Burden between caregivers of patients with symptomatic and remitted bipolar affective disorder: A comparative study

Abstract Background: Bipolar affective disorder (BPAD) significantly impacts both patients and their caregivers, especially in India, where stigma and limited community-based services increase caregiver responsibilities. Caregivers face emotional, physical, and financial demands, exacerbated by frequent patient relapses and high hospitalization rates. The present study seeks to compare caregiver burden between those caring for symptomatic and remitted BPAD patients and to examine the effects of caregiving burden on caregivers’ functioning. Methods: A cross-sectional comparison study was done among caregivers of symptomatic and remitted BPAD patients of a tertiary care hospital. The sociodemographic characteristics were recorded in a semistructured pro forma. The caregiver burden, patients’ overall functioning, and the patient’s symptom severity were assessed using standard scales. Results: The two groups of patients were similar based on sociodemographic characteristics. Caregivers of symptomatic BPAD patients experienced higher levels of burden ( t = 48.77, P < 0.001) and their patients had lower functioning ( t = −2.201, P = 0.008) compared to their counterparts. Among symptomatic patients, increased caregiver burden was associated with greater symptom severity ( r = 0.313, P = 0.012), and higher symptom severity was associated with reduced overall functioning ( r = −0.536, P < 0.001). Among remitted patients, increased caregiver burden was associated with reduced functioning in patients ( r = −0.508, P < 0.001) and lower symptom severity ( r = −0.277, P = 0.03). Conclusions: Acute, symptomatic phases in BPAD are associated with reduced functioning of patients and greater caregiver burden. Remission phases in BPAD, though associated with better overall functioning of patients, were still associated with high levels of caregiver burden possibly due to caregivers’ commitments and enduring responsibilities.