Cirrhosis leads to considerable morbidity and mortality, compromises quality of life,
and often necessitates assistance in activities of daily living. An informal caregiver
bears the psychological burden of coping with the needs of the patient and the knowledge
of morbid prognosis of a loved one. This aspect is rarely recognized and almost never
addressed in a clinical practice. This cross-sectional study assessed the factors
influencing psychological burden of cirrhosis on the caregivers in a predominantly
lower-middle socioeconomic class Indian population. Patients underwent psychometric
tests [Psychometric Hepatic Encephalopathy Score (PHES)], and questionnaires for quantifying
caregiver burden [Perceived Caregiver Burden (PCB) and Zarit Burden Interview (ZBI)]
and assessing depression [Beck Depression Inventory (BDI)] and anxiety [Beck Anxiety
Inventory (BAI)] were administered. One hundred patients with cirrhosis [70% male,
27% with past hepatic encephalopathy (HE), and 53% with minimal HE] and their caregivers
(66% women, 81% spouse, 26.51 years of mean relationship) were evaluated. Caregiver
burden scores were higher in patients with previous overt HE than in those without
previous overt HE [PCB (74.63 vs . 66.15, P = 0.001), ZBI (27.93 vs . 21.11,
P = 0.023), BDI (11.63 vs . 8.96, P = 0.082), and BAI (11.37 vs . 8.12, P =
0.027)]. Similarly, caregivers of patients with minimal HE had higher caregiver burden
that those of patients who did not have minimal HE [PCB (70.74 vs . 65.85, P = 0.027),
ZBI (26 vs . 19.51, P = 0.015)]. Burden scores correlated well with each other
and with liver disease severity scores and negatively correlated with socioeconomic
status. Repeated hospital admissions, alcohol as etiology, and lower socioeconomic
status were the independent predictors of caregiver burden. Higher perceived burden
is common in caregivers of patients with cirrhosis. Repeated hospital admissions,
alcoholism, and lower socioeconomic status influence caregiver burden.