Anxiety and stress among spouses of persons with psychosis and their association with coping and family functioning: A cross-sectional study from Goa, India

Background: Spouses of persons with psychosis carry a distinct caregiving burden, but Indian studies often group them with other relatives. The study aims to assess anxiety and stress among spouses of persons with psychosis, examine their association with coping and family functioning, and explore differences by gender and marriage duration. Materials and Methods: In this cross-sectional analytical study, 80 spouses (32 men, 48 women) were recruited by purposive sampling at a tertiary psychiatric hospital in Goa. Anxiety and stress were measured with DASS-21 subscales, family functioning with the General Functioning subscale of the McMaster Family Assessment Device (FAD-GF), and coping with a 10-item researcher-constructed questionnaire. Results: Severe or extremely severe anxiety was reported by 95.0% of spouses, while 86.3% had moderate stress. Anxiety (ρ = 0.31, p = 0.005) and stress (ρ = 0.42, p < 0.001) were positively correlated with FAD-GF scores, indicating poorer family functioning with greater psychological distress. Coping scores were negatively correlated with anxiety (ρ = −0.27, p = 0.015) and FAD-GF scores (ρ = −0.30, p = 0.007), indicating that lower coping scores, defined as more frequent and effective coping, were unexpectedly associated with greater anxiety and poorer family functioning. The correlation between coping and stress was not statistically significant (ρ = −0.21, p = 0.062). Women reported higher anxiety than men (p = 0.047). Family functioning differed across marriage-duration groups (p = 0.036), although no pairwise differences remained significant after Bonferroni correction. Conclusion: Severe anxiety was very common among spouses and was associated with poorer family functioning. Because the design is cross-sectional, the sample is small and from one centre, and the coping scale is not validated, the findings show association only. Routine assessment of spouses and family-focused support are indicated.