Caregiver Burden, Stress, and Belief Systems in Attendants of Individuals Afflicted with Psychiatric Illnesses

Authors

  • Rubab Zehra Memon
  • Shahab Muhammad
  • Asif Hanif
  • Ata Ullah
  • Hassan Iqbal
  • Asfia Waseem

Keywords:

Psychiatric illness, Caregiver burden, perceived stress, depression, Belief systems, Zarit Burden Interview, Perceived Stress Scale

Abstract

OBJECTIVE: To explore the magnitude of caregiver burden, psychological stress, and belief systems among individuals attending to psychiatric patients.

METHODOLOGY: A cross-sectional study was conducted on 363 caregivers of psychiatric patients at Department of Psychiatry, PNS Shifa Karachi, using structured interviews and validated tools to assess caregiver burden, stress levels, and belief systems. The study was conducted from January - July 2024. Caregivers of patients with psychiatric disorders aged 18 years and above were included and those who had a psychiatric illness, a history of taking medication for such conditions, and those diagnosed with Alzheimer's or memory loss excluded. Reliability scores for the instruments were 76.3% and 71.6%, respectively. Data was analyzed using SPSS 26.

RESULTS: This study reported that most patients were suffering from depression (60.6%), followed by anxiety (30.0%), and psychosis (9.4%). Caregivers were predominantly female (59%). 51% of caregivers reported moderate to severe burden, and 64.7% experienced moderate stress. No significant differences in burden or stress were found by caregiver or patient gender and relationship (p>0.05). However, both burden and stress were significantly higher among caregivers of patients with depression (p < 0.001). Belief in supernatural causes such as "Nazar" and "Jadu" was common, with 57% and 59% endorsing them, respectively.

CONCLUSION: Caregivers of psychiatric patients experience significant levels of burden and stress, particularly when dealing with depressive disorders. Belief in supernatural causes remains widespread and may influence perceptions and practices of caregiving. There is an urgent need for culturally tailored support systems, psychoeducation, and policy-level interventions.

References

1. Organization WH. Mental disorders 2022. Available from: https://www.who.int/news-room/fact-sheets/detail/mental-disorders.

2. Andualem F, Melkam M, Tadesse G, Nakie G, Tinsae T, Fentahun S et al. Burden of care among caregivers of people with mental illness in Africa: a systematic review and meta-analysis. BMC Psychiatry. 2024; 24(1): 778.

3. GBD 2019 Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatr. 2022; 9(2): 137-50.

4. Alvi MH, Ashraf T, Naz F, Sardar A, Ullah A, Patel A et al. Burden of mental disorders by gender in Pakistan: analysis of Global Burden of Disease Study data for 1990-2019. BJPsych Bulletin. 2024; 48(6): 333-40.

5. Radu M, Ciuc? A, Cri?an CA, Pintea S, Predescu E, ?ipos R et al. The impact of psychiatric disorders on caregivers: An integrative predictive model of burden, stigma, and well-being. Perspect Psychiatr Care. 2022; 58(4): 2372-82.

6. Liu Z, Heffernan C, Tan J. Caregiver burden: A concept analysis. Int J Nurs Sci. 2020; 7(4): 438-45.

7. Treudley MB. Mental illness and family routines. Ment Hyg. 1946; 30: 235-49.

8. 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(12): 2423.

9. Mirhosseini S, Parsa FI, Gharehbaghi M, Minaei-Moghadam S, Basirinezhad MH, Ebrahimi H. Care burden and associated factors among caregivers of patients with bipolar type I disorder. BMC Prim Care. 2024; 25(1): 321.

10. Milic J, Zrnic I, Vucurovic M, Grego E, Jovic D, Stankovic V et al. The Impact of Patient-Centered Care in Bipolar Disorder: An Opinion on Caregivers' Quality of Life. J Clin Med. 2025; 14(7): 2209.

