Department of Psychiatry, Columbia University, New York, USA.
Early Interv Psychiatry. 2008 Nov;2(4):256-61. doi: 10.1111/j.1751-7893.2008.00086.x.
Family burden is prevalent in psychotic disorders, but little is known about burden experienced by families of patients in early illness. In this exploratory study, we examined the extent of burden reported by families of patients during a putative prodromal period and in the after-math of psychosis onset.
Family burden was assessed in 23 family members of patients with emerging or early psychosis. The Family Experiences Interview Schedule was used to assess both objective and subjective burden. Objective burden is comprised of increased resource demands and disruption of routine. Subjective burden includes worry, anger/displeasure and resentment at objective burden.
Family burden was comparable for the clinical high-risk and recent-onset psychosis patients. Worry was as high as previously reported for more chronic patients. By contrast, there was a relative absence of displeasure/anger. Family members endorsed assisting patients in activities of daily living, although not 'minding' doing so, and reported little need to supervise or control patients' behaviour.
Early in emerging psychotic illness, families report helping patients and worrying about them, but their lives are not yet disrupted and they do not have much anger or resentment.This may be an ideal time then for intervention with families, as worry may motivate help-seeking by families.
精神障碍患者的家庭负担普遍存在，但对于处于疾病早期的患者家庭所经历的负担知之甚少。在这项探索性研究中，我们考察了在所谓的前驱期和精神病发作后，患者家庭所报告的负担程度。
我们评估了 23 名处于早期或新发精神病患者的家庭成员的家庭负担。使用家庭经历访谈量表评估客观和主观负担。客观负担包括资源需求增加和日常生活规律被打乱。主观负担包括对客观负担的担忧、愤怒/不快和怨恨。
处于临床高风险和近期精神病发作的患者的家庭负担相当。与慢性患者相比，担忧与之前报道的一样高。相比之下，没有明显的不愉快/愤怒。家庭成员表示会帮助患者进行日常生活活动，尽管他们并不“介意”这样做，并且报告很少需要监督或控制患者的行为。
在新发精神病的早期，家庭报告帮助患者并担心他们，但他们的生活还没有被打乱，他们也没有太多的愤怒或怨恨。那么，这可能是对家庭进行干预的理想时机，因为担忧可能会促使家庭寻求帮助。
