December 2025, Volume 3, Issue 12

Author

Senthil Kumar Arumugam Subramanian

Abstract

Introduction: Living with a person with major psychiatric illness burdens forcing a unique and predominantly negative experience down spiralling to burnout and chronic psychological morbidity in long-term caregivers. Quantifying the burden and burnout would be useful in screening, early diagnosis and therapy including primordial to tertiary prevention, protecting spousal carers from incarceration. Aims: The objective was to estimate burden and burnout correlates of caregiving experience, and study their association with severity of illness, apathy and duration of caregiving, among female spouses of persons with alcohol dependence syndrome, bipolar affective disorder and schizophrenia. Materials and Methods: In this cross-sectional, comparative study with consecutive samples of consenting male patients and their spouses 64 pairs in each group attending the Outpatient Psychiatry department at a tertiary care hospital in South India. Apathy inventory, SADDQ, CGI-BP and CGI-SCH, Burden Assessment Schedule, and a composite score from Care-derived Self-esteem subscale of Caregiver Reaction Assessment (CRA) scale, High appreciation subscale of Positive Caregiving Experience scale, and Burnout subscale of Negative Caregiving Experience scale, were used. Results: Total burden, and burden in 'spouse's mental health' dimension was higher both in bipolar and schizophrenia groups. Spouses perceiving increased apathy had higher burden scores in schizophrenia group, and lower in alcohol group. As duration of caregiving increased beyond 18 years in carers of alcohol dependents, the initial low burden scores spiked to become on par with other groups. Burnout experience was frequent in alcohol group. There was a positive correlation between burden and positive experience (overcoming burnout) with statistical significance, only in schizophrenia group. Burden and positive experience correlated positively with illness severity in all three groups, the most in alcohol group. Conclusion: Increased burden of care and burnout in female spouses are very common and severe in major psychiatric disorders and to similar levels in alcohol dependence syndrome. This warrants spouse-specific psychological treatment approaches to prevent depression in spouses, and improving drug adherence and prognosis in patients.