Do needs, symptoms or disability of outpatients with schizophrenia influence family burden?

Background Most needs of outpatients with schizophrenia are met by the family. This could cause high levels of family burden. The objective of this study is to assess the relationship between the patients' needs and other clinical and disability variables and the level of family burden. Method A total sample of 231 randomly selected outpatients with schizophrenia was evaluated with the Camberwell Assessment of Needs, Positive and Negative Syndrome Scale, Global Assessment of Functioning and Disability Assessment Scale. A total of 147 caregivers also answered the objective and subjective family burden questionnaire (ECFOS-II). Correlations between total number of needs and family burden, t tests between presence or absence of need for each domain of family burden and regression models between family burden and needs, symptoms, disability and sociodemographic variables were computed. Results The number of patients' needs was correlated with higher levels of family burden in daily life activities, disrupted behaviour and impact on caregiver's daily routine. The patients' needs most associated with family burden were daytime activities, drugs, benefits, self-care, alcohol, psychotic symptoms, money and looking after home. In a regression model, a higher number of needs, higher levels of psychopathology and disability, being male and older accounted for higher levels of family burden. Conclusion Patients with schizophrenia with more needs cause greater family burden but not more subjective concerns in family members. The presence of patients' needs (daytime activities, alcohol and drug), severity of psychotic symptoms and disability are related to higher levels of family burden.