Caregivers’ burden and psychological distress in bipolar disorder in everyday clinical practice

• Nationwide study on interventions involving caregivers of patients with bipolar disorder in everyday clinical practice. • Caregivers reported low levels of burden and psychological distress. • Use of an emergency plan was associated with less burden in caregivers. The effect of interventions involving caregivers of patients with bipolar disorder (BD) in everyday clinical practice has been understudied. To investigate associations between the use of an emergency plan on emerging symptoms and participation in group psychoeducation versus burden and psychological distress experienced by caregivers, while controlling for patients’ severity of illness. A nationwide naturalistic study on long-term outpatient treatment of BD, using self-report questionnaires about patients’ treatment and illness outcome, caregivers’ burden as measured with the core module of the Involvement Evaluation Questionnaire (IEQ), and caregivers’ psychological distress as measured with the General Health Questionnaire (GHQ-12). In total 777 dyads of patients and caregivers participated. Caregivers reported low levels of burden and psychological distress. Use of an emergency plan was associated with decreased level of caregivers’ burden ( p =.014) and remained so ( p =.003) when testing the independent association given the effect of group psychoeducation and controlling for patients’ severity of illness. No evidence was found for an effect on psychological distress. Participation in group psychoeducation was not associated with either outcome measure. The study used self-report questionnaires, and possibly included better functioning patients with a Dutch cultural background, and more resilient caregivers being mostly spouse or partner. Use of an emergency plan was associated with less burden in caregivers of patients with BD. Longitudinal studies are needed to gain better insight in the effects of interventions on caregiver outcomes in BD.