Vol 14, Issue 11, 2021 Online - 2455-3891 Print - 0974-2441 IMPACT OF FAMILY STIGMA AND CAREGIVER BURDEN ON QUALITY OF LIFE AMONG WIVES OF PATIENTS WITH ALCOHOL AND OPIOID USE DISORDER ROHIT GARG 1 *, ABHISHEK GUPTA 2 , DEEPAM KUNDAL 1 , SAVIJOT SINGH 3 1 Department of Psychiatry, Government Medical College, Patiala, Punjab, India. 2 Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India. 3 Department of Surgery, Government Medical College, Patiala, Punjab, India. Email: drrohitgarg@hotmail.com Received: 28 August 2021, Revised and Accepted: 09 October 2021 ABSTRACT Objectives: Spouses of patients with alcohol use disorder (AUD) and opioid use disorder (OUD) suffer from burden, stigma, and low quality of life (QoL). The present study assessed the impact of stigma and burden on QoL among wives of patients with AUD and OUD. Methods: 90 wives of in-patients with severe AUD (n=54) and OUD (n=36) as per DSM-5 were assessed using socio-demographic pro forma, WHO QoL Bref Hindi, Hindi family stigma scale and Family Burden Interview Schedule. Statistical Package for the Social Sciences Inc., Chicago, IL, version 25.0 for Windows was used for analysis. Appropriate statistical tests including Kolmogorov–Smirnov tests of normality, Mann–Whitney test, and Kruskal–Wallis test were used. To see the relationship between two variables Pearson Correlation coefficient was calculated. All statistical tests were two-sided and performed at a significance level of α=.05. Results: Majority of the wives were more than 30 years old, literate and belonged to rural areas. Higher financial burden reduced overall QoL (p=0.001**), satisfaction with physical health (0.006**), psychological health (p=0.032*), and environment (p=0.001**). There was a negative correlation of satisfaction with environment with disruption of family interaction (p=0.003**), burden on mental health (p=0.001**), overall burden (p=0.000**), and discrimination (p=0.032*). Conclusion: QoL of spouses of patients with AUD and OUD reduces significantly due to stigma and burden. Enhancing QoL of spouses should be a part of management of AUD and OUD. Keywords: Alcohol, Burden, Opioid, Quality of life, Stigma, Wives. INTRODUCTION Substance use disorders (SUD) cause significant burden and stigma to patients as well as their family members. It leads to a significant reduction in quality of life (QoL) of patients and their spouses [1]. Caregiver burden is the strain or load borne by a person caring for an elderly, chronically ill or disabled family member [2]. Multiple studies have demonstrated very high caregiver burden among spouses of patients with SUD [3]. The burden could be financial, psychological, physical, disruption in family routine, interaction, leisure activities, etc. [3]. Wives of persons with SUD face stigma and discrimination which causes avoidance, reduced life opportunities, guilt, social exclusion, reduced self-esteem, hopelessness, treatment gap, poor compliance, etc. [4]. To the best of our knowledge of the authors, no study from India has assessed the impact of caregiver burden and family stigma on QoL. Studies from elsewhere have reported that family stigma reduced QoL, anticipated stigma had direct negative impact on psychological and physical health, and caregiver burden significantly reduces QoL of spouses of patients with SUD [5-7]. The present study was planned to assess the impact of burden and family stigma on QoL among spouses of patients with SUD. METHODS It was a descriptive, cross-sectional study conducted from January to October 2019 at the 50 bedded Model De-addiction Centre of Department of Psychiatry, Government Medical College and Hospital in North India. 90 wives between 18 and 65 years, who were the primary caregivers and gave written informed consent, were included. The wives of only those patients were included who fulfilled criteria for severe dependence and required admission. Wives who were suffering from SUD and psychiatric illness (as assessed clinically using DSM-5 criteria) were excluded from the study. Wives were excluded if they or their patient suffered from any other medical or surgical disorder which would lead to a reduction in QoL or is stigmatizing such as HIV, hepatitis, leprosy, tuberculosis, and physical handicap. Wives of patients with dual diagnosis or multiple SUD except nicotine and caffeine were also excluded from the study. Wives who refused to participate in the study or whose husband’s prohibited them from doing so were excluded. Those who agreed were then assessed using the following tools. Socio-demographic and clinical pro forma A semi-structured pro forma was prepared to record the sociodemographic and clinical variables. WHO QoL Bref Hindi version WHO QoL Bref Hindi version was used to measure subjective health related QoL. The 26 items are further divided into four domains (satisfaction with physical health, psychological health, social relations, and environment) and two general questions related to satisfaction with overall QoL and overall health. This is one of the most commonly used scales to measure QoL and has excellent reliability and validity [8]. Stigma scale The Hindi self-stigma scale previously standardized in India was used for the study. It has 28 self-rated items with each item rated from 0 to 2 (agree, neither agree nor disagree and disagree). The 28 items are divided into three domains namely discrimination (13 items), disclosure (ten items), and positive aspects of stigma (five items). Higher score on each domain and the total scale score denotes higher stigma. The scale has been previously standardized in India on a variety of patients with mental illnesses and was found to have good internal consistency and test-retest reliability [9]. © 2021 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/ licenses/by/4.0/) DOI: http://dx.doi.org/10.22159/ajpcr.2021v14i11.43006. Journal homepage: https://innovareacademics.in/journals/index.php/ajpcr Research Article