1365 – Family functioning, expressed emotion and family burden in relatives of first- episode and chronic patients with schizophrenia and bipolar disorder: preliminary findings

Abstract

Introduction The influential role of family in the outcome of chronic mental illness is well documented; however there has been relatively little research on the intrafamilial relationships of people experiencing their first episode of psychosis (FEP). Objectives To investigate possible differences in family environment between FEP and chronic patients with schizophrenia and bipolar disorder. Aims To compare family measures between relatives of FEP and chronic psychotic patients. Methods Family functioning (FACES-IV), expressed emotion (FQ), family burden (FBS) and psychological well being (GHQ- 28) were assessed in relatives of 30 FEP and 30 chronic patients. Results Multivariable linear regression models adjusted for confounders revealed that relatives of chronic patients scored significantly lower in balanced cohesion (β coefficient -4.27, 95% CI: -08.03, -1.71) and balanced flexibility (β coefficient -4.01, 95% CI: -6.91, -1.10), as well as communication (β coefficient -6.61, 95% CI: -11.70, -1.50) and satisfaction scales (β coefficient -7.32, 95% CI: -13.23, -1.41). Relatives caring for a chronic patient had significantly higher scores in critical comments (β coefficient 7.81, 95% CI: 3.95, 11.68) and emotional overinvolvement (β coefficient 3.70, 95% CI: 0.24, 7.16). They, also, reported higher objective (β coefficient 12.23, 95% CI: 3.76, 20.71) and subjective (β coefficient 2.79, 95% CI: 0.45, 5.14) burden, as well as poorer psychological well being (β coefficient 12.23, 95% CI: 3.76, 20.71). Conclusions These findings suggest that chronicity adversely affects patients’ family. Early intervention strategies are needed to reduce family burden which in turn may adversely affect the course of the patient’s illness.