Abstract
A case series to study factors related to family expectation regarding schizophrenic patients was conducted in an out-patient setting in the city of S. Paulo, Brazil. Patients diagnosed as presenting schizophrenia by the ICD 9th Edition and having had the disease for more than four years were included in the study. Family Expectation was measured by the difference between the Katz Adjustment Scale (R2 and R3) scores based on the relative's expectation and the socially expected activities of the patient (Discrepancy Score), and social adjustment was given by the DSM-III-R Global Assessment Scale (GAS). Outcome assessments were made independently, and 44 patients comprised the sample (25 males and 19 females). The Discrepancy mean score was twice as high for males as for females (p < 0.02), and there was an inverse relationship between the discrepancy score and social adjustment (r = -0.46, p < 0.001). Moreover, sex and social adjustment exerted independent effects on the discrepancy score when age, age at onset and number of psychiatric admissions were controlled by means of a multiple regression technique. There was an interaction between sex and social adjustment, the inverse relationship between social adjustment and discrepancy score being more pronounced for males. These findings are discussed in the light of the potential association between the family environment, gender and social adjustment of schizophrenic patients, and the need for further research, i.e. ethnographic accounts of interactions between patient and relatives sharing households particularly in less developed countries.
Highlights
Schizophrenia is a disruptive illness both for the individual and for the family
The interview had the following components: a) critical comments, which were judged by the tone of the voice and/or a clear statement of resentment, disapproval or dislike; b) hostility, indicating rejection and generalized critical comments; c) emotional over-involvement, for rating unusually marked concerns about the patient and/or anxiety demonstrated with regard to unimportant problems; and d) warmth, the only positive rating incorporated comments of support and spontaneous demonstration of sympathy and concern
There were no significant differences between males and females regarding social adjustment, family expectations, age, age at onset, duration of the illness and number of psychiatric admissions
Summary
Schizophrenia is a disruptive illness both for the individual and for the family. The disease is not evident when the child is borne and for a considerable period of life social function and performance seem normal. After the publication of the British researchers, many investigations were conducted using the Camberwell Family Interview (CFI): in California[26], Denmark and North India[29,30], Italy[5] and Greece[17] These studies showed cross-cultural variations in the schizophrenic’s relative’s expressed emotions and based on these results some authors concluded that EE could be a major factor explaining the better outcome of schizophrenia in developing countries[14]. Due to the scarcity of studies involving relatives of schizophrenic patients in less developed countries, of the present study the aim is the investigation of gender differences in the relationship between social performance and family expectations in an out-patient sample of schizophrenic patients in Brazil
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