Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-22T17:28:32.407Z Has data issue: false hasContentIssue false

Valutazione del carico familiare in un campione di parenti di pazienti con diagnosi di schizofrenia paranoide: risultati preliminari

Published online by Cambridge University Press:  07 August 2014

Franco Veltro*
Affiliation:
Istituto di Psichiatria, Prima Facoltà Medica, Università di Napoli, Napoli Dipartimento di Salute Mentale USL 5, Benevento
Lorenza Magliano
Affiliation:
Istituto di Psichiatria, Prima Facoltà Medica, Università di Napoli, Napoli
Silvana Lobrace
Affiliation:
Istituto di Psichiatria, Prima Facoltà Medica, Università di Napoli, Napoli
Pierluigi Morosini
Affiliation:
Istituto Superiore di Sanità, Roma
Mario Maj
Affiliation:
Istituto di Psichiatria, Prima Facoltà Medica, Università di Napoli, Napoli
*
Indirizzo per la corrispondenza: Dr. F. Veltro, Istituto di Psichiatria, Prima Facoltà Medica, Università di Napoli. Largo Madonna delle Grazie, 80138 Napoli. Fax ( + 39) 081-449.938.

Summary

Objective - assessment of the burden perceived by a sample of key-relatives of schizophrenic patients. Design - Observational study of key-relatives of patients with a PSE-CATEGO diagnosis of active paranoid schizophrenia. Assessment of possible correlations between the family burden, the patients' symptoms and disabilities, as well as the relatives attitude of overinvolvement and criticism. Setting - Inpatient and outpatient psychiatric units of the Department of Psychiatry of the First Medical School, University of Naples. Subjects - 25 patients, with a diagnosis of active paranoid schizophrenia, according to ICD-9 diagnostic criteria, minimun illness history 1 year, at least one previous admission, living with at least one adult relative. Main outcome measures - Standardized assessment of patients clinical status and social disability and of relatives clinical status attitude and perceived burden. Results - The burden, both objective and subjective, was found to be present to a marked or very marked degree in more than 50% of the inteviewed relatives. A marked effect of the patients illness was observed especially on relatives social contacts and leisure activities. Also the attitudes of criticism and overinvolvement were detected in the great majority of the relatives. 52% of the relatives, when assessed by the PSE-9, received a psychiatric diagnosis. The objective burden was found to be associated with some «negative» symptoms and deficits of social functioning in the patients. Finally, significant correlations were observed between the objective and subjective dimensions of the burden and the relatives attitudes of hypercriticism toward the patients. Conclusions - The present study seems to be relevant both from the epidemiological point of view and for psychiatric care planning.

Type
Articoli
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

BIBLIOGRAFIA

Brown, G. W., Bone, M., Dalison, B. & Wing, J. K. (1966). Schizophrenia and Social Care. Oxford University Press: London.Google Scholar
Clausen, J. A. & Yarrow, M. R. (1955). The impact of mental illness on the family. Journal of Social Issues 11, 364.CrossRefGoogle Scholar
Fadden, G., Bebbington, P. & Kuipers, L. (1987). Caring and its burdens. A study of the spouses of depressed patients. British Journal of Psychiatry 151, 660667.CrossRefGoogle ScholarPubMed
Fleiss, J. L. (1981). Statistical Methods for Rates and Proportions. John Wiley & Sons: New York.Google Scholar
Gallio, G., Morosini, P. L. & Veltro, F. (1991). Malattia mentale e carico familiare: analisi di un campione di famiglie di utenti dei servizi di salute mentale di Trieste. Relazione presentata al XXXVIII Congresso Nazionale della Società Italiana di Psichiatria.Google Scholar
Gibbons, J. S., Horn, S. H., Powell, J. M. & Gibbons, J. L. (1984). Schizophrenic patients and their families. A survey in a psychiatric service based on a DGH Unit. British Journal of Psychiatry 144, 7077.CrossRefGoogle Scholar
Grad, J. & Sainsbury, P. (1963). Mental illness and the family. Lancet i, 544547.CrossRefGoogle 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.CrossRefGoogle ScholarPubMed
Hoenig, J. & Hamilton, M. W. (1967). The burden of the house-hold in an extramural psychiatric service In New Aspects of the Mental Health Services, (ed. Freeman, H.). Pergamon Press: London.Google Scholar
Jackson, H. J., Smith, N. & McGregory, P. (1990). Relationship between expressed emotion and family burden in psychotic disorders: and exploratory study. Acta Psychiatrica Scandinavica 82, 243249.CrossRefGoogle ScholarPubMed
Maldebrote, B. M. & Folkard, S. (1961). Some problems and needs of schizophrenics in relation to a developing psychiatric community service. Comprehensive Psychiatry 2, 317328.Google Scholar
Mavreas, V. G. & Bebbington, P. (1988). Greeks, British Greeks, Cypriots and Londoners: a comparison of morbidity. Psychological Medicine 18, 433442.CrossRefGoogle ScholarPubMed
Morosini, P. L., Veltro, F., Cerreta, A., Gaio, R., Palomba, U. & Ventra, C. (1988). Disability sociale e carico familiare. Studio di riproducibilita di un nuovo strumento di valutazione. Rivista Sperimentcle di Freniatria 3, 541563.Google Scholar
Morosini, P., Roncone, R., Veltro, F., Palomba, U., Casacchia, M. (1991). Routine assessment tool in psychiatry: a case of questionnaire of family attitudes and burden. Italian Journal of Psychiatry and Behavioural Sciences 1, 95101.Google Scholar
Morosini, P. L., Coppo, P., Veltro, F. & Pasquini, P. (1992). Prevalence of mental disorders in Tuscany: a community study in Lari (Pisa). Annali dell'Istituto Superiore di Sanità di Roma (in press).Google Scholar
Ray, L., Parmanand, K. & Ajit, A. (1991). Social burden of positive and negative schizophrenia. The International Journal of Social Psychiatry 37, 4, 242250.Google Scholar
Veltro, F., Morosini, P., Sannino, A., Vega, M. L. (1987). Presentazione e validazione di un nuovo strumento per l'accertamento della disabilità e del carico familiare (A.D.C.). In Atti del Convegno Nazionale di Studi sulla Psichiatria nei Servizi Pubblici, pp. 15. Spazi della Mente: Napoli.Google Scholar
Veltro, F., Magliano, L., Lobrace, S., Morosini, P. (1990). Nuovo studio di riproducibilità di un'intervista semistrutturata per l'accertamento della disabilità sociale e del carico familiare (A.D.C.). Neurologia, Psichiatria e Scienze Umane 5, 813820.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.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorious, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
Wing, J. K. & Sturt, (1978). The PSE-ID-CATEGO System: Supplementary Manual. Medical Research Council, Institute of Psychiatry: London.Google Scholar
World Health Organization (1978). Glossary and Guide to the Classification of Mental Disorders in Accordance with the Ninth Revision of the International Classification of Disease. WHO: Geneva.Google Scholar