What is associated with caregiver burden for adults with bipolar affective disorder: Illness severity or financial well being?

ABSTRACT

Background: Persons with bipolar affective disorder (BPAD) need long-term care and support. As most of the expenses for this are met personally by the caregivers, it will have financial implications for them. However, we do not know how much financial well-being is associated with the caregivers' burden as compared to the illness severity. Aim: This study aimed to examine the association between financial well-being and illness severity with the caregivers' burden in the context of BPAD. Materials and Methods: This study adopted a cross-sectional descriptive design. The first 50 consenting caregivers of persons with an International Classification of Diseases (ICD)-10 diagnosis of BPAD, who visited the National Institute of Mental Health and Neurosciences (NIMHANS) within 2019-2021, were included in the study. The patients were assessed on the Clinical Global Impression (CGI) and the Global Assessment of Functioning (GAF) for the severity of the symptoms and the current level of functioning, respectively. Caregivers were assessed on the Personal Finance Well-Being Scale. Results: In this study, the majority of caregivers were males (62%), with a median, monthly household income of Rs. 24,000, and expenditure of Rs. 12,000. The median cost of medicine was Rs. 1000 per month. The majority (64%) of patients did not have any health insurance. A total of 28 (56%) caregivers reported the cost of damage due to illness behavior. It was found that the severity of illness and current level of functioning had a significant negative correlation with caregivers' burden. The financial well-being as reflected through income and health expenditure did not have a significant correlation with the caregivers' burden. Conclusions: Caregivers of persons with BPAD meet the treatment expenditure out of their pocket. Though they have the financial burden, it is the illness severity and functioning capacities that are associated with caregivers' burden. These findings have implications for mental health care in persons with BPAD.