People who care for a severely mentally ill family member not only face a heavy emotional burden but are also at high risk of physical illness, new research shows.

Among 70 people who cared for family members with schizophrenia, those with the most severely ill family members had four times as many respiratory and other infections than did those who cared for the least ill patients, report scientists at Washington State University at Spokane, and the University of Washington, Seattle.

"Recent estimates indicate that between one-third and two-thirds of persons with long-term psychiatric disabilities currently reside with family members," said Dennis G. Dyck, PhD, head of the study. "Studies indicate that families are significantly affected by the responsibility of their caregiving function."

The researchers interviewed caregivers about their physical health during the previous six months, their coping strategies, their perceived support from others, and the level of burden they felt in caring for their ill family members. Investigators also assessed the severity and range of each patient's schizophrenia symptoms. Overall, 44 percent of the caregivers experienced at least one illness over the six-month period. The results of the study appear in the current issue of Psychosomatic Medicine.

The researchers found that the severity and range of the patient's symptoms predicted how burdened caregivers felt and how many infections they had experienced. Burden was highest among caregivers who cared for patients who were highly apathetic, emotionally flat, and rated high in other "negative" symptoms of schizophrenia.

Respiratory and other infections, in contrast, were more common the more severe the patients' "positive" symptoms of schizophrenia, including hallucinations, disorganized thoughts, and grandiose behavior.

As has been demonstrated in previous studies of caregivers, social support played a prominent role in the caregiver's health. Caregivers with the largest networks of friends and relatives to draw on felt the least burden in caring for their family members. Those who were most satisfied with the support they received from others experienced the fewest respiratory or other infections during the six-month period.

The researchers are currently testing a family education and support intervention designed to reduce caregiver isolation and burden and lessen relapse among patients with schizophrenia.

The study was supported by a grant from the National Institute of Mental Health.

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Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society, published bimonthly. For information about the journal, contact Joel E. Dimsdale, MD, at (619) 543-5468.