Family support and depression

High levels of support from one's family are associated with a more rapid recovery from depression while low levels are linked to people being ill for longer. However, there have been few long-term studies into this issue. Researchers from Stanford University studied 373 depressed people over a 23-year period. They found that higher family support was associated with less severe depression at the start of the study and a quicker recovery over the 23-year period. Women with supportive families reported the most rapid recovery from depression.

Kamen, Charles - Family Support and Depressive Symptoms: A 23-Year Follow-Up Journal of Clinical Psychology, Vol. 67(3), 215-223 (2011)

Measuring the burden of care

As more and more mentally-ill people are looked after in the community the responsibility for looking after them tends to fall on their relatives. A team of researchers from Karlstad University in Sweden looked into the 'burden of care' of 226 relatives from the Norwegian National Association for Families of Mentally-Ill Persons. They found that the relatives were 'burdened' and also reported poor health, with women experiencing a greater burden than men. For relatives who were single, divorced or widowed the burden of care was greater and health was poorer - and financial troubles and frequent phone calls with the mentally-ill relative made matters worse. The researchers also looked into the relatives' sense of coherence - the degree to which they found life to be comprehensible, manageable and meaningful - and found that this was lower in people who felt more of a sense of burden and had poorer health.

Weimand, Bente M. ... [et al] - Burden and Health in Relatives of Persons with Severe Mental Illness: A Norwegian Cross- Sectional Study Issues in Mental Health Nursing, 31:804–815, 2010

Bleak outlook for older alcoholics' partners

There has been quite a lot of research into the problems experienced by the spouses of people with drug problems among younger and middle-aged groups but much less on how a partner's drink problem affects older people. A team of researchers from Stanford University in California studied 167 people with an average age of 59.6. They fell into three groups; one group had partners who had never had a drinking problem, one group had partners who had had a drinking problem but had managed to get over it over the course of the 10-year study and the third group had partners who had a drink problem at the start and end of the study. At the start of the study the people whose partners had drink problems drank more themselves, had poorer health, were more depressed and had worse social lives than those whose partners did not drink. The spouses whose partners managed to give up drinking over the course of the study became comparable to the partners of non-drinkers by the end. However, the spouses of people who continued drinking heavily drank more, suffered more as a result of their drinking and had friends who approved more of drinking.

Moos, Rudolf H. ... [et al] - Spouses of older adults with late-life drinking problems: health, family and social functioning Journal of Studies on Alcohol and Drugs July 2010, 71(4), 506-514

Dementia spouses have increased risk

People married to someone with dementia are six times more likely than other people to develop the condition themselves. Researchers from Utah State University studied elderly couples where one of the partners had dementia. They took into account environmental factors and suggested that it was the stress of looking after someone with dementia that raised the risk in the spouses. Carers often report that looking after someone with dementia is more demanding than caring for someone with physical disabilities.

You can find out more about this research at

http://www.telegraph.co.uk/health/healthnews/7676967/Spouse-of-dementia-sufferer-six-times-more-likely-to-develop-same-condition.html

Research shows true cost of caring

Researchers from Pennsylvania State University and the Benjamin Rose Institute in Cleveland, Ohio have been looking into the toll taken on people looking after someone with dementia, and their findings do not make cheerful reading. The study of 67 caregivers found that they frequently experienced overwhelming stress that could lead to breakdown and depression. Behaviour issues were a common source of stress as well as the feeling of losing a relationship with a family member and conflict with siblings or relatives. Around 4 million people in the U.S. care for someone with dementia and some people end up doing so for 15 or 20 years.

You can find out more about this research at

http://www.sciencedaily.com/releases/2010/04/100422112641.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29&utm_content=Google+Reader

New website launched for psychosis carers

A new website giving straightforward information, advice and support to relatives and friends of people with psychosis – including people who have schizophrenia and bipolar disorder – was launched on the 8th of February.

http://mentalhealthcare.org.uk/

The Institute of Psychiatry, King’s College London, the South London and Maudsley NHS Foundation Trust and Rethink, the mental health charity that runs support groups for carers, worked together to set up the site and the Wellcome Trust gave a grant to pay for its development.

People looking after friends or relatives with psychosis want accurate, reliable information which they can get easily and quickly. Although there are lots of websites about psychosis on the internet, there are not many British ones, and even less that are reliable. Many of the sites say completely different things so it is hard to know who to believe.

