressed emotion are known to exert a major influence on outcome in other major psychiatric disorders, but research on family factors in bipolar illness is virtually non-existent. The proposed research aims to examine the direct and indirect effects of family burden on outpatient service utilization, relapse and community tenure in bipolar illness, and to evaluate the scope of burden and associated mental health costs to families. 375 SADS-diagnosed bipolar patients consecutively admitted to an urban or suburban outpatient clinic and their family caregivers will be assessed on measures of patient symptoms and behavior, and on measures of family burden, health and coping: 1) upon admission; 2) 7 and 15 months later. Data on outpatient service utilization (duration, frequency, modality) will be entered into a computerized data base on an ongoing basis, and monthly measures of level and type of symptoms, role functioning and treatment compliance will be obtained. Linear structural equation analytic techniques (LISREL) will be used to model the relationships among exogenous (bipolar symptoms), mediating (family burden, health, coping) and service utilization and community tenure variables. Event history analysis will be employed to model the extent to which bipolar symptoms predict the risk of hospitalization at varying burden levels. The results will be used to develop more precisely targeted treatments to enable families and mentally ill persons to cope more effectively with the burdens of bipolar illness.

双相情感障碍是一种严重的精神疾病， 利用精神病门诊服务，复发率高 和利用住院服务;自然主义研究表明， 大约50%的双相患者从住院治疗出院， 15-18个月内再次入院。 这些数据尤其引人注目 在药物治疗的最新进展的背景下， 双相情感障碍，表明迫切需要研究检查 对双相情感障碍患者的服务使用和结局的社会心理影响， 迄今为止很少受到关注的影响。 家庭因素，如照顾者负担，社会支持和表达 情绪对其他专业的结果有很大的影响 精神障碍，但对双相情感障碍的家庭因素的研究 几乎不存在 拟议的研究旨在审查 家庭负担对门诊服务的直接和间接影响 利用，复发和社区保有权在双相情感疾病， 评估负担的范围和相关的心理健康费用， 家庭 375例确诊为SADS的双相情感障碍患者连续入住城市 或郊区门诊诊所和他们的家庭护理人员将 评估患者症状和行为的措施，以及措施 家庭负担、健康和应对：1）入院时; 2）7和15 月后 门诊服务利用数据（持续时间， 频率、方式）将输入计算机化数据库， 持续的基础上，每月测量的水平和类型的症状，作用 将获得功能和治疗依从性。 线性结构 方程分析技术（LISREL）将被用来模拟 外源性（双相症状）、介导性（家庭） 负担、健康、应对）和服务利用以及社区保有权 变量 将采用事件历史分析来模拟 双相情感障碍症状预测住院的风险， 负担水平。 研究结果将用于更精确地开发 有针对性的治疗，使家庭和精神病患者能够科普 更有效地减轻双相情感障碍的负担。