Which factors influence the psychological distress among relatives of patients with chronic functional psychoses? An exploratory study in a community mental health care setting

Abstract

Aim: This research aimed to assess the contribution of the five core areas of the transactional stress model to the relatives' psychological distress (PD) when informally taking care of patients with functional psychoses treated in community mental health care. Subjects and methods: Cross-sectional data from 163 relatives were collected in interviews, while data on 158 patients were collected by analyzing clinical charts. The following areas were assessed: socio-demographic and illness-related features of the patients, socio-demographic features of the relatives (environmental variables); sense of coherence, mastery, causal attributions and opinions of relatives about mental disorders (person variables); interpersonal problems with the patients as well as the assessment of their symptoms by the relatives themselves (primary appraisal); support received, critical life events and burden of relatives caused by their own illnesses (secondary appraisal); control behavior and efforts of relatives to engage the patients in activities (coping). PD was assessed with the 12-item version of the General Health Questionnaire. Bi-variate correlation analysis and a multiple linear regression model were the main test statistical approaches. Results: Correlation analysis showed that differences between diagnostic groups referred to primary and secondary appraisal processes, in particular. Results of the statistical model provided evidence for the importance of primary appraisal and person variables for influencing PD, and for the lack of importance of coping and environmental variables. Conclusion: The study enhanced the validity of the transactional stress model to demonstrate the influence of salutogenetic concepts such as sense of coherence.