Caregiver burden in alcohol dependence syndrome and its sociodemographic correlates: A cross-sectional study from South India

Jithin T  Joseph; V R Aniji; V  Arun; Mathew J Valamparampil

doi:10.30834/KJP.36.2.2023.401

Authors

Jithin T Joseph Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka https://orcid.org/0000-0001-6559-9497
Aniji V R Government Mental Health Centre, Thiruvananthapuram, Kerala
Arun V Government Mental Health Centre, Thiruvananthapuram, Kerala
Mathew J Valamparampil Department of Health Services, Government of Kerala

DOI:

https://doi.org/10.30834/KJP.36.2.2023.401

Keywords:

Caregiver burden, alcohol dependence syndrome, severity of alcohol dependence

Abstract

Background: Caring for people with severe mental and medical illness adversely affects their natural caregivers, which is measured as caregiver burden (CGB). Even though many studies have investigated CGB in chronic medical and mental illnesses, such studies are minimal in substance use disorders with a chronic course, relapses and remissions. The current study intended to investigate the extent of CGB among caregivers of alcohol dependence syndrome (ADS) patients and how different sociodemographic and clinical variables affect CGB. Methods: We conducted a cross-sectional study in a tertiary psychiatry hospital among those who were admitted for the treatment of alcohol dependence. One hundred patients and their caregivers were included in the study. Data was collected using a semi-structured questionnaire, the severity of dependence assessed using the Severity of Alcohol Dependence Questionnaire (SADQ) and the burden using the Burden Assessment Schedule. Data were analysed using SPSS software, and relevant statistical tests were used. Results: All our patients were male, educated and married. Most of the patients started alcohol use before the age of 20 years, had been using alcohol for more than 10 years, 91% had a history of deaddiction treatment, and 80% were using nicotine. Most caregivers were females, either the spouse or parent, from low socioeconomic status, nuclear families, from a rural background. Most were educated but didn't have jobs and stayed with the patient for more than 10 years. Our study found that 93% of the caregivers experienced moderate to severe burden, and 73% of the patients had severe alcohol dependence. The caregiver being illiterate, unemployed, and not having a permanent residence were significantly associated with a high caregiver burden, and the caregiver being male with a low burden. Patients being illiterate, unemployed, and having more than two previous admissions were the factors associated with a severe burden. Logistic regression analysis found caregiver gender and education, patient employment and number of admissions to be predictors of severe burden. Conclusions: There is a high burden among caregivers of alcohol dependent patients. Caregiver gender and education, patient employment and number of admissions were the predictors of severe burden.

References

Platt S. Measuring the burden of psychiatric illness on the family: An evaluation of some rating scales. Psychol Med 1985;15:383–93.

Smith BJ, Tang KC, Nutbeam D. WHO Health Promotion Glossary: new terms. Health Promot Int 2006;21:340-5. DOI: 10.1093/heapro/dal033.

Hoenig J, Hamilton MW. Elderly psychiatric patients and the burden on the household. Eur Neurol 1966;152:281–93.

Brouwer WBF, van Exel NJA, van de Berg B, Dinant HJ, Koopmanschap, van den Bos GAM. Burden of caregiving: evidence of objective burden, subjective burden, and quality of life impacts on informal caregivers of patients with rheumatoid arthritis. Arthritis Rheum 2004;51:570–7.

Möller-Leimkühler AM, Wiesheu A. Caregiver burden in chronic mental illness: the role of patient and caregiver characteristics. Eur Arch Psychiatry Clin Neurosci 2012;262:157–66.

Lasebikan VO, Ayinde OO. Family burden in caregivers of schizophrenia patients: prevalence and sociodemographic correlates. Indian J Psychol Med 2013;35: 60–6.

Gania AM, Kaur H, Grover S, Khan AW, Suhaff A, Baidya K, et al. Caregiver burden in the families of the patients suffering from bipolar affective disorder. British Journal of Medical Practitioners 2019;12: a006.

Mannelli P. The burden of caring: drug users & their families. Indian J Med Res 2013;137:636–8.

Given CW, Given B, Stommel M, Collins C, King S, Franklin S. The caregiver reaction assessment (CRA) for caregivers to persons with chronic physical and mental impairments. Res Nurs Health 1992;15: 271–83.

Pai S, Kapur RL. The burden on the family of a psychiatric patient: development of an interview schedule. Br J Psychiatry 1981; 138: 332–5.

Thara R, Padmavati R, Kumar S, Srinivasan L. Instrument to assess burden on caregivers of chronic mentally ill. Indian J Psychiatry 1998;40:21-9.

Rehm J, Gmel G, Sempos CT, Trevisan M. Alcohol-related morbidity and mortality. Alcohol Res Health; 2003;27:39-51.

World Health Organization. Global status report on alcohol and health 2018. Geneva: World Health Organization; 2018. DOI: /entity/substance_abuse/publications/global_alcohol_report/en/index.html.

Cargiulo T. Understanding the health impact of alcohol dependence. Am J Health Syst Pharm 2007;64(5 Suppl 3):S5-11. DOI: 10.2146/ajhp060647.

