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The Importance of the Role of the Patient in the Outcome of Schizophrenia

Published online by Cambridge University Press:  02 January 2018

R. D. Scott*
Affiliation:
Barnet General Hospital (retired) and Claybury Hospital
L. Fagin
Affiliation:
Claybury Hospital
D. Winter
Affiliation:
Barnet Health District and Division of Psychology, University of Hertfordshire
*
257 Alexandra Road, Muswell Hill, London N10 2EU

Abstract

The Family Interpersonal Perception Test (FIPT) was used to explore the relationships between schizophrenic patients and their parents, and how these related both to relapse in the year after discharge and to improvement in social functioning. Forty schizophrenic patients and their parents were tested during their first ever admission to hospital and again two years later. Parents' and patient's views of each other were more negative in those with worse outcome, but what most significantly distinguished groups with different outcomes was how patients expected their parents to see them. The FIPT, therefore, reveals patterns of interaction in which the patient's role in outcome is at least as important as that of the parents, and can aid the identification of specific features with which to work in therapy.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Brown, G. W., Birley, J. L. T. & Wing, J. K. (1972) The influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry, 126, 241258.CrossRefGoogle Scholar
Doane, J. A., Goldstein, M. J., Rodnick, E. H., et al (1981) Communication deviance and affective style: the prediction of schizophrenic spectrum disorders in vulnerable adolescents. Archives of General Psychiatry, 38, 679685.Google Scholar
Doane, J. A., Falloon, I. R. H., Goldstein, M. J., et al (1985) Parental affective style and the treatment of schizophrenia. Archives of General Psychiatry, 42, 3442.Google Scholar
Doane, J. A., Hill, W. L. Jr, Kaslow, N., et al (1988) Family system functioning: behaviour in the laboratory and the family treatment setting. Family Process, 27, 213227.Google Scholar
General Register Office (1968) Studies on Medical and Population Subjects. No. 22. Glossary of Mental Disorders. London: HMSO.Google Scholar
Hahlweg, K., Goldstein, M. J. & Doane, J. A. (1989) Expressed emotion and patient-relative interaction in families of recent onset schizophrenics. Journal of Consulting and Clinical Psychology, 57, 1118.Google Scholar
Laing, R. D., Phillipson, H. & Lee, A. R. (1966) Interpersonal Perception. London: Tavistock Publications.Google Scholar
Leff, J. P. & Vaughn, C. E. (1981) The role of maintanence therapy and relatives' expressed emotion in relapse in schizophrenia: a two year follow-up. British Journal of Psychiatry, 139, 102104.Google Scholar
Leff, J. P. & Vaughn, C. E. (1985) Expressed Emotion in Families: Its Significance for Mental Illness. New York: Guilford Press.Google Scholar
Miklowrnz, D. J., Goldstein, M. J., Falloon, I. R. H., et al (1984) Interactional correlation of expressed emotion in the families of schizophrenics. British Journal of Psychiatry, 144, 482487.Google Scholar
Office of Population Census and Surveys (1975) Census 1971 England and Wales Economic Activity County Leaflet for Greater London. London: HMSO.Google Scholar
Parker, G., Fairley, M., Greenwood, J., et al (1982) Parental representations of schizophrenics and their association with the onset and course of schizophrenia. British Journal of Psychiatry, 141, 573581.CrossRefGoogle ScholarPubMed
Rea, M. M., Strachan, A. M., Goldstein, M. J., et al (1991) Changes in patient coping style following individual and family treatment for schizophrenia. British Journal of Psychiatry, 158, 642647.CrossRefGoogle ScholarPubMed
Scott, R. D. (1973) The Treatment Barrier: part 2. The patient as an unrecognised agent. British Journal of Medical Psychology, 46, 5767.Google Scholar
Scott, R. D. & Ashworth, P. L. (1967) “Closure” at the first schizophrenic breakdown: a family study. British Journal of Medical Psychology, 40, 109145.Google Scholar
Scott, R. D. & Ashworth, P. L. & Casson, P. D. (1970) Violation of parental role structure and outcome in schizophrenia. A scored analysis of features in the parent-patient relationship. Social Science and Medicine, 4, 4164.CrossRefGoogle Scholar
Scott, R. D. & Montanez, A. (1972) The nature of tenable and untenable parent-patient relationships and their hospital outcome. In Proceedings of the IVth International Symposium on Psychotherapy of Schizophrenia (ed. Rubinstein, D.). Amsterdam: Excerpta Medica.Google Scholar
Scott, R. D. & Alwyn, S. (1978) Patient-parent relationships and the course and outcome of schizophrenia. British Journal of Medical Psychology, 51, 343355.Google Scholar
Strachan, A. M., Leff, J. P., Goldstein, M. J., et al (1986) Emotional attitudes and direct communication in the families of schizophrenics: a cross national replication study. British Journal of Psychiatry, 149, 279288.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, 157165.Google Scholar
Vaughn, C. E., Snyder, K. S., Jones, J. S., et al (1984) Family factors in schizophrenic relapse: a California replication of the British research on expressed emotion. Archives of General Psychiatry, 41, 11691177.Google Scholar
Warner, R. & Atkinson, M. (1988) The relationship between schizophrenic patients' perception of their parents and the course of the illness. British Journal of Psychiatry, 153, 344353.Google Scholar
Winter, D., Baker, M. & Goggins, S. (1992) Into the unknown: transitions in psychiatric services as construed by clients and staff. International Journal of Personal Construct Psychology, 5, 323340.Google Scholar
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