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The association between family dysfunction and admission to an acute mental health inpatient unit: a prospective study

Published online by Cambridge University Press:  12 September 2019

J. H. P. Tan Open the ORCID record for J. H. P. Tan [Opens in a new window] ,
C. Conlon ,
A. Tsamparli ,
D. O’Neill  and
D. Adamis Open the ORCID record for D. Adamis [Opens in a new window]
J. H. P. Tan*
Affiliation:
Sligo Leitrim Mental Health Services, St. Columba’s, Ballytivnan, Clarion Road, Sligo, Ireland
C. Conlon
Affiliation:
Sligo Leitrim Mental Health Services, St. Columba’s, Ballytivnan, Clarion Road, Sligo, Ireland
A. Tsamparli
Affiliation:
Clinical Psychology Unit, Department of Primary Education, University of the Aegean, Rhodes, Greece
D. O’Neill
Affiliation:
Sligo Leitrim Mental Health Services, St. Columba’s, Ballytivnan, Clarion Road, Sligo, Ireland
D. Adamis
Affiliation:
Sligo Leitrim Mental Health Services, St. Columba’s, Ballytivnan, Clarion Road, Sligo, Ireland
*
*Address for correspondence: T. H. P. Jason, Sligo Leitrim Mental Health Services, St. Columba’s, Ballytivnan, Clarion Road, Sligo F91 CD34, Ireland. (Email: [email protected])
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Abstract

Objectives:

With the shift from deinstitutionalization to community care in mental health services, relatives of persons with severe and enduring mental illnesses have had to take over the role as primary caregivers. Disturbed family dynamics have been observed within families with an ‘ill’ member. Although schizophrenia and related mental illnesses are biologically based disorders, environmental stress (including stress within family relationships) plays a major role in the onset and maintenance of symptoms. With this study, we assume that family dynamics play a central role in the course of severe psychiatric illness and hypothesized that dysfunction within family systems is a prognostic indicator of hospitalization in the course of schizophrenia/bipolar and schizoaffective disorders.

Methods:

Prospective, observational cohort study evaluating family functioning of 121 patients (schizophrenia/bipolar and schizoaffective disorder) from community at baseline and followed-up over 12-month period after recruitment. Measurements included demographics, diagnosis, Family Assessment Device – General Functioning, Perceived Criticism Scale, Brief Psychiatric Rating Scale, Global Assessment of Functioning and Social Support Questionnaire-6.

Results:

Significant differences found between patients admitted and not admitted during the 12-month time period for age (p = 0.003), Brief Psychiatric Rating Scale (BPRS; p = 0.026), Family Assessment Device – General Functioning (FAD-GF; p = 0.007) and Social Support Questionnaire total satisfaction level (p = 0.042) at baseline. Bivariate analysis showed that those admitted into hospital were younger with a higher BPRS score, less social satisfaction and disturbed family dynamics. FAD-GF (p = 0.006) and age (p = 0.022) were significant independent predictors for admission.

Conclusion:

This provides further evidence supporting importance of promoting better family functioning through modified family dynamics, integrating and involving family into the care of such patients.

Keywords

Admissionbipolar affective disorderchronic enduring mental illnessfamily functionschizoaffective disorderschizophrenia
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 39 , Issue 4 , December 2022 , pp. 340 - 350
Copyright
© College of Psychiatrists of Ireland 2019

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