The new site aims to solve these problems by providing:

• short films of interviews with health professionals and researchers talking about different aspects of psychosis, treatment and care
• Ask the Pharmacist, Ask the Psychologist and Ask the Psychiatrist pages where visitors to the site can submit general questions
• summaries of IoP research about psychosis, written in plain English
• information on how to get involved with research
• links to other useful websites.

All the information on the website is based on research carried out to learn more about the causes of psychosis, develop new treatments or improve existing ones. Researchers from the IoP and mental health professionals from SLAM provide information for the site which is easy to find your way around, clearly laid out and written in plain English. It uses simple language and explains mental health terms; gives information about drugs and their side effects; describes other treatments, such as psychotherapy and explains how mental health services work.

Measuring the effects of respite care

Carers of people with mental illness often suffer from an increased burden, distress, health problems and lower life satisfaction. Respite care involves relieving carers of their duties by employing professional carers and volunteers for a short time. Researchers from Queensland University in Australia studied 20 carers, 10 of whom used respite care and 10 of whom did not. Over the course of the 3-month study the group receiving respite care showed a decrease in burden but an increase in stress while the other group did not change over time.

Jardim, Claudia and Pakenham, Kenneth I. - Pilot investigation of the effectiveness of respite care for carers of an adult with mental illness Clinical Psychologist November 2009, 13(3), 87-93

Caregivers, sleep and stress

In the U.K. nearly seven million people provide help for a sick, disabled or elderly person and in the U.S. more than 44 million people have been identified as caregivers. Researchers from the University of Birmingham looked into the links between the burden of caring for someone and depression and anxiety in a sample of 393 caregivers. They found that the strain and burden of caregiving were linked to depression and anxiety both at the time and five years later. The quality of sleep was found to be an important factor in the link between caregiver stress and depression and anxiety.

Phillips, Anna C. ... [et al] - Symptoms of depression in non-routine caregivers: the role of caregiver strain and burden British Journal of Clinical Psychology November 2009, 48(4), 335-346

Measuring the burden on caregivers

Around 8% of adults with a mental-health problem have a serious mental illness, defined as a diagnosable mental disorder that is so long-lasting and severe that it seriously interferes with a person's ability to take part in important life activities. Many people with a severe mental illness live with their families and two-thirds of family caregivers are women. Studies have shown that these family members are at a high-risk of developing depression themselves and researchers from Case Western Reserve University in Ohio looked at 60 women care-givers of people with severe mental illness. Some of the participants were Caucasian and others were African-Americans. The Caucasians reported higher stress than the African-Americans although both groups were similar in depressive cognitions, resourcefulness and quality of life. In both groups stress was linked to depressive cognitions and both together were linked with poorer mental health. In African-Americans stress was also linked to lower personal resourcefulness and both together were linked to poorer mental health.

Zauszniewski, Jaclene A., Bekhet, Abir K. and Suresky, M. Jane - Relationships among perceived burden, depressive cognitions, resourcefulness, and quality of life in female relatives of seriously mentally-ill adults Issues in Mental Health Nursing 30(3), 142-150

Caregivers and elder abuse

A survey of 220 caregivers looking after a family member with dementia has found that abuse is more common than was previously thought. The survey was carried out by researchers from University College, London and surveyed people from a range of socio-economic and ethnic backgrounds. A third of caregivers said they frequently swore at or insulted their relative with dementia while half said that they occasionally screamed or yelled at them.

You can find out more about this research at

http://uk.reuters.com/article/healthNews/idUKTRE50M0G420090123?feedType=RSS&feedName=healthNews&sp=true

Service users' siblings

Little is known about the impact of learning disabilities and mental illness on service users' siblings. Researchers from the University of Wisconsin-Madison studied 351 people over a 46-year period all of whom had at least one sibling with either a mental illness or a learning disability and compared them to 791 people with unaffected siblings. The researchers found that people who had siblings with mental illnesses were 63% more likely to report having a depressive episode during their lifetime. Siblings of people with learning disabilities were more likely to live in the same states as them but reported much less contact with their learning-disabled siblings and reported feeling less emotionally close to them. People with a brother with a mental illness had lower levels of psychological wellbeing than those in the comparison group but people with a sister with mental illness were not at increased risk of a mental-health problem.

http://psychcentral.com/news/2008/12/10/challenges-for-siblings-of-mentally-disabled/3482.html

Fathers with psychosis

One in five men with chronic mental-health problems are fathers yet despite this no research has specifically investigated fathers with psychosis. A qualitative study of 10 fathers with psychosis being treated by community mental health services in West and North London looked at some of the ways psychosis affected fatherhood. The fear of one's children inheriting psychosis was a common concern among the group but they also identified positive aspects of fatherhood including: a sense of pride in the father role, a sense of purpose to one's life, a feeling of pleasure in the creation and development of life and the motivation to change for the better.

