Do carers of adolescents at first episode psychosis have distinctive psychological needs? A pilot exploration

McKenna, A., Hazell, C.M., Souray, R., Cai, E., Man, L.C., Brown, L., Floyd, C., Lyons, N., Widuch, K., James, G., Keay, D., Souray, J., Afsharzadegan, R. and Raune, D. 2021. Do carers of adolescents at first episode psychosis have distinctive psychological needs? A pilot exploration. International Journal of Social Psychiatry. Advanced online publication. https://doi.org/10.1177/0020764021992828

TitleDo carers of adolescents at first episode psychosis have distinctive psychological needs? A pilot exploration
TypeJournal article
AuthorsMcKenna, A., Hazell, C.M., Souray, R., Cai, E., Man, L.C., Brown, L., Floyd, C., Lyons, N., Widuch, K., James, G., Keay, D., Souray, J., Afsharzadegan, R. and Raune, D.
Abstract

Background:
Carers of patients experiencing first episode psychosis (FEP) are at an increased risk of mental and physical health problems themselves. However, little is known about how the psychological needs of carers may differ between those caring for an adolescent versus an adult who has FEP.

Aims:
This pilot study aimed to explore any differences in the psychological needs of carers caring for adolescents versus adults with FEP.

Methods:
We surveyed 254 carers of 198 FEP patients (34 carers of adolescents of 24 FEP adolescent patients). Carers completed self-report measures of anxiety, depression, burnout, subjective burden, coping, and key illness beliefs. The sample was divided according to whether the patient was under (adolescent) or over (adult) age 18, and analysed using mixed model logistic regressions.

Results:
Compared to the carers of adult patients, carers of adolescents were more than twice as likely (12% vs. 30%) to experience overall burnout syndrome (all three domains), and to develop it much quicker (19.4 vs. 10.1 months). They were also more likely to adopt behavioural disengagement avoidance as a form of coping. However, there was no difference between carers in terms of anxiety, depression, beliefs and subjective burden. For carers of adolescents, burnout was independently predicted by: a negative belief about the consequences of psychosis for the adolescent patient and an incoherent understanding of the patient’s mental health.

Conclusions:
If our findings can be replicated in a larger sample, then Rapid-Onset-Burnout-Syndrome (ROBS) is a particular problem in carers of adolescents at FEP, suggesting a need for routine screening and possible prophylactic intervention. Carers of adolescent’s use of behavioural escape coping maybe also require early intervention. Theoretically, consideration could be given to the development of an adolescent sub-branch to the cognitive model of caregiving.

KeywordsFirst episode psychosis, caregiver, adolescence, burnout, avoidant coping
JournalInternational Journal of Social Psychiatry
ISSN0020-7640
1741-2854
Year2021
PublisherSage
Accepted author manuscript
File Access Level
Open (open metadata and files)
Digital Object Identifier (DOI)https://doi.org/10.1177/0020764021992828
PubMed ID33554710
Web address (URL)https://journals.sagepub.com/doi/10.1177/0020764021992828
Publication dates
Published online07 Feb 2021

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