The importance of family in the long-term evolution of psychoses

Abstract

Introduction

Adherence and tolerance to treatment are important factors, which may predict the long-term evolution of a psychosis. Family members may influence prognosis by modulating emotional expressivity and treatment supervision.

Objectives

To assess the role of family members in the long-term evolution of psychoses.

Method

The present study is retrospective, conducted on patients with psychosis. Data were obtained from psychiatric records extending for a period of four years. The following parameters were analyzed: socio-demographic data, family relationships (parents, spouses) and clinical/evolutive data (onset age for psychosis, number of recurrences).

Results

We analyzed 71 patients, 42 (59.2%) women and 29 (40.8%) men with a mean age of 30.38 years (SD = 9.33). The subjects were diagnosed according to ICD 10 criteria with acute and transient psychotic disorder (50 patients, 70.4%), schizophrenia (13 patients, 18.3%), and schizoaffective disorder (8 patients, 11.3%). Patients who reported conflicts between parents had significantly more recurrences (t = –2.1, P = 0.04), while those who reported satisfactory relationships in their family of origin had fewer recurrences (t = 2.58, P = 0.01) and a later onset age (t = –2.89, P = 0.006). Unmarried/single subjects had the psychosis onset at a significantly earlier age (t = 4.72, P = 0.0001). In addition, these patients had more conflicts between parents (Z = –2.02, P = 0.04) in comparison with married ones.

Conclusions

Conflicts in the family of origin may predispose to a greater number of recurrences and to an earlier disorder onset. The presence of a spouse may represent a protective factor.

Disclosure of interest

The authors have not supplied their declaration of competing interest.