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The Burden of Care

The Impact of Functional Psychiatric Illness on the Patient's Family

Published online by Cambridge University Press:  02 January 2018

G. Fadden*
Affiliation:
St Columba's Hospital, Sligo, Eire
P. Bebbington
Affiliation:
MRC Social Psychiatry Unit
L. Kuipers
Affiliation:
Institute of Psychiatry, London
*
Correspondence

Abstract

This paper reviews the literature on the effect of severe mental illness on other members of the patient's family. The burdens of caring for a patient at home are considerable. They often affect the caring relative's social and leisure activities, and financial problems arise frequently. Relatives have difficulties in understanding and coming to terms with illness-related behaviour. ‘Negative’ symptoms are often a particular problem. Despite their burden, relatives do not complain much, although they receive little support, advice or information from the professionals engaged in treating the patient; much is now known about the difficulties relatives face, but we still need to know how they can best be helped. Failure to do this will have bad effects on both relatives and patients.

Type
Review Article
Copyright
Copyright © 1987 The Royal College of Psychiatrists 

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References

Barrowclough, C. & Tarrier, N. (1984) ‘Psychosocial’ interventions with families and their effects on the course of schizophrenia: a review. Psychological Medicine, 14, 629642.CrossRefGoogle ScholarPubMed
Birtchnell, J. & Kennard, J. (1983) Does marital maladjustment lead to mental illness? Social Psychiatry, 18, 7988.Google Scholar
Brown, G. W., Monck, E. M., Carstaks, G. M. & Wing, J. K. (1962) Influence of family life on the course of schizophrenic illness. British Journal of Preventive and Social Medicine, 16, 5568 Google Scholar
Brown, G. W., Bone, M., Dalison, B. & Wing, J. (1966) Schizophrenia and Social Care. London: Oxford University Press.Google Scholar
Brown, G. W., Birley, J. L. T. & Wing, J. K. (1972) Influence of family life on the course of schizophrenic disorders: A replication. British Journal of Psychiatry, 121, 241258.Google Scholar
Bruner, J. & Taguiri, R. (1954) The perception of people. In Handbook of Social Psychology (ed. G. Lindzey). Cambridge, Mass: Addison-Wesley.Google Scholar
Clausen, J. A. & Yarrow, M. R. (1955) The impact of mental illness on the family. Journal of Social Issues, 11, 364.Google Scholar
Clausen, J. A., Yarrow, M. R., Deasy, L. C. & Schwartz, C. G. (1955) The impact of mental illness: research formulation. Journal of Social Issues, 11, 611.CrossRefGoogle Scholar
Collins, J., Kreitman, N., Nelson, B. & Troop, J. (1971) Neurosis and marital interaction: III Family roles and functions. British Journal of Psychiatry, 119, 233242.Google Scholar
Creer, C. & Wing, J. K. (1974) Schizophrenia at Home. Surbit on: National Schizophrenia Fellowship.Google Scholar
Creer, C., Sturt, E. & Wykes, T. (1982) The role of relatives. In Long Term Community Care: Experience in a London Borough (ed. J. K. Wing) Psychological Medicine, Monograph Supplement 2.Google Scholar
Deasy, L. C. & Quinn, O. W. (1955) The wife of the mental patient and the hospital psychiatrist. Journal of Social Issues, 11, 4960.CrossRefGoogle Scholar
Fadden, G. B., Kuipers, L. and Bebbington, P. E. (1987) Caring and its burdens: a study of the relatives of depressed patients. British Journal of Psychiatry. (In press).Google Scholar
Falloon, I. R. H., Boyd, J. L., McGill, C. W., Razani, J., Moss, H. B. & Gilderman, A. M. (1982) Family management in the prevention of exacerbations of schizophrenia. A controlled study. New England Journal of Medicine, 306, 14371440.Google Scholar
Grad, J. & Sainsbury, P. (1963a) Evaluating a community care service. In Trends in Mental Health Services (eds H. Freeman & J. Farndale), Oxford: Pergamon.Google Scholar
Grad, J. & Sainsbury, P. (1963b) Mental illness and the family. Lancet, i, 544547.Google Scholar
Hinchcliffe, M. K., Hooper, D. & Roberts, F. J. (1978) The Melancholy Marriage. Chichester: Wiley.Google Scholar
Hoenig, J. & Hamilton, M. W. (1966) The schizophrenic patient in the community and his effect on the household. International Journal of Social Psychiatry, 12, 165176.Google Scholar
Hoenig, J. & Hamilton, M. W. (1969) The Desegregation of the Mentally III. London: Routledge & Kegan Paul.Google Scholar
