Relatives’ beliefs about schizophrenia: a 10-year follow-up survey

Background/Objectives: Relatives’ opinions about schizophrenia may influence expressed emotions, family burden and patients’ adherence to Behavioural Family Therapy (BFT). Although BFT proved effective in the treatment of schizophrenia after 24 months, only a few studies have explored relatives’ beliefs about family therapy in the long term. Our research examines how the opinion of a group of relatives of persons with schizophrenia attending a BFT treatment changed ten years after the intervention.

Methods: In the year 2000, the subjective beliefs of 18 relatives of an equal number of persons with schizophrenia participating in a BFT treatment were assessed with the „Italian Questionnaire on the Opinions of the Family“ (QOF). Family burden was measured with an ad hoc inventory describing 13 objective consequences, such as reduction of spare time or economical difficulties for the caregiver. Ten years after, a second evaluation was performed on a subgroup of 6 relatives participating in the original BFT group whose members joined a self-help association.

Results: Although no differences emerged in the QOF scores after 10 years, statistically significant differences appeared between scores in two areas of the objective inventory: the burden of caregiving (Wilcoxon Z=-1.84; p=0.03) and the economical problems induced by a mental disease affecting the family leader (Z=-1.96; p=0.03). Spearman's correlations showed that, in the year 2000, the burden of caregiving was associated to QOF factors „Utility of Treatments“ (r=-0.57; p=0.01), „Biopsychosocial Causes of Schizophrenia“ (r=-0.53; p=0.02) and „Social Distance“ (r=-0.52; p=0.03). In the second evaluation in 2010, the objective burden of caregiving was positively correlated to QOF factor „Biopsychosocial Causes“ (r=-0.88; p=0.02) and negatively correlated to QOF „Social Restrictions“ factor (r=-0.94; p=0.005). Regression analysis showed that, after 10 years, the objective burden of caregiving explained more than 90% of the variance of the affected sibs’ length of illness (F=235.2; p<0.001).

Discussion/Conclusions: Although performing a Behavioural Family Therapy induces a reduction of subjective family burden, the objective burden for caregivers remains high in the long term. Relatives’ hardships are directly associated to the length of illness of their affected sibs. Psychiatric services support of self-help group of relatives may help recovery of the users.

Funding: None declared.

Keywords: Burden of illness, recovery, schizophrenia.