Burden among caregivers of patients with substance use disorder

Main Article Content

Anchida Khamkaew


Objective: To study the burden of caregivers and the factors associated with caregiver burden among caregivers of patients with substance use disorder at Somdejphajaotaksinmaharaj Hospital

Methods: This study was a cross-sectional descriptive design. Participants were 64 caregivers of patients with substance use disorder (diagnosed by psychiatrists) who received treatment at outpatients and inpatients of the psychiatric department in Somdejphajaotaksinmaharaj Hospital during May 2022-October 2022.  Participants had to be over 18 years old and had been taking care of the patients for at least 6 months. The instruments for data collection included demographic characteristics of caregivers and patients, the Thai version of Zarit Burden Interview (ZBI), and Substance Use Disorder Screening Test (SUDST).

Results: According to data collected from 64 caregivers, it was found that 50 caregivers (78.1%) perceived no burden to mild burden and 14 caregivers (21.9%) perceived moderate burden to severe burden. The majority of caregivers in this study were female with an average age of 47.65 years, married, parents, and employed. About 35.9% of caregivers have ever had a bad experience in taking care of patients, including being verbally abused (21.9%), physically abused (0.4%), and having the patients refuse to cooperate during activities of caring (28.1%). For patients, it was found that most of the patients were male with an average age of 33.62 years, had a severe level of disorder (59.4%), and had been hospitalized (48.4%). The result from logistic regression analyses showed that the factors statistically significantly associated with moderate to severe caregiver burden were having been physically abused by the patients (adjusted OR 32.549, 95%CI 2.709-391.041, p=0.006) and the patient’s history of hospitalization (adjusted OR 6.417, 95%CI 1.228-33.525, p=0.028).

Conclusion: The study revealed that most of the participants perceived no to mild burden, and the factors associated with a moderate to severe burden of care were having a history of being physically abused and the patient’s history of hospitalization. Caregivers’ burden might cause health problems. Therefore, physicians should recognize and assess such conditions to reduce the incidence or severity of illness. Based on this study, if the caregiver has a history of being abused or the patient has previously been hospitalized, they should be monitored and screened for physical and mental health problems to reduce subsequent illnesses and provide proper treatment.

Article Details

How to Cite
Khamkaew, A. (2023). Burden among caregivers of patients with substance use disorder. Journal of the Psychiatric Association of Thailand, 68(2), 181–193. Retrieved from https://he01.tci-thaijo.org/index.php/JPAT/article/view/261155
Original Articles


Thiraphon Singlor. ‘More people are using drugs, and there are more drugs, and more types of drugs, than ever ’ [Internet]. Bangkok: Centre for SDG Research and Support: SDG Move; 2022 [cited 2023 Mar 16]. Available from: https://www.sdgmove.com/2022/06/24/report-unodc-drug-east-southeast-asia-2022/

American Psychiatric Association. Substance-related and addictive disorders. In: American Psychiatric Association, editor. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington(VA): American Psychiatric Association Publishing; 2013. p. 481-589.

United Nations Office on Drugs and Crime (UNODC). World drug report 2020. Place unknown: United Nations publication; 2020.

Bethesda (MD). Common comorbidities with substance use disorders research report [Internet]. place unknown: National Institutes on Drug Abuse (US); 2018 [cited 2023 Mar 20]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK571451/

Mueser KT, Gottlieb JD, Cather C, Glynn SM, Zarate R, Smith MF, et al. Antisocial personality disorder in people with co-occurring severe mental illness and substance use disorders: clinical, functional, and family relationship correlates. Psychosis 2012;4(1):52–62.

Armstrong TD, Costello EJ. Community studies on adolescent substance use, abuse, or dependence and psychiatric comorbidity. J Consult Clin Psychol 2002;70(6): 1224–39.

Ross S, Peselow E. Co-occurring psychotic and addictive disorders. Clin Neuropharmacol 2012; 35(5): 235–43.

Hannah Ritchie and Max Roser. Drug use [Internet]. Place unknown: Our World in Data; 2019 [cited 2022 Mar 16]. Available from: https://ourworldindata.org/drug-use

Ayakdas Dagli D, Baysan Arabaci L, Tas Soylu G, Buyukbayram Arslan A. Relationship between caregivers’ care burden and their social functioning perceptions toward addicted patients: a cross-sectional survey. Florence Nightingale J Nurs 2021;29(3):353–60.

Vadher S, Desai R, Panchal B, Vala A, Ratnani IJ, Rupani MP, et al. Burden of care in caregivers of patients with alcohol use disorder and schizophrenia and its association with anxiety, depression and quality of life. Gen Psychiatr 2020;33(4); e100215.

