Resilience, Self-Esteem, and Self-Efficacy in Caregivers of Schizophrenia Patients

Abstract

Background: Schizophrenia is a severe mental disorder that leads to significant functional impairment, necessitating substantial long-term care from informal caregivers. While the burdens of caregiving are well-documented, there is limited research from India on the protective psychological resources that enable caregivers to cope effectively. Objective: To evaluate the levels of resilience, perceived social support, self-esteem, and self-efficacy among caregivers of patients with schizophrenia, and to examine the correlations between these variables and their association with caregiver duration. Methods: A cross-sectional study was conducted at the Department of Psychiatry, Timergara Teaching Hospital from June 2025 to December 2025. A total of 150 caregivers of patients diagnosed with schizophrenia (ICD-10 criteria) were recruited using convenience sampling. Data were collected using a semi-structured proforma and four standardized scales: the Connor-Davidson Resilience Scale (CD-RISC), Rosenberg Self-Esteem Scale (RSES), General Self-Efficacy Scale (GSE), and Multidimensional Scale of Perceived Social Support (MSPSS). Statistical analysis employed descriptive statistics, Pearson's correlation coefficient (p < 0.001), and appropriate tests of significance. Results: The majority of caregivers were female (52.7%), married (72.7%), and had middle school education (43.3%). Most caregivers demonstrated moderate resilience (44.7%, mean 61 ± 14.6), with 28.7% showing high resilience and 26.7% low resilience. Perceived social support was moderate overall (47.34 ± 12.33), with family support (21.22 ± 4.5) being substantially higher than friend support (7.11 ± 3.4). Mean self-esteem and self-efficacy scores were 20.22 ± 3.4 and 19.34 ± 2.3 respectively. Significant positive correlations were found among all psychological variables (p < 0.001), particularly between resilience and perceived social support (r = 0.856). Caregiver duration showed significant negative correlations with all study variables, most strongly with perceived social support (r = -0.724, p < 0.001). Conclusion: Caregivers of schizophrenia patients demonstrate moderate resilience and family support but markedly low support from friends, likely attributable to stigma. The significant decline in all protective factors with increasing caregiver duration highlights the progressive toll of long-term caregiving. The strong intercorrelations among resilience, social support, self-esteem, and self-efficacy suggest these factors are mutually reinforcing. Community-based psychoeducational interventions are recommended to enhance these protective resources and reduce stigma