Hooley, J. M., Orley, J. & Teasdale, J. (1986) Levels of Expressed Emotion and relapse in depressed patients. British Journal of Psychiatry 148, 642647.Google Scholar
Kreisman, D. E. & Joy, V. D. (1974) Family response to the mental illness of a relative: a review of the literature. Schizophrenia Bulletin, 10, 3457.Google Scholar
Kreitman, N. (1964) The patient's spouse. British Journal of Psychiatry, 110, 159173.Google Scholar
Kreitman, , Collins, J., Nelson, B. & Troop, J. (1970) Neurosis and marital interaction: I Personality and symptoms. British Journal of Psychiatry, 117, 3346.CrossRefGoogle ScholarPubMed
Kuipers, L. (1987) Depression and the family. In Coping with Disorder in the Family (ed. J. Orford) London: Croom-Helm.Google Scholar
Leff, J. P., Kuipers, L., Kerkowitz, R., Eberlein-Fries, R. & Sturgeon, D. (1982) A controlled trial of social intervention in schizophrenic families. British Journal of Psychiatry, 141, 121134.Google Scholar
Liberman, R. P., Wallace, C. J., Falloon, I. R. H. & Vaughn, C. E. (1981) Interpersonal problem solving therapy for schizophrenics and their families. Comprehensive Psychiatry, 22, 627630.Google Scholar
Mandelbrote, B. M. & Folkard, S. (1961a) Some problems and needs of schizophrenics in relation to a developing psychiatric community service. Comprehensive Psychiatry, 2, 317328.Google Scholar
Mandelbrote, B. M. & Folkard, S. (1961b) Some factors related to outcome and social adjustment in schizophrenia. Acta Psychiathca Scandinavica, 37, 223235.Google Scholar
Mann, S. & CrEe, W. (1975) The ‘new long-stay’ in mental hospitals. British Journal of Hospital Medicine, 14, 5663.Google Scholar
Mills, E. (1962) Living with Mental Illness: A Study in East London. London: Routledge & Kegan Paul.Google Scholar
Nelson, B., Collins, J., Kreitman, N. & Troop, J. (1970) Neurosis and marital interaction: II Time sharing and social activity. British Journal of Psychiatry, 117, 4758.Google Scholar
Ovenstone, I. M. K. (1973a) The development of neurosis in the wives of neurotic men. Part 1 : symptomatology and personality. British Journal of Psychiatry, 122, 3343.Google Scholar
Ovenstone, I. M. K. (1973b) The development of neurosis in the wives of neurotic men. Part 2: Marital role functions and marital tension. British Journal of Psychiatry, 122, 711717.Google Scholar
Platt, S. (1981) Social adjustment as a criterion of treatment success: just what are we measuring? Psychiatry, 44, 95112.Google Scholar
Platt, S. (1985) Measuring the burden of psychiatric illness on the family: an evaluation of some rating scales. Psychological Medicine, 15, 383394.CrossRefGoogle ScholarPubMed
Rogler, L. & Hollingsheao, A. (1965) Trapped: Families and Schizophrenia. New York: Wiley.Google Scholar
Schachter, S. (1951) Deviation, rejection and communication. Journal of Abnormal and Social Psychology, 46, 190207.Google Scholar
Stevens, B. (1972) Dependence of schizophrenic patients on elderly relatives. Psychological Medicine, 2, 1732.Google Scholar
Sturt, E. S., Kumakura, N. & Der, G. (1984) How depressing life is: lifelong risk of depression in the general population. Journal of Affective Disorders, 7, 109122.Google Scholar
Vaughn, C. E. (1977) Patterns of interactions in families of schizophrenics. In Schizophrenia: The Other Side (ed. H. Katschnig). Vienna: Urban & Schwarzenberg.Google Scholar
Vaughn, C. E. & Leff, J. P. (1976) The influence of family and social factors on the course of psychiatric illness: a comparison of schizophrenic and depressed neurotic patients. British Journal of Psychiatry, 129, 125137.Google Scholar
Waters, M. A. & Northover, J. (1965) Rehabilitated long-stay schizophrenics in the community. British Journal of Psychiatry, 111, 258267.CrossRefGoogle ScholarPubMed
Wing, J. K. (1982) Rehabilitation and management of schizophrenia. In Handbook of Psychiatry III: Psychoses of Uncertain Aetiology (eds J. K. Wing and L. Wing). London: Cambridge University Press.Google Scholar
Wing, J. K., Monck, E., Brown, G. W. & Carstairs, G. M. (1964) Morbidity in the community of schizophrenic patients discharged from London mental hospitals in 1959. British Journal of Psychiatry, 110, 1021.Google Scholar
Yarrow, M., Clausen, J. & Robbins, P. (1955a) The social meaning of mental illness. Journal of Social Issues, 11, 3348.Google Scholar
Yarrow, M., Clausen, J., Schwartz, C. G., Murphy, H. S. & Deasy, L. C. (1955b) The psychological meaning of mental illness in the family. Journal of Social Issues, 11, 1224.Google Scholar
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