11. Chen Y, Zhang L, Zhang S, Zhang J, Yu H, Li Q et al. Prevalence and sociodemographic configurations of anxiety and depression among caregivers of individuals with mental illness: A meta-analysis and qualitative comparative analysis. J Affect Disord. 2025; 375: 486-95.

12. Alzahrani SH, Fallata EO, Alabdulwahab MA, Alsafi WA, Bashawri J. Assessment of the burden on caregivers of patients with mental disorders in Jeddah, Saudi Arabia. BMC Psychiatry. 2017; 17(1): 202.

13. Hsiao CY, Lu HL, Tsai YF. Caregiver burden and health-related quality of life among primary family caregivers of individuals with schizophrenia: a cross-sectional study. Qual Life Res. 2020; 29(10): 2745-57.

14. Rady A, Mouloukheya T, Gamal E. Posttraumatic Stress Symptoms, Quality of Life, and Stress Burden in Caregivers of Patients With Severe Mental Illness: An Underestimated Health Concern. Front Psychiatr. 2021; 12: 623499.

15. Bédard M, Molloy DW, Squire L, Dubois S, Lever JA, O'Donnell M. The Zarit Burden Interview: a new short version and screening version. Gerontol. 2001; 41(5): 652-7.

16. Cohen S, Kamarck T, Mermelstein R. Perceived stress scale. Measuring stress: A guide for health and social scientists. 1994; 10(2): 1-2.

17. Phillips R, Durkin M, Engward H, Cable G, Iancu M. The impact of caring for family members with mental illnesses on the caregiver: a scoping review. Health Promot Int. 2022; 38(3): daac049.

18. Naik G, Kommisetty V, Renuka B, Ravikumar P, Pushpalatha S. Assessment of caregiver burden in psychiatric illness patients admitted in tertiary care hospital. Int J Acad Med Pharm. 2023; 5(6): 590-4.

19. Rahmani F, Roshangar F, Gholizadeh L, Asghari E. Caregiver burden and the associated factors in the family caregivers of patients with schizophrenia. Nurs Open. 2022; 9(4): 1995-2002.

20. Fatima S, Bashir N, Ain Qu, Assad F, Naheed A, Siddiqa S, et al. Anxiety, Depression and Coping Mechanisms in Caregivers of Psychiatric Patients. Foundation Univ J Psych. 2025; 9(1): 14-22.

21. Darlami K, Ponnose R, Jose P. Caregiver's stress of psychiatric patients. J Universal Coll Med Sci. 2015; 3(2): 39-43.

22. Barutcu CD. Secondary traumatic stress and coping strategies in family caregivers. Psychol Health Medicine. 2025: 1-13.

23. Tasmin S, Sultana H, Haque A, Islam MM, Alam MR, Halim KS et al. Stress and coping status among caregivers of major psychiatric patients. Bangla Med J. 2020; 49(1): 38-44.

24. Shafiq S. Perceptions of Pakistani community towards their mental health problems: a systematic review. Glob Psychiatr. 2020; 3(1): 28-50.

25. Khan Z, Qureshi O, Pasha A, Majid O, Saleem S, Fearon P et al. Exploring biomedical and traditional care pathways for people with psychosis in Karachi, Pakistan. Front Psychiatr. 2023; 14: 1086910.

26. Gupta AK, Grover S, Thapaliya S, Shrestha S, Sawant S, Shoib S. Pathways to care and supernatural beliefs among patients with psychotic disorders in Nepal. Middle East Curr Psychiatr. 2021; 28(1): 61.

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Published

31-12-2025

How to Cite

1.
Rubab Zehra Memon, Muhammad S, Asif Hanif, Ata Ullah, Hassan Iqbal, Asfia Waseem. Caregiver Burden, Stress, and Belief Systems in Attendants of Individuals Afflicted with Psychiatric Illnesses. J Liaq Uni Med Health Sci [Internet]. 2025 Dec. 31 [cited 2025 Dec. 31];24(04):360-5. Available from: http://121.52.154.205/index.php/jlumhs/article/view/1673

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