Relationship between family attitude, symptoms’ severity and social functioning of people suffering from schizophrenia over 20 years. A prospective study

Purpose
The aim of the study was to assess the relationship between the family attitude and clinical and social outcome measures in the group of 45 people diagnosed with schizophrenia during 20 years of illness.

Methods
For the evaluation of clinical and social variables, the Anamnestic and Catamnestic Questionnaire, the BPRS scale and the scale of social functioning according to the DSM-III axis V were used. The family attitude during the first hospitalisation was measured with CFI. In subsequent measurement points, a 4-stage clinical scale based on the CFI categories (warmth and kindness, criticism, hostility, emotional overinvolvement) was used, which was then analysed as a dichotomous variable: favourable/unfavourable attitude.

Results
A significant tendency to improve the family attitude within years of illness was observed. In women, the change in the family attitude was faster than in case of men. The unfavourable family attitude was associated with more frequent relapses and re-hospitalisations after 3 and 12 years after the first hospitalisation. The severity of symptoms and the level of social functioning were not related to the family attitude at any measurement point.

Conclusions
In the community treatment program, during the 20-year course of schizophrenia, the unfavourable family attitude improved among both women and men, but beneficial changes occurred faster in women. Depending on the time of disease, there was a relationship between the unfavourable family attitude and more frequent relapses, re-hospitalisations and lack of connection with the severity of symptoms and the general level of social functioning.