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Background: Spouses of people with mental disorder experience various forms of objective and subjective burden. This should negatively affect their quality of life. However, until now no single study has addressed this question. Aims: To investigate the quality of life of spouses of people with schizophrenia, depression or anxiety disorders. Method: Spouses of patients suffering from schizophrenia (n = 45), depression (n = 49) and anxiety disorders (n = 39) were consecutively recruited from outpatient services in the city of Leipzig. Quality of life was assessed by means of the WHOQOL-BREF, a self-administered questionnaire developed by the World Health Organisation. Results: Compared with the general population, the quality of life of the spouses of mentally ill people was lower in the domains 'psychological well-being' and 'social relationships'. There was a significant association between the patient's functional level and the spouse's quality of life. Conclusions: Better treatment, professional support and participation in self-help and advocacy groups may help to improve the quality of life of spouses of mentally ill people.

Family caregivers for relatives with Alzheimer's Disease (AD) often experience significant stress-related problems in mental and physical health. Patients with AD often survive for protracted periods of time, placing an extensive burden of care on the caregiver prior to the patient's death. The present study addresses ethnic differences in the experience of AD caregivers around the time of their loved one's death, including life-sustaining treatment decisions and reactions to death. The results showed that, in our sample, more patients died in their homes than has been reported for deaths in the United States. African-American and White caregivers differed substantially in their reports of end of life care and subjective reactions to the death. Compared with White caregivers, African-American caregivers were less likely to make a decision to withhold treatment at the time of death, less likely to have their relative die in a nursing home, and reported less acceptance of the relative's death and greater perceived loss. Results suggest that death after AD caregiving deserves further study, and that ethnic differences in end of life care and bereavement may be of particular importance.

Support groups for family members of persons with mental illness have become common in the past fifteen years. Much has been written about appropriate formats and content for such groups, and research indicates that persons who participate in them frequently receive important benefits. However, less has been written about the process of effectively recruiting members for groups. Family members, for various reasons, are often reluctant to take the step of joining a support group. In this paper, the authors report their experience in organizing a support group for siblings and adult children of persons with mental illness. The role of the facilitator is highlighted, which was found to be essential in helping interested but ambivalent prospective members eventually join the group.

Effective ethnic-sensitive social work practice requires an understanding of the cultural compatibility between an intervention model and the client group. This study evaluated the cultural fit of psychoeducational family group treatment with ethnic Chinese and Malay families in Singapore. Process evaluation of five treatment groups determined that incompatibilities in beliefs, world views, and treatment expectations between the model and the clients resulted in difficulties in client role behavior. Cognitive-behavioral interventions were partially successful in facilitating members' participation in group activities and goal achievement.

Little research examines the reasons adult siblings might provide social support to unmarried, dependent brothers and sisters. This article examines how obligation, reciprocity, and the quality of personal relationships affect whether siblings provide social support to the seriously mentally ill. It uses a sample of 108 siblings of 85 participants in a treatment program for the seriously mentally ill to examine the factors that predict several aspects of help provision. Reciprocity is an important predictor of reported and projected support: The more help respondent siblings receive from ill siblings, the more willingness to help they show in return. The availability of parental and other sibling caregivers is also associated with reported help from siblings. Neither norms of family obligation nor relational quality are highly correlated with support. The results indicate that professionals should take into account the potential importance of siblings as providers of social support to the seriously mentally ill and encourage their clients to develop reciprocal interactions with their brothers and sisters.

Sixty patients diagnosed as |positive' or |negative' schizophrenics were studied to evaluate social burden experienced by a key relative. The study had a prospective design and the patients were followed for a period of six months. At the time of initial assessments, in the |positive schizophrenia' group, no significant correlation between ratings on psychopathology and social burden was observed, although at the end of the period of follow-up significant reductions in ratings on psychopathology and social burden as well as significant correlation between severity of psychopathology and burden of care were noted. In the |negative schizophrenia' group, the severity of psychopathology and social burden were significantly correlated, but at the end of six months no significant change either in severity of psychopathology or social burden emerged.

The Family Building Projective Technique (FBPT) therapeutic program encouraging mentally ill clients in an adult partial hospitalization program (PHP) to talk about emotional family issues is discussed.

Associations of families of the mentally ill arose in Italy in the early 1980s mainly in the country's northern and central regions. They denounced the inadequacies of an extramural service conceived of as an out-patient clinic filling the void left by the shutting down of asylums. The positions elaborated by these associations focus on four main themes: the distribution of the 'burden of care' for the ill between services and families; the ill-conceived interpretation of the families' needs owing to the professional's alleged tendency to 'point the finger of guilt' at the families themselves; the demand for greater power in regard to decisions made by the services; the interaction with the rights and liberties of the mentally ill. Two different ranges of problems are discussed. First, there is the conflict within the family between the interests and rights of its income-producing and its 'dependent' members. The conflict points not to a loss but to an overload of functions shifted to the family at a time of rising expectations for the satisfaction of needs. It therefore calls for services of a new kind, i.e. services capable of making these conflicting interests and rights compatible. Second, extramural services either reject or misinterpret the asylum's labour-saving function. These services thus ascribe care for the material life of the mentally ill to the family's own resources alone. Hence the need in the field of mental health to rethink the type of approach to the family, and the necessity--crucial throughout the welfare system--of deep-going organizational and cultural transformations in order to revise the distribution of the time to care among families, public and private institutions, conventional and voluntary services.

The family history of major psychiatric disorders was examined among relatives of 193 in-patients fulfilling the Research Diagnostic Criteria (RDC) for Schizophrenia, Unspecified Functional Psychoses, Schizoaffective Disorder, Manic Disorder or Major Depressive Disorder. The morbid risk (MR) for schizophrenia was greater among the relatives of probands with non-affective psychoses whereas the MR for mania was greater among the relatives of probands with affective bipolar disorder. When major psychiatric syndromes were examined, only manic syndrome showed familial aggregation.

Socio-therapy of schizophrenia cannot fail to consider such an important element as assistance to relatives. This report will review the main treatment methods used today and presents an intervention model which acts on the family of the schizophrenic at different levels. While the schizophrenic patient receives an individual treatment (pharmacological and psychotherapeutic), his/her relatives undergo a two-step group intervention. The first phase concerns an information group. This paper gives an early assessment as to the efficacy of the information groups for relatives. Particularly, it focuses on the actual ability of the group in conveying information to relatives. Such transfer of information is measured by means of a structured interview (Knowledge Interview). Results demonstrate that after an information group family members had a significant statistical increase of their information level (p

A study of a local chapter of the National Alliance for the Mentally Ill (NAMI) suggests that parents think about the causes of their offsprings' psychiatric disabilities in terms of psychogenic, organic and moral attributions. Comparisons of retrospective and current self-reports suggest that parents' attributional processes were influenced by their organizational participation. Comparatively stronger endorsement of the organic attribution (that biochemical illness is a primary causal factor) and comparatively weaker endorsement of the psychogenic attribution (that deficits in parenting are a primary causal factor) were associated with participation. Increased comfort in parent-child relationships was also associated with participation. It was speculated that these cognitive and behavioral changes were mediated by learning a comprehensive schema of information about schizophrenia that included information about causes, symptoms and methods of treatment.