Quality of life of adult daughters of women with schizophrenia: Associations with psychological resource losses and gains

Psychological and physical wellbeing in adults who grew up with a mentally ill parent: A systematic mixed-studies review

OBJECTIVE

Genetic vulnerability factors and adverse childhood experiences (ACE) are associated with an increased risk of psychopathology and other adverse health outcomes across the lifespan. However, less is known about how childhood experiences of parental mental illness affect psychological and physical wellbeing in adulthood. This review synthesizes research on the consequences of growing up as a child of a parent with mental illness (COPMI) for adult psychological and physical wellbeing.

METHODS

A systematic review was conducted following PRISMA guidelines using a mixed-method-studies approach to enable evaluation of the broad array of research designs (Prospero registration #CRD42020221983).

RESULTS

Qualitative studies (k = 10; N = 361) revealed that a COPMI background is associated with substantial psychological challenges in adulthood. Quantitative studies (k = 21; N = 865.402) suggested that COPMI are at increased risk of adult psychopathology, including anxiety and depressive disorders, suicidality, somatoform disorders, substance abuse, but also general medical morbidity and mortality.

CONCLUSIONS

Growing up with a mentally ill parent is associated with adverse psychological and physical outcomes in adulthood, but the evidence-base is limited. Longitudinal studies are needed that go beyond establishing genetic and environmental risk factors to further evaluate how a COPMI background influences wellbeing in adulthood and which targeted clinical interventions could be developed.

Focusing on quality of life in the family caregivers of patients with schizophrenia from the perspective of family functioning: A cross-sectional study

The study aimed to explore the association between family functioning and quality of life (QOL) in family caregivers of patients with schizophrenia.Totally 121 family caregivers were surveyed in the cross-sectional study by the self-administration questionnaires about sociodemographic characteristics, family functioning and QOL. Family functioning was evaluated in terms of the family assessment device and the Family Adaptability and Cohesion Evaluation Scale II China Version. QOL was evaluated in terms of TSDHE short-form 12-item health survey, version 2. Multiple regression models were built to explore the association between QOL and family functioning.A regression analysis showed that poorer physical health of family caregivers was significantly associated with the lower educational level of caregivers, the closer kinship with patients and the multiple episodes schizophrenia. The other regression analysis showed that better family adaptability and affective responsiveness were significantly associated with the better mental health of family caregivers.Family functioning is associated with mental health rather than the physical health of family caregivers. Psychoeducational intervention could focus on family caregivers with a lower educational level and closer kinship, and those who look after patients with multiple episodes schizophrenia. Further family intervention could focus on family adaptability and affective expression in family caregivers of patients with schizophrenia.

Quality of life and self-esteem in 7-year-old children with familial high risk of schizophrenia or bipolar disorder: the Danish High Risk and Resilience Study-VIA 7-a population-based cohort study

It is well established that children with familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) have a higher risk of developing mental disorders, however, little is known of to what degree the genetic and environmental vulnerabilities affect the quality of life and self-esteem of these children. We aimed to compare the quality of life and self-esteem between children with FHR-SZ or FHR-BP and controls. We used Danish nationwide registers to retrieve a cohort of 522 7-year-old children with FHR-SZ or FHR-BP and controls. Quality of life was assessed with the 'Health-related Quality of Life Screening Instrument', KIDSCREEN-27, and the scale 'Social Acceptance (Bullying)' from the KIDSCREEN-52. Self-esteem was assessed with the self-report scale 'I think I am'. Assessors were blind to familial risk status of the children. Children with FHR-SZ displayed lower levels of the general quality of life, as well as lower scores on the 'Psychological Well-being' scale and the 'School Environment' scale of the KIDSCREEN-27 compared with controls. Both children with FHR-SZ and FHR-BP reported more bullying victimization compared with controls. Children with FHR-SZ reported lower self-esteem on the total scale of 'I think I am', as well as on the 'Skills and talents', the 'Psychological well-being', and the 'Relationships with others' subscales compared with controls. The findings of lower quality of life and self-esteem in children with FHR-SZ together with more bullying victimization in both familial high-risk groups call for studies on low risk, early intervention strategies towards this group of vulnerable children.