Evenson, Erik ... [et al] - The experience of fathers with psychosis Journal of Mental Health December 2008, 17(6), 629-642

Psychosocial intervention for dementia caregivers

As well as affecting those who actually have the condition Alzheimer's disease also takes a terrible toll on caregivers, leading to anxiety and depression among this group. A U.S. study of 158 spouse-caregivers looked into the effectiveness of counselling and social support in helping to prevent or ameliorate depression. Half the participants were given a comprehensive psychosocial intervention, including two individual and three family counselling sessions, as well as telephone counselling on demand for two years; the other participants were merely given information on request. Symptoms of depression in the caregivers were measured at the start of the study, and at regular follow-up assessments over two years. Over the course of the study the group receiving the psychosocial intervention showed reduced levels of depression whereas levels of depression increased in the control group.

You can find out more about this research at

http://psychcentral.com/news/2008/11/03/intervention-helps-alzheimer-caregivers/3254.html

ADHD ups divorce risk

A study of 488 children and their families in Pittsburgh, U.S. has found that families with young children with Attention Deficit Hyperactivity Disorder (ADHD) were almost twice as likely to divorce, although there was no difference in the divorce rate after the child reached eight. The study found that for families with children with ADHD having a father with antisocial behaviour was the biggest risk factor for divorce. Other risk factors were: mothers who had substantially less education than their fathers; children being diagnosed with ADHD at a younger age; being from an ethnic minority and children who also had serious problems with 'oppositional defiant disorder' (not doing what they were told) and 'conduct disorder' (being naughty).

You can find out more about this research at

http://psychcentral.com/news/2008/10/22/childs-adhd-increases-divorce-risk/3176.html

Men coping with women's drinking

The impact of having a close relative with a drinking problem can be considerable. The family directly experience the consequences of the drinking behaviour and attempts to cope can produce a variety of negative emotional, psychological, physical and social reactions. And, in turn, family members' coping strategies can have a role in the progression of people's drinking problems. Despite a significant amount of research looking at the families of problem drinkers, little is known about male partners of problem drinkers. Some studies have found that men use a withdrawal style of coping behaviour either physically (by going into a different room or going out) or emotionally (by avoiding confrontation or an active involvement in the problem). A study of 29 male partners of female problem drinkers found that, in fact, the men were more likely to use engaged coping behaviours, trying to change their partners' drinking behaviour, than withdrawal ones. However, the longer the women had had a drink problem the more likely the men were to use a passive or withdrawn coping style.

Philpott, H. and Christie, M.M. - Coping in male partners of female problem drinkers Journal of Substance Use June 2008, 13(3), 193-203

Suicide and support in Sweden

A team of researchers looking into unnatural teenage deaths in northern Sweden analysed 10 cases of suicide to see their effect on family members left behind. They examined post-suicidal reactions, impacts on daily living and the families' need for support after the event. At the time of the research the participants were still struggling to explain why the suicide had occured. Although most had returned to an ostensibly normal life they were still profoundly affected by their loss. They said that post-suicide support was often badly-timed and insufficient, especially for younger siblings, and said that they would welcome earlier assistance from friends, family and the clergy.

You can read more about this research at

http://psychcentral.com/news/2008/04/22/family-support-after-teen-suicide/2174.html

Sense of coherence and stress in caregivers

Sense of Coherence is a perception of the world as comprehensible, manageable and meaningful. It develops during childhood and youth and is thought to be fully developed by the age of 30 after which it remains stable unless radical changes in living or social surroundings take place. Sense of Coherence is believed to be important to people's mental health and has been found to be low in neurotic patients and even lower in depressed patients. A U.S. study of 60 women family members of adults with severe mental illness looked into the links between caregiving, stress and Sense of Coherence. The study found that higher levels of stress decreased people's Sense of Coherence and quality of life. But, a greater Sense of Coherence enhanced people's quality of life and helped to ameliorate some of the effects of stress.

