An online survey of caregivers for patients with tardive dyskinesia (TD) was developed to assess the impact of caretaking on psychological well-being, caregiving tasks, and daily activities, according to research recently presented at Psych Congress 2021, held from October 29 through November 1, 2021, in San Antonio, Texas.
Surveyed caregivers were required to be unpaid for at least 3 months. Responses were rated according to the impact of TD on psychological well-being, caregiving tasks, and daily activities from 1 (least impact) to 5 (most impact). The impact of TD on professional life was assessed using the Work Productivity and Activity Impairment Questionnaire.
The surveyed caregivers (N=162) represented the diversity of races/ethnicities in the United States, although caregivers with higher education may have been over-represented (74.7% held a bachelor’s degree or higher). Approximately 56% of the surveyed caregivers were caring for patients who they identified as a parent or guardian. A total of 35.2% of caregivers reported the patient as having severe or very severe symptoms, while 69.7% reported that the patient was either “quite a bit” or “very much bothered” by their symptoms.
Among the surveyed caregivers, 23.5% reported that the patient’s TD had a severe impact (defined as a score ≥4 on ≥1 item within each domain) across well-being, caregiving tasks, and daily activities. Mean (SD) scores were 2.5 (0.9) for psychological well-being, 2.1 (1.1) for tasks and 2.7 (0.9) for daily activities. Concerning psychological well-being, 34.6% of caregivers reported that they either often or always felt anxious or worried due to the patient’s TD; 29.0% reported feeling sad or unhappy, 23.5% reported feeling overwhelmed, 22.8% reported feeling overburdened, and 21% reported feeling stressed or strained. Employed caregivers (n=136, 84%) experienced a 49.5% overall work impairment. These individuals reported missing 13.8% of work time and reported impairment 44.0% of the time while at work.
The study investigators conclude, “Although most caregivers did not consider helping patients with individual tasks burdensome, responses regarding impact on their own activities and psychological well-being reflect a cumulative burden of supporting patients with TD. These results highlight the importance in recognizing the incremental impact of TD on caregivers.”
Disclosure: This clinical trial was supported by Teva Pharmaceutical Industries. Please see the original reference for a complete list of authors’ disclosures.
Findings of a study published in JAMA Network Open suggest written exposure therapy (WET) to be a more efficient treatment approach for post-traumatic stress disorder than cognitive processing therapy (CPT).
Active-duty United States military personnel (N=169) stationed at 2 bases in Texas seeking treatment for PTSD were recruited for this study between 2016 and 2020. Participants were randomized to receive cognitive processing therapy (n=84) or written exposure therapy (n=85). CPT comprised 12 biweekly 1-hour sessions which focused on trauma using progressive worksheets. WET comprised 5 weekly 45 minute to hour-long sessions during which time the participant wrote for 30 minutes about their trauma and the therapist checked whether the patient had any challenges completing the task.
The military personnel were 80.5% men, aged mean 33.65 (standard deviation [SD], 8.43) years, 34.9% were White, 33.7% were Black, 24.9% were Hispanic, 76.9% were married, 61.5% had some college, 0.7% had never been deployed, and they had been in the military for 155.31 (SD, 89.84) months.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) PTSD Scale scores were 36.71 (SD, 1.12) and 34.24 (SD, 1.13) at baseline for the WET and CPT cohorts, respectively. At 10 weeks, PTSD Scale scores had changed by -5.16 (SD, 1.17) and -9.12 (SD, 1.28) points for each group, respectively. By week 30, there was little difference in the score changes between cohorts (difference, 0.33; standard error [SE], 2.58).
At week 30, 37.5% of the CPT and 47.2% of the WET participants exhibited a reliable change in PTSD severity, as defined by a 12-point change in Clinician-Administered PTSD Scale for DSM-5 score.
Most participants (54%) experienced adverse events. The events were primarily psychiatric symptoms of anxiety, depression, and sleep disturbances.
CPT recipients were more likely to drop out of the study (45.2% vs 23.5%; odds ratio [OR], 2.69; 95% CI, 1.39-5.20).
This study was limited by its relatively high drop-out rate and the lack of long-term outcomes.
The study authors concluded, “the option of a brief PTSD treatment is likely to be of high value in the military setting, where military service operations may limit treatment engagement. One clear pattern of findings in this study is the high variability of treatment outcomes among service members. Better understanding of the factors associated with who does and who does not benefit from PTSD treatment is an important direction for the field.”
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.
Sloan DM, Marx BP, Resick PA, et al. Effect of written exposure therapy vs cognitive processing therapy on increasing treatment efficiency among military service members with post-traumatic stress disorder: a randomized noninferiority trial. JAMA Netw Open. 2022;5(1):e2140911. doi:10.1001/jamanetworkopen.2021.40911
Jain R, Goldschmidt D, King S, Popadic L, Wilhelm A, Leo S. Caregiver burden of tardive dyskinesia in the United States: a survey of impact on caregiving tasks, psychological well-being, and daily activities. Presented at: Psych Congress 2021; October 29-November 1, 2021; San Antonio, Texas. Poster 43.
This article originally appeared on Psychiatry Advisor