Ram F, Paswan B, Singh SK, Lhungdim H, Shekhar C, Singh A, et al. National Family Health Survey-4 (2015-16). Econ Polit Wkly 2017;52:66-70.

Daley DC. Family and social aspects of substance use disorders and treatment. J Food Drug Anal 2013;21:S73-6.

Suchman NE, Pajulo M, Mayes LC, editors. Parenting and substance abuse: Developmental approaches to intervention. New York: Oxford University Press;2013. Available from: https://doi.org/10.1093/med:psych/9780199743100.001.0001.

Rehm J. The risks associated with alcohol use and alcoholism. Alcohol Res Health 2011;34:135-43.

Vaishnavi R, Karthik MS, Balakrishnan R, Sathiananthan R. Caregiver burden in alcohol dependence syndrome. J Addict 2017; 2017: 8934712. doi: 10.1155/2017/8934712.

Rospenda KM, Minich LM, Milner LA, Richman JA. Caregiver burden and alcohol use in a community sample. J Addict Dis 2010;29: 314–24.

Kumar S, Schess J, Velleman R, Nadkarni A. Stigma towards dependent drinking and its role on caregiving burden: A qualitative study from Goa, India. Drug Alcohol Rev 2022;41:778–86.

Tyo MB, McCurry MK. An integrative review of measuring caregiver burden in substance use disorder. Nurs Res 2020;69: 391–8.

Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. PLoS Med 2007;4:1628–54.

World Health Organization. The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. Geneva: World Health Organization, 1993.

Sen SK, Victor R, Saxena K. Family burden in alcohol dependence: a study in north-eastern India. Int J Med Sci Public Health 2016;5:2402-9.

Stockwell T, Murphy D, Hodgson R. The severity of alcohol dependence questionnaire, reliability and validity. Br J Addict 1983; 78:145-55.

Cham CQ, Ibrahim N, Siau CS, Kalaman CR, Ho MC, Yahya AN, et al. Caregiver burden among caregivers of patients with mental illness: a systematic review and meta-analysis. Healthcare (Basel); 2022;10:2423. DOI: 10.3390/healthcare10122423.

Savage S, Bailey S. The impact of caring on caregivers' mental health: a review of the literature. Aust Health Rev 2004;27:111–7.

Gupta V. Female employment in India: tracking trends during 2005–2019. The Indian Journal of Labour Economics 2021;64:803–23.

Mattoo SK, Nebhinani N, Anil Kumar BN, Basu D, Kulhara P. Family burden with substance dependence: a study from India. Indian J Med Res 2013;137:704–11.

Official Website of Kerala State Economics and Statistics Department, Government of Kerala [Internet]. Literacy rates in 2011 census – district wise. Thiruvananthapuram: Department of Economics and Statistics, Government of Kerala; [reviewed 2023 Nov 2; cited 2023 Nov 2]. Available from: https://www.ecostat.kerala.gov.in/data-subset/292.

Bierut LJ, Dinwiddie SH, Begleiter H, Crowe RR, Hesselbrock V, Nurnberger Jr JI, et al. Familial transmission of substance dependence: alcohol, marijuana, cocaine, and habitual smoking: a report from the Collaborative Study on the Genetics of Alcoholism. Arch Gen Psychiatry 1998;55: 982–8.

Shekhawat BS, Jain S, Solanki HK. Caregiver burden on wives of substance-dependent husbands and its correlates at a tertiary care centre in Northern India. Indian J Public Health 2017;61:274–7.

Mishra N, Nagpal S, Chadda RK, Sood M. Help-seeking behavior of patients with mental health problems visiting a tertiary care center in north India. Indian J Psychiatry 2011;53:234–8.

Senthil M, Kiran M. Family interaction pattern among caregivers of patients with epilepsy and alcohol dependence. IOSR Journal of Humanities and Social Science (IOSR-JHSS) 2015;20:1–9.

Gossop M, Neto D, Radovanovic M, Batra A, Toteva S, Musalek M, et al. Physical health problems among patients seeking treatment for alcohol use disorders: a study in six European cities. Addiction Biol 2007;12:190–6.

Drobes DJ. Concurrent alcohol and tobacco dependence: mechanisms and treatment. Alcohol Res Health 2002;26:136-42.

Swaroopachary RS, Kalasapati L, Ivaturi S, Reddy PKCM. Caregiver burden in alcohol dependence syndrome in relation to the severity of dependence. Arch Ment Health 2018;19:19–23.

Mattoo SK, Ghosh A, Basu A. Substance use and family burden: A narrative review. Indian J Soc Psychiatry 2019;35:158-63.

Vadher S, Desai R, Panchal B, Vala A, Ratnani IJ, Rupani MP, et al. Burden of care in caregivers of patients with alcohol use disorder and schizophrenia and its association with anxiety, depression and quality of life. Gen Psychiatr 2020;33: e100215. DOI: 10.1136/gpsych-2020-100215.

Ohaeri JU. Caregiver burden and psychotic patients' perception of social support in a Nigerian setting. Soc Psychiatry Psychiatr Epidemiol 2001;36:86–93.