Is Anxiety and Depression Related with Personality in Caregivers for Patients with Bipolar Disorder? Enver Demirel Yilmaz 1* , Erdem Devecİ 1 , Hüseyin Güleç 2 , Ali Görkem Gençer 3 , Özge Ünal 4 , Emel Koçer 1 and İsmet Kırpınar 1 1Department of Psychiatry, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey 2Department of Psychiatry, Erenköy Training and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey 3Department of Psychiatry, Başak şehir State Hospital, Istanbul, Turkey 4Department of Psychiatry, Istanbul Education and Research Hospital, Istanbul, Turkey *Corresponding author: Enver Demirel Yılmaz, MD, Department of Psychiatry, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Avenue 34083 Fatih / Istanbul, Turkey, Tel: +9 0 212 453 17 00, +9 0 505 524 90 56; Fax: +9 0 212 621 75 80; E-mail: enveryilmaz6@yahoo.com.tr Received date: March 7, 2014, Accepted date: April 26, 2014, Published date: May 5, 2014 Copyright: © 2014 Yılmaz ED, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Objective: The objective of this study is to analyse the correlation between state and trait anxiety, depression and personality traits in caregivers of patients diagnosed with bipolar affective disorder. Method: The study sample consists of care-givers of 34 patients diagnosed with bipolar affective disorder according to the DSM IV-TR criteria, and 37 healthy voluntary subjects demographically matched. The Temperament and Character Inventory (TCI), Hamilton Depression Rating Scale (HDRS) and State-Trait Anxiety Inventory (STAIX I-II) scales have been applied to the subjects. Results: In this study, it has been found that STAIX-I and STAIX-II anxiety scores are higher in caregivers. The comparison between the groups has revealed that persistence (P) scores are higher in caregivers (P<0.001). A statistically significant correlation has been found between the STAIX –I score and harm avoidance (HA) score (r=0.36, P=0.04); STAIX-II score and harm avoidance (HA) (r=0.57, P<0.001); self-transcendence (ST) (r=0.41, P=0.01) and self-directedness (SD) scores (r=-0.60, P<0.001); HDRS score and harm avoidance (HA) (r=0.47, P=0.01) of TCI. Conclusion: Our results suggest that considering their personality traits, caregivers of patients with bipolar affective disorder should be assessed by clinicians more carefully and comprehensively in respect of anxiety. Keywords: Bipolar affective disorder; Caregivers; Anxiety; Temperament; Depression Introduction Chronic psychiatric diseases are mental health problems that affect caregivers as much as patients themselves. Bipolar Affective Disorder (BAD) is a chronic disease which progresses with relapses and remissions. Although the patients may have remission periods, the attacks cause severe symptoms that require hospitalization, thus severely affecting caregivers [1]. In Turkey, most patients live with their families who are in charge of their care without any outside support after such periods of hospitalization [2]. Various studies indicate that caregivers of chronic psychiatric patients develop depressive symptoms and anxiety frequently as a result of constant stress [3]. Naturally, such psychological problems of caregivers affect the treatment process negatively [1]. Nowadays, treatment of chronic psychiatric diseases extends beyond the borders of traditional physician-patient relationship, becoming a broader process that also involves the patients’ relatives. This development increased the families’ responsibilities as caregivers during post-rehabilitation process. As a result, there is an increased interest in the literature about the relation between the psychiatric disorders and the caregivers’ behaviors [4]. Nowadays, it is a widely accepted fact that the caregivers have an essential role in the treatment process [5]. Caregivers are one of the three basic components of treatment along with the patient and healthcare professionals. Therefore, cooperation with caregivers becomes even more important for the sustainability of treatment. Various studies on BAD patients and their relatives indicate that negative attitudes and reactions by the society are perceived as stigmatization by caregivers, resulting in fear of social isolation. Aggressive and homicidal behavior and symptoms like excessive sexual activity observed during the episodes of BAD can cause stigmatization during the remission periods, creating extra burden on the patients and caregivers [6]. Personality traits are the most important determinants of caregivers’ emotional or behavioral reaction to their caregiving responsibilities. Treating the psychiatric problems of caregivers along with those of the patients themselves is essential for more effective treatment. Therefore, it is vital for the clinician to evaluate the personalities of caregivers and thus predict the correlation between these personality traits and the possible emergence of mental health problems like anxiety and depression. This study aims to analyze the relation between the state and trait anxiety levels, as well as depression levels of Yilmaz et al., J Psychiatry 2014, 17:4 DOI: 10.4172/2378-5756.1000122 Research Article Open Access J Psychiatry An open access journal Volume 17 • Issue 4 • 1000122 Journal of Psychiatry J o u r n a l o f P s y c h i a t r y ISSN: 2378-5756