Caregiver Burden as a Potential Proxy Marker of Poor Psychosocial Functioning after Hospitalisation for Psychosis: A Brief Report

Abstract

Functional recovery after hospitalisation for psychosis may remain incomplete despite symptomatic improvement, and relatives often provide substantial informal care during this period. This post-hoc analysis examined whether caregiver burden at one-year follow-up was associated with patient psychosocial functioning and whether it could identify poor psychosocial functioning. Data were obtained from a prospective study of 96 patients hospitalised for psychotic exacerbation and their primary caregivers. Psychosocial functioning was assessed with the Personal and Social Performance Scale (PSP), and caregiver burden with the Burden Assessment Scale (BAS). Multivariable linear regression tested the association between BAS and PSP at follow-up, adjusting for diagnosis, age, comorbidity, baseline admission duration, and psychiatric rehospitalisation. Receiver operating characteristic analysis examined BAS classification accuracy for poor psychosocial functioning, defined as PSP < 60. Complete regression data were available for 83 patients. Higher BAS at follow-up was independently associated with poorer PSP, B = −0.906, SE = 0.152, β = −0.535, p < 0.001; the model explained 45.7% of PSP variance. BAS showed good classification accuracy for PSP < 60, AUC = 0.822, 95% CI [0.718, 0.927], p < 0.001. Caregiver burden may serve as a clinically useful family-reported proxy marker of poor psychosocial functioning after hospitalisation for psychosis.