Suresky, M. Jane, Zauszniewski, Jaclene A. and Bekhet, Abir K. - Sense of coherence and quality of life in women family members of the seriously mentally ill Issues in Mental Health Nursing March 2008, 29(3), 265-278

Children of depressed parents - 23 years later

Many children of depressed parents are at risk of poor functioning but few studies have followed them into adulthood to see how they are doing then. A study of 476 people in the U.S. compared the children of depressed parents with a control group. Children with depressed parents were more likely to be depressed themselves and to suffer from disability and obtained more help for mental-health problems. They also reported more severe recent stressors but were more likely to use positive thinking and seek alternative rewards in order to cope. There was no difference in the levels of other mental-health problems, physical functioning and pain, social functioning and hospitalizations and medication use for depression. Adult children of parents who had still not recovered from their depression were the most likely to show impaired functioning compared to the control group.

Timko, C. ... [et al] - Functioning status of adult children of depressed parents: a 23-year follow up Psychological Medicine March 2008, 38(3), 343-352

Caring for people with eating disorders

It is well established that caring for someone with a mental health problem has negative effects on both the mental and physical health of the carer and previous research has found that the carers of people with eating disorders experience a high level of distress and burden in their caregiving role. A sample of 115 individuals currently caring for someone with an eating disorder found that approximately 36% of them showed mental-health difficulties with 17% experiencing high psychological distress. A negative experience of caregiving was associated with carers' distress. The dependency of the individual with the eating disorder and the stigma associated with the illness were most highly predictive of carers' distress. Looking after someone who had recently become ill, higher levels of needs and a higher perception of the seriousness of the consequences of eating disorders also contributed to greater negative caregiving appraisals. The belief that the illness was attributable to the sufferer's personality was associated with fewer positive appraisals of caregiving.

Whitney, Jenna ..l [et al] - Caring for people with eating disorders: factors associated with psychological distress and negative caregiving appraisals in carers of people with eating disorders British Journal of Clinical Psychology 2007 46(4), 413-428

Post-traumatic stress disorder and growth in wives and partners

Post-traumatic stress disorder (PTSD) can have many negative effects, not just on the people suffering from it but on their wives and partners as well. They can suffer from tension, physical illness, anxiety, depression, low self-esteem, loneliness, confusion, loss of control and self-blame. However, most women continue to cope and stay with their husbands and recent research has been addressing how they cope with their partners' problems. Research has found that they maintain a reservoir of good feelings towards their husbands from before their mental-health problems and that the experience of watching their husbands' daily struggle can deepen their appreciation of their courage and determination and enhance their love for them. Their husbands' struggle serves as an example which facilitates their coping and their husbands' difficulties were often seen as enhancing their sensitiveness towards their wives. The women also gained a sense of strength and empowerment from their own struggle to help their husbands and keep their families together. These unexpected gains from their partners' PTSD have been called post-traumatic growth. A study of 161 wives of veterans of the Yom Kippur war in Israel compared those married to former prisoners of war (who, for the purposes of the study were assumed to have suffered from more PTSD) with those married to other veterans of the conflict. The researchers also looked at the women's attachment styles. Attachment is the way in which we make and conduct relationships with other people. Those who show avoidant attachment prefer not to rely on or open up to other people, feel uncomfortable with intimacy and are less secure with depending on others and having others depend on them. Those who show anxious attachment tend to worry about whether their partner is available to them and responsive. People with secure attachment are comfortable with intimate relationships and see their partner as being responsive. They perceive themselves in a positive and coherent way, have good problem-solving skills, tend to view stressful situations optimistically and believe that others will help them in their time of need. The study found that the wives of former prisoners of war had both higher levels of distress and of growth than the wives of former veterans. The worse their husbands' PTSD the higher the wives' levels of growth and distress were. Those women with anxious and avoidant attachment styles suffered from more distress but also experienced more growth as a result of their husbands' PTSD.

Dekel, Rachel - Post-traumatic distress and growth among wives of prisoners of war : the contribution of husbands' post-traumatic stress disorder and wives' own attachment American Journal of Orthopsychiatry July 2007, 77(3), 419-426