Personality factors and mental health outcome in caregivers of first hospitalized schizophrenic and depressed patients: 2-year follow-up results.

While neuroticism has been intensely investigated in caregivers of patients with serious somatic disorders, studies in caregivers of patients with mental illness are lacking. Additionally, most studies are cross-sectional not allowing conclusions about long-term effects of personality factors. The present study examines the impact of personality factors on the course of subjective burden and psychological well-being by a mediational model in a sample of caregivers of first hospitalized patients with schizophrenia or depression within a 2-year follow-up period. At baseline, 83 caregivers could be enrolled in the study, the drop-out rate was about 23% at 2-year follow-up. Personality factors were assessed by the German version of the NEO-FFI (Borstenau and Costa 1993) only at baseline. At each follow-up, subjective burden was assessed by the FBQ (Möller-Leimkühler acc. to Pai and Kapur (Brit J Psychiat 138:332-335, 1981)), and psychological well-being by the SCL-90 R (Derogatis in SCL-90-R, administration, scoring and procedures. Manual for the r(evised) version. John Hopkins University School of Medicine, Baltimore, 1977). Among the personality factors, neuroticism turned out to be the most relevant predictor of subjective burden and self-rated symptoms, showing direct as well as indirect effects. The direct effects on caregivers' mental health were mediated to a considerable amount by subjective burden. The mediational model was stable across time and even revealed increasing indirect effects of neuroticism. Caregivers' neuroticism as a dispositional trait plays a crucial role in the course of the stress process. As neuroticism is associated with perceptual distortion, the latter should be targeted by long-term family interventions in order to reduce subjective burden and enhance mental health of the caregivers.