EPA-0738 – Family functioning in families of first-episode patients in comparison to chronic patients and healthy controls

Abstract

Introduction Research focused on the intrafamilial environment of people experiencing their first episode of psychosis (FEP) is limited. Objectives To investigate possible differences in family environment between FEP patients, chronic psychotic patients and healthy controls. Aims To compare family variables between relatives of FEP patients, chronic patients and healthy controls. Methods Family cohesion and flexibility (FACES-IV) and psychological well-being (GHQ-28) were evaluated in relatives of 50 FEP patients, 50 chronic patients and 50 controls, whereas expressed emotion (FQ) and family burden (FBS) were assessed between the two clinical groups. Results Multivariable linear regression analysis adjusted for several confounding variables revealed statistically significant differences in the total ratio for family cohesion and flexibility between the three groups indicating poorer family functioning for chronic families as compared to FEP families (β coefficient −0.47, 95% CI: −0.77, −0.18) and lower scores for FEP families as compared to controls (β coefficient −0.59, 95% CI: −0.81, −0.37). Chronic families scored significantly higher in critical comments (β coefficient 7.17, 95% CI: 3.45, 10.89), and reported higher subjective (β coefficient 2.85, 95% CI: 0.69, 5.01) and objective burden (β coefficient 8.25, 95% CI: 4.67, 11.84) as compared to FEP families. Non-significant differences were found in psychological well-being between FEP and chronic families, whereas FEP families reported higher levels of psychological distress as compared to controls. Conclusions Having a family member with a major psychiatric disorder is a general stressor for families and family interventions should be considered to minimize disruption to family life.