Family Functioning in First-Episode and Chronic Psychosis: The Role of Patient’s Symptom Severity and Psychosocial Functioning

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• 作者：Katerina Koutra ; Sofia Triliva ; Theano Roumeliotaki…
• 刊名：Community Mental Health Journal
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：52
• 期：6
• 页码：710-723
• 全文大小：450 KB
• 刊物类别：Behavioral Science
• 刊物主题：Psychology
  Psychology
  Psychiatry
  Health Psychology
  Personality and Social Psychology
  Community and Environmental Psychology
  Public Health
  
• 出版者：Springer Netherlands
• ISSN：1573-2789
• 卷排序：52

文摘

The aim of the present study was to assess the relationship between illness-related characteristics, such as symptom severity and psychosocial functioning, and specific aspects of family functioning both in patients experiencing their first episode of psychosis (FEP) and chronically ill patients. A total of 50 FEP and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) and their family caregivers participated in the study. Family functioning was evaluated in terms of cohesion and flexibility (FACES IV Package), expressed emotion (FQ), family burden (FBS) and caregivers’ psychological distress (GHQ-28). Patients’ symptom severity (BPRS) and psychosocial functioning (GAS) were assessed by their treating psychiatrist within 2 weeks from the caregivers’ assessment. Increased symptom severity was associated with greater dysfunction in terms of family cohesion and flexibility (β coefficient −0.13; 95 % CI −0.23, −0.03), increased caregivers’ EE levels on the form of emotional overinvolvement (β coefficient 1.03; 95 % CI 0.02, 2.03), and psychological distress (β coefficient 3.37; 95 % CI 1.29, 5.45). Family burden was found to be significantly related to both symptom severity (β coefficient 3.01; 95 % CI 1.50, 4.51) and patient’s functioning (β coefficient −2.04; 95 % CI −3.55, −0.53). No significant interaction effect of chronicity was observed in the afore-mentioned associations. These findings indicate that severe psychopathology and patient’s low psychosocial functioning are associated with poor family functioning. It appears that the effect for family function is significant from the early stages of the illness. Thus, early psychoeducational interventions should focus on patients with severe symptomatology and impaired functioning and their families.KeywordsSymptom severityPsychosocial functioningFamily functioningExpressed emotionFamily burdenPsychological distress