Coping strategies in relatives of people with schizophrenia before and after psychiatric admission.
BACKGROUND
Most research on expressed emotion (EE) has used an empirical approach to describe relatives' ways of coping with people with schizophrenia.


OBJECTIVE
To use the stress and coping model proposed by Lazarus and Folkman to examine how relatives coped with patients.


METHODS
Patients with DSM-III-R schizophrenia and their relatives were assessed just after hospitalisation of the patients and nine months after discharge. Both assessments included the symptoms of the patients and the coping strategies, burden, distress and levels of EE of the relatives.


RESULTS
Fifty patients and 50 relatives were assessed at inclusion, and 31 patients and 36 relatives at follow-up. Coping strategies were used more frequently at inclusion than at follow-up. Problem-focused coping was the strategy used more often at both assessments. Avoidance coping was strongly associated with burden, distress and high EE at both assessments.


CONCLUSIONS
Ways of coping are influenced by relatives' perceptions of the situation with patients. Avoidance strategies seem to be less effective in regulating the distress of care-givers than problem-focused strategies.
Scazufca
M
M
Department of Psychology, Institute of Psychiatry, London.
Kuipers
E
E
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001362:Avoidance Learning; D003688:Deinstitutionalization; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D013315:Stress, Psychological / Q000209:etiology