Vaishnavi R, Karthik MS, Balakrishnan R, Sathianathan R. Caregiver burden in alcohol dependence syndrome. J Addict 2017;2017:1–6.

Swaroopachary R, Kalasapati L, Ivaturi S, Reddy C. Caregiver burden in alcohol dependence syndrome in relation to the severity of dependence. Arch Ment Health 2018;19(1):19–23.

Kaur A, Mahajan S, Deepti SS, Singh T. Assessment of role of burden in caregivers of substance abusers: a study done at Swami Vivekananda Drug De-addiction Centre, Govt. Medical College, Amritsar. Int J Community Med Public Health 2018;5(6):2380-2383.

Ólafsdóttir J, Hrafnsdóttir S, Orjasniemi T. Depression, anxiety, and stress from substance-use disorder among family members in Iceland. Nordisk Alkohol Nark 2018;35(3):165–78.

Daley DC. Family and social aspects of substance use disorders and treatment. J Food Drug Anal 2013;21(4): S73–6.

Lander L, Howsare J, Byrne M. The impact of substance use disorders on families and children: from theory to practice. Soc Work Public Health 2013; 28(3–4):194–205.

Mauri MC, Cirnigliaro G, Piccoli E, Vismara M, de Carlo V, Girone N, et al. Substance abuse associated with aggressive/violent behaviors in psychiatric outpatients and related psychotropic prescription. Int J Ment Health Addict [Internet]. 2022[cited 2023 Mar 20]; Available from: https://doi.org/10.1007/s11469-022-00842-w

Noghani F, Seyedfatemi N, Karimirad MR, Akbarzadeh A, Hasanpour-Dehkordi A. Health related quality of life in family caregivers of patients suffering from mental disorders. J Clin Diagn Res 2016;10(11): VC05–9.

Sharma A, Sharma A, Gupta S, Thapar S. Study of family burden in substance dependence: a tertiary care hospital-based study. Indian J Psychiatry 2019;61(2):131–8.

Kittirattanapaiboon P, Tantirangsee N, Chutha W, Tanaree A, Kwansanit P, Assanangkornchai S. Prevalence of mental disorders and mental health problems: Thai national mental health survey 2013. J Ment Health Thai 2017;25(1):1-19.

พระราชบัญญัติให้ใช้ประมวลกฎหมายยาเสพติด พ.ศ.2564.[สืบค้นเมื่อ 28 มีนาคม 2566]. ราชกิจจานุเบกษา เล่ม 138 ตอนที่ 73ก (ลงวันที่ 8พฤศจิกายน พ.ศ.2564). สืบค้นจาก: https://ratchakitcha.soc.go.th/documents/17186429.pdf

Whitlatch CJ, Zarit SH, von Eye A. Efficacy of interventions with caregivers: a reanalysis. Gerontologist 1991; 31(1):9–14.

Zarit SH, Zarit JM. Instructions for the burden interview. Technical Document, University Park (PA): Pennsylvania State University; 1987.

Zarit SH, Zarit JM. The memory and behavior problems checklist and the burden interview. University Park (PA): The Pennsylvania State University, Gerontology Center; 1990.

Orawan Silpakit, Chatchawan Silpakit, Rossukon Chomchuen. Psychometric study of the Thai version of Zarit Burden Interview in psychiatric caregivers. J Ment Health Thai 2015; 23(1):12-23.

Pinyopornpanish K, Pinyopornpanish M, Wongpakaran N, Wongpakaran T, Soontornpun A, Kuntawong P. Investigating psychometric properties of the Thai Version of the Zarit Burden Interview using Rasch model and confirmatory factor analysis. BMC Res Notes. 2020;13(1):120.

Saengduenchai S, Nilaban S, Singhtho T, Ranuwattananon A. The Development of Substance Use Disorder Screening Test (SUDST) according to the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders[Internet]. Nonthaburi(TH): The Graphico systems; 2020 [cited 2022 Apr 14]. Available from: http://www.pmnidat.go.th/thai/downloads/research/64/63-1.pdf

Afridi F, Dinkelman T, Mahajan K. Why Are Fewer Married Women Joining the Work Force in India? A Decomposition Analysis over Two Decades. J Popul Econ 2018;31:783-818.

Income - Expenditure Statistics Group SSDNSO. THE 2021 HOUSEHOLD SOCIO-ECONOMIC SURVEY WHOLE KINGDOM[Internet]. Bangkok: Text and Journal Publication; 2022[cited 2022 Dec 22]. Available from: http://www.nso.go.th/sites/2014en/Pages/survey/Social/Household/The-2017-Household-Socio-Economic-Survey.aspx

Gruber KJ, Taylor MF. A Family Perspective for Substance Abuse: Implications from the Literature. J Soc Work Pract Addict 2006;6(1